Sorry, I forgot to tell you guys that those are my Free T3 and T4 results. And these are the ranges, along with my most recent lab results:
TSH: 0.02 (.35-4.94)
Free T4: 0.63 (0.7-1.48)
Free T3: 2.9 (1.7-3.7)
Thanks in advance for your help.
From your symptoms and those lab results you are obviously very hypothyroid. It is surprising that your first few doctors did not accept that there was a problem. So it is good that you found a doctor who recognized a problem and started you on thyroid med.
There are two basic types of hypothyroidism. One is primary, related to Hashimoto's Thyroiditis and characterized by increasing levels of TSH and inadequate levels of the biologically active thyroid hormones, Free T4 and Free T3. The second type is central hypothyroidism associated with dysfunction in the hypothalamus/pituitary system resulting in inadequate output of TSH to stimulate the thyroid gland. Your results are a bit unusual in that your TSH is so low, making me wonder how your thyroid gland is functioning at all. Yet you still have some amount of T4 and T3. That is kind of like an engine running without any gasoline.
A good thyroid doctor will treat a hypo patient clinically, by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just lab results. Going to an Endo doesn't guarantee a good thyroid doctor. Since your internist has reacted correctly, I think I would go back in 4 weeks after starting on the Synthroid and re-test and get an increase in meds. Then continue on that path until you get your Free T4 to the middle of its range, at minimum, and your Free T3 high enough in its range to relieve symptoms. Since hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin, you should get those tested as well. D should be about 55-60, B12 in the upper end of its range, and ferritin should be 60 minimum for women. Low levels can cause symptoms that mimic hypothyroidism. D and ferritin are very important in metabolizing thyroid hormone also.
It might also be a good idea to ask the internist about the hypothalamus/pituitary dysfunction and what tests should be done to identify any issues there. It may be that the internist will handle all of that for you, or at least refer you to someone that he is comfortable with. That would be a lot better than just selecting an Endo without any assurance he is a good thyroid doctor.
Thank you so much for your reply gimel. Coincidentally, an appointment with my new endocrinologist opened up yesterday. He looked at my tests and the previous ones from August and diagnosed me with central hypothyroidism. He said that my precious endo should've done more research and said he didn't want to scare me, but based on all my tests from August and my symptoms, I may have a pituitary tumor. He ordered a lot of labs and a pituitary MRI. I'm kinda scared. I'm keeping a positive attitude about the fact that I'm lucky to have gotten what seems like a good endo and a good internist, and I hope that if I do have a tumor, it won't be one of those that have spread but a little tiny one. Do you know of anyone with these same issues? Thanks so much for your help and support.
No, sorry but I don't know of any current members with those same issues, however, if you will go to the top right hand corner and type "pituitary tumor" in the search area, you will see that there has been lots of info posted over the years.
I'm glad you got to see the Endo quickly and it sounds like you got the right diagnosis of central hypothyroidism, possibly due to pituitary tumor. You will know a lot more about the tumor possibility from the lab tests and the MRI. The Endo may be everything you need short term, but keeping in mind my definition of a good thyroid doctor above, longer term you will need to find out if he is willing to treat clinically as described or if he is one of those that predominantly rely on the "Immaculate TSH Belief" and use "Reference Range Endocrinology". That doesn't work. If you want more insight into what I mean by this, have a look at this link written by a good thyroid doctor.
Thanks so much, I will check it out. I just received some of my tests back from the endo via an online automated system and my numbers were:
Cortisol: range (3.1 - 22.4 ug/d) = 23.3
Leutinizing Hormone: range (0.50 - 76.30 mIU/mL) = <0.07
TESTOSTERONE: range (14.0 - 76.0 ng/dL) = <10.0
ACTH: range (15 - 66 pg/mL) =9
Everywhere I've looked online for the meaning of these results say that a tumor is the primary reason, so now I'm concerned. I'm going to take your advice and post on the pituitary tumor forums.
Thanks so much for your help.