Cortisol is an antagonist of thyroid hormone. Your cortisol was right at the top of the range, so that would further add to the problem of low Free T3. I would follow the suggestion of the internist and increase the WP Thyroid and also add up to maybe 10 mcg of T3 (Cytomel). No need to switch meds and add another variable to the mix.
From everything we've covered I expect that your hair loss is due to inadequate levels of Free T3 mainly, and also Free T4 should be at least mid-range. I think you should take your doctor's suggestion and increase your med dosage. Also, I think you should ask for T3 med to increase your Free T3 level.
Please let me know when you have cortisol results. Also will be interested in hearing what your hematologist has to say.
Please review and answer the prior question related to ferritin.
So it appears that something is adversely affecting conversion of T4 to T3. The usual suspects would be would be low ferritin or high cortisol. Since your ferritin is way high, and biotin can affect iron levels, when did you start on that and was your prior ferritin level okay ?
Also, could you possibly call and get the actual result and range for the cortisol test?
Good. So looking at your test results, your TSH is below range, which is not a concern because the majority of hypo patients taking adequate doses of replacement thyroid med find that their TSH becomes suppressed. A suppressed TSH does not mean hyperthyroidism, unless there are accompanying hyper symptoms due to excessive levels of Free T4 and Free T3, which clearly you don't have. Your Free T4 is only at 34% of its range, when it should be at least mid-range. Your Free T3 is only at 12.5% of its range, when it should be in the upper half of its range, and adjusted from there as needed to relieve symptoms. When taking desiccated thyroid med like WP Thyroid, the FT3 is typically higher in range than the FT4. So yours is a somewhat unusual pattern for FT4 and FT3, especially since your Reverse T3 is at mid-range.
So it appears that something is adversely affecting conversion of T4 to T3. The usual suspects would be would be low ferritin or high cortisol. Since your ferritin is way high, and biotin can affect iron levels, when did you start on that and was your prior ferritin level okay ? At any rate, I think you need a full iron test panel (serum iron, TIBC, % saturation, and ferritin). Cortisol also needs to be tested. The best for that is a diurnal saliva cortisol (free cortisol) panel of 4 tests done at different times of day. Doctors typically will not order that test and instead order a morning serum cortisol test (total cortisol), which is not nearly as revealing, but at least is an indicator.
So for symptom relief you need to get your Free T4 a bit higher, and your Free T3 substantially higher. The whole point of thyroid medication is to raise the FT4/FT3 levels high enough to relieve symptoms. Symptom relief is all important, not just test results, and especially not TSH results when taking thyroid med. But before just increasing your WP Thyroid and perhaps adding some T3 as required, I think you need to first get the iron panel and cortisol tests done.
Before discussing further, I have questions. Did you take your morning dose of thyroid med before the blood draw for those tests? If so what time was blood drawn?