Should I take Levothyroxine? Doctors are being contradictory

[sah302]

Hi all I really need some advice. I been suffering from sleeping problems for years, but thyroid tests always normal. Past 6 months my sleeping has gotten even worse, thyroid tests are finally abnormal, my thyroid is enlarged with a cyst on it too. Doctor says I might have hashimoto's, but is making me wait 6 months to do any further tests. Furthermore I have borderline-low/low cortisol, which was never tested before. They didn't even test my Free T3, my GP proscribe me Levo for Low T4, but my endo said don't take it because my thyroid appear to function normally right now.

Then the latest symptoms is my eyes are even more puffy, I had tingling in my hands and feet for a week (at least that went away), and have now been constipated for 2 weeks. My GP refuse to see me again and said it's up to endo refer to them, but take Levo until you can. I told my endo my new symptoms. He said it doesn't warrant any change to waiting 6 months, and symptoms are not related. (WTF!?)

So I have conflicting advice now about taking Levo 25mcg, I feel like crap everyday, sleep horribly, and cannot have movements. My GP won't see me anymore for this issue, and my endo making me wait 6 months to do more thyroid /hasti/graves test. I tried getting a second opinion and earliest appointment is in 3 months!

Here are my lab results:

TSH: 1.43 (.3-3.5)
T4: 3.3 (4.9-11.7) 5.0 in 2013
Free T4: .78 (.7-1.48)  .94 in 2014, 1.01 in 2013, 1.12 in 2012, and 1.13 in 2011
Free T3: NOT TAKEN
Cortisol: 2.2 (didn't include ref range, but online says either 2-18 or 3-17 for afternoon draw)

Docs say everything is fine, because my free T4 is in range, but compared to my previous years test it's been falling year over year along with total T4. Also I am worried since my horrible sleeping predated my abnormal lab results and my adrenals/cortisol were never tested once that the thyroid problem may be secondary, since adrenal issues can also cause insomnia,puffy eyes.

What can I do?

[goolarra]

Yes, it could be adrenal.  The whole endocrine system is interdependent, so a disturbance in one part is often reflected in another.  However, that also means you can bring adrenals back into line by adjusting thyroid hormone levels with meds.  I'd try meds and see how well you tolerate them.  Don't forget that until you increase to a therapeutic dose, it's not unusual for symptoms to worsen a bit or new ones to appear.  That's why it's very important to follow up in a month or so.

[sah302]

Thanks I will and see how I feel. Do you think it could be adrenal? I've read adrenal problems can cause random inflammations on skin and or organs from low cortisol. It seems hard to get to the root cause of the problem without proper pituitary and adrenal tests because they can all mess each other up.

[sah302]

I still have the Levo and refills and as I mentioned, the GP said start taking it when I complained about the constipation and tingling. So I've done that now for 2 days so far. Even though my endo said not to take it. I called my endo about those new symptoms and he's not changing anything. I can't stand to look in the mirrior, my eyelids are so damn puffy that my eyes are half closed. I've read low cortisol and adrenal problem can also cause that, though it maybe mostly just because of my horrible sleep.

[goolarra]

Your FT4 is just barely in range.  Many of us find that we still have hypo symptoms until FT4 is about the middle of the range (50%), and yours is only at 10% of range.  Also, as you have observed, it's been steadily falling, so this is obviously not "normal" for you.  You need to find a different endo.  Is your GP still offering meds, and will s/he follow up on those and adjust as necessary?