Thyroid?

[Oliveoilmimi]

So I need an endocrinologist ? I had an issue with my prolactin about five years ago, and I was checked and didn't have a tumor.
I just got insurance recently and had a general work up done.
So far I have a vitamin D deficiency (9), MPV (7.4), and my ferritin (11), TSH (0.76), T4 free (1.1), T4 total (7.4)
The doctor didn't bother to test my prolactin even after I explained to him that I've been fatigued for about about a year already. He also didn't bother to run a full thyroid panel. I'm 26 and very skinny. I've weighed the same since I was 17. Never gain weight no matter how much I eat. I have heart palpitations which are not of any concern to the cardiologist, coldness, headaches, spotting, I'm tired all the time, forgetfulness, dry skin.
I felt like my trip to the PCP was pointless and I'm not sure if I should bother to see an endocrinologist

[gimel]

I just sent you a PM with info.  To access, just click on your name and then from your personal page click on messages.  

[Oliveoilmimi]

Hey gimel
I'm located in Miami FL

[gimel]

In the words of a good thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

So, lacking the Free T3 information, but with your symptoms and the Free T4 at only 30% of its range, it is likely that you have central hypothyroidism.  Central hypothyroidism is a dysfunction of the hypothalamus/pituitary system, characterized by levels of TSH that are too low to stimulate the thyroid gland to produce enough thyroid hormone.  

So you need a good thyroid doctor as described above.  If you will tell us your location, perhaps we can suggest a doctor that has been recommended by other hypo patients.  It is also very important in the interim for you to supplement for Vitamin D and ferritin to optimize.

[Oliveoilmimi]

Thank you for your comment. Here are the ranges
T4 free 1.1 (0.8-1.8)
T4 total 7.4 (4.5-12.0)
TSH 0.76 (> 0.40-4.5)

[gimel]

Although ignored by most doctors during diagnosis for potential thyroid issues, symptoms are really the most important consideration.  You have many symptoms that relate to hypothyroidism.  Next consideration should be your Free T4 and Free T3 levels.  To best evaluate your Free T4 I really need to know the reference range shown on the lab report, so please post the range.  

You should always make sure in the future to be tested for both Free T4 and Free T3.  Free T3 is used by the entire body, and it correlates best with hypo symptoms.  

You do not necessarily need an Endo, just a good thyroid doctor.  By that I mean a doctor that will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  

In addition, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.   Your Vitamin D and ferritin are terribly low.  D needs to be about 50, and ferritin should be about 70, so you really need to supplement as required to optimize.  You should also test for B12 and supplement as needed to get it into the very upper end of its range.  

[Oliveoilmimi]

I forgot to mention that some of my hair is growing like brittle. It' has a very odd feel to it. My skin has also become very sensitive to the point that it burns to shave.