I have a better idea. Click on my name and then on my personal page, scroll down to my Journal and read the 2 page Overview of a paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective. The Overview explains that dosing a hypothyroid patient based on TSH doesn't work and that thyroid med dosage should be increased enough to relieve hypo symptoms without creating any hyper symptoms. Also important to optimize Vitamin D, B12 and ferritin.
I would give the doctor a copy of the Overview and ask to be treated clinically, as described, rather than just based on TSH. If he bothers to read the paper and look at some of the listed references, he can learn that your treatment based on TSH is inadequate. if he refuses to reconsider, then you have good reason to tell him you are going to find a good thyroid doctor that will treat clinically, as described.
What symptoms do you have? What are the results from your thyroid related test results and reference ranges shown on the lab report?
I also meant to also ask what is the dosage of thyroid med? Did you take it the morning before the blood draw for those tests?
I take my 165 mcg NP thyroid after blood draw
I will have to go and look at the latest labs
Your FT4 of 1.38 is 59% of its range. Your FT3 of 3.5 is 62% of its range. Your Reverse T3 is also high in range. The FT3 to RT3 ratio is 1.6, which is lower than optimal. Those levels are a bit unusual when taking NDT type med. Due to the ratio of T4 to T3 the FT3 is usually quite a bit higher in range than FT4. Which leads me to question your ferritin level. Hypothyroid patients are frequently deficient in Vitamin D, B12 and ferritin. Low ferritin levels adversely affect the conversion of T4 to T3. Low ferritin, along with low Vitamin D and B12 are also some of the variables that can cause higher levels of Reverse T3. So I think it is very important for you to get tested for ferritin, Vitamin D, B12 and I would also suggest a saliva cortisol (free cortisol) test panel taken at 4 times during the day.
You may be getting close to your optimal dose of NDT, so it is very important that you test and supplement as needed to optimize Vitamin D, B12 and ferritin. Vitamin D should be at least 50 ng/mL, B12 in the upper part of its range, and ferritin should be at least 100. The cortisol test is needed to make sure it is optimal also. Females with hypothyroidism are frequently too low in cortisol. Doctors will usually only order a morning serum cortisol test (total cortisol), which is not nearly as useful as the saliva cortisol test. If you want to pursue that, here is a link where you can order a test kit.
For the saliva cortisol, did you have test for the early morning also? If so, what was the result and range?
Is the new doctor who doesn't care about TSH willing to treat clinically, as described?
Good. Please let us know how you are progressing.
With that result I suggest that you should request from the doctor a full iron test panel: serum iron, TIBC, UIBC, % saturation, and ferritin.
Have you been supplementing with any form of iron?
Very glad to hear that you are making some progress. Please keep in touch and let us know how you are doing.