Dr. Mark,
I have a question about diagnosing pituitary disorders. I suspect that I might have one. First, here are my labs:
02/21 02/28 Norms
TSH 0.453 0.746 .4-4.2
T4-Free 0.5 0.6 .8-1.9
Direct
T3SerPlQn N/A 145 82-179
My MD started me on Levoxyl 75 mcg, stating I was hypothyroid. However, when I questioned this, he had me stop the Levoxyl, wait 4 weeks and have labs redrawn by a different method to see if my T4-Free was really low. The labs were:
T-Uptake 40 (right in the middle of normal)
FTI 5.8 (low) the normal I believe starts at 6.0
T4 SerPlQn 5.8 (the lowest it can be still in normal range)
He also took a Prolactin level (normal), but did not order a TSH -he thought he had, but one was not drawn.
He is not questioning my pituitary status stating this would be "very rare". However, why else would my TSH be low normal and my Free T-4 low? He is a good doctor, but I don't think he understands this - he says that the TSH is the main indicator of thyroid status. Which is true, if there is no issue with the pituitary or hypothalamus!
Would you recommend that I pursue this? I'm in a mananaged plan, so I can not see a Specialist without my GP's approva1. My GP was fine with me starting back on the Levoxyl (which is helping), but I know the dosage should be measured by the T4 and not the TSH if it is a pituitary problem!
Thank you for your help. Is there something I am not seeing in all of this?
Thanks,
Marijo