Concerned about tsh level and not being medicated

[hashi]

I have hashimoto. I get my tsh checked every 3 months. I went 3 months ago and tsh was .71. I went again beginning of July and it is .41. My Dr. says it is in normal range and I don't need any meds at this point and will check it again in one month. When I was first diagnosed with thyroid problems, my tsh was .41 then and I was feeling tired. In the past 7-8 months I have been having problems with my large joints. First my shoulder, then my hip and now I have terrible tennis elbow and have to take time off work til it heals and can't really afford it.I haven't been on any meds for 2 years.I was on t3 only because my synthroid started to bother me , and my ex doc thought maybe I wasn't converting t4 to t3. After I went through the regimen and got my temp. up, he told me to wean off off of it and haven't been on any meds since. I changed docs because he increased my synthroid, first be fore taking t3 and I told him I wasn't feeling good on higher dose but wouldn't see me. so when I went to see a nathuropath I saw a couple of times, he checked my blood pressure and it was so high I could of had a stroke or a heart attack.So I changed docs.I like my new doc but my tsh level is a little concerning to me.I also developed i.b.s. and endometrium atrophy in that 2 year span. Should I tell her I am concerned about tsh level even though I feel okay other than other problems I already have.

[Mark Lupo, M.D.]

With the TSH listed and previous experience with thyroid meds, thyroid supplementation is NOT indicated or suggested. Would monitor thyroid labs every 4-6 months.

[edra]

Assuming you have primary hypothyroidism, the TSH isn't going to tell you everything you need to know.  My doc reads my TSH, FT3, and FT4.  The idea being that, if either FT3 or FT4 isn't comfortably in the middle of its range, you could have a conversion problem.

I had significant joint issues (esp. a bad case of tennis elbow) while I was hypothyroid.  But, thyroid isn't the only hormone affecting joints.  You might want to look at your steroids, esp. cortisol (hydrocortisone).

[hashi]

You know after I was on synthroid for about 3 years, I started feeling just not right. Mt ex-doctor suggested then that I might have a conversion problem. I am on propranalol (beta blocker) for 1 heart palpitation I had 5 years ago after my first husband died. It can interefere with the conversion of t4 to t3. My knew dr. just prescribed eltroxin to me just before she goes on holidays, because I mentioned to her that my tsh was the same now as when I was first told I had low thyroid.
I'm not sure what to do. Whether to start taking it or wait til she gets back in 3 weeks when we check my tsh level. She checked mt thyronine level (t4 right) and it was right in the middle. I'm confused as to what to do.Maybe I'll get her to check all that before I procede with the new meds.  Thanks for your input and what do you think. It is still all confusung to me even after 5 years.

[Mark Lupo, M.D.]

your TSH is in the low normal range - most thyroid experts would NOT put you on thyroid hormone at this time.  Checking free T4/T3 is fine but these are likely to be normal at this point.  IF both are low and TSH is low/low-normal then there may be a pituitary problem -- this is very rare though.