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HIgh TSH and T4

I am a 31 years old and was diagnoses with hypothyroidism a few years ago. I have been taking Cytomel (50 mg) since diagnosis with some relief of symptoms but they have recently returned. My doctor decided to test again. My TSH (Thyroid Stimulating Hormone) level is < 0.015 Range: 0.465-4.680 - mIU/mL and my Free T4 (Free Thyroxine) is 0.32 Range: 0.78-2.19 - ng/dL. What are the chances that I have hypopituitarism. What else could it be?
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Thanks again for replying. I will make sure that I get all of the other levels checked that you mentioned to get a more complete look at exactly going on.
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Avatar universal

Whenever taking T3 meds it is best to split the dose and take half in the early morning and the other half in the early afternoon.  This is because T3 acts quickly and reaches full effect on serum levels in about 3-4 hours.  So splitting the dose evens out the effect over a longer time.  If you take it too late in the day, yes it can affect sleep.  

A good thyroid doctor will treat  a hypo patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good insight from this link written by a good thyroid doctor.  It might be worthwhile giving a copy to your doctor and asking if he is wiling to treat clinically as described above.  If not, then you will need to find a good thyroid doctor that will do so.


http://www.hormonerestoration.com/Thyroid.html
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Avatar universal
By the way, just realized I put HIGH TSH and T3 levels in description, I meant low.
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Avatar universal
I'm not really sure exactly when I was diagnosed (I would say at least 3 years ago) and I don't know if there was ever an identified cause. At first I took Cytomel both at night and in the morning but I found that it made falling asleep more difficult. I already have insomnia but it was a lot worse with taking it at night. Do the levels of TSH and T4 not say anything on their own?
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Avatar universal
A couple of quick questions before going further.  First, when you were diagnosed as hypothyroid, what was the identified cause?  Second, when you take your Cytomel, do you split the dose and take half in the morning and the other half in the early afternoon?
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Avatar universal
Thank you for replying. I also tested low for vitamin D a few years ago, I have been taking 2000 IUs of vitamin D since then. Honestly, the doctor I am seeing is not exactly what I would call competent and blamed my low TSH and T4 on too much Cytomel. She has never tested me for T3. She has sent a referral to an endocrinologist but they don't have anything open until November, unless they find that that these levels (TSH and T4) warrant a more urgent appointment. I'm trying to figure out if this is the case since my doctor has no idea.
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Avatar universal
I can't understand why the doctor would have prescribed only T3 med.  You need both T4 and T3.  Many members here say that relief from hypo symptoms required Free T4 at the middle of its range, at minimum, and Free T3 in the upper third of its range, or as necessary to relieve symptoms.
You don't show a test for Free T3.  Free T3 largely regulates metabolism and many other body functions.  Free T3 also correlates best with hypo symptoms.  You need to know your level.    

In addition hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  D needs to be about 55-60, B12 in the very upper end of its range, and ferritin about 70 minimum.  Deficiency in either can cause symptoms that mimic hypothyroidism.  Low D or ferritin can adversely affect metabolism of thyroid hormone.  If not tested for these you should do so and then supplement as necessary to optimize.  
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