Hypothyroidism or pituitary probelm?

[akkella]

Hi,

I'm so confused. When I was first diagnosed with hypothyroidism last year, my TSH was 6.5 and my T4 was 14 (normal range 10-20 ish).

I started on synthroid, the lowest dose. Six months later I was still feeling sluggish sometimes, even though I felt great intitially. I re-checked my levels -- TSH 2.5 and T4 12.

Shouldn't my TSH climb up in response to my dropping T4?

I also have a slightly elevated FSH. So I'm wondering if all these things together mean that I have issues with my pituitary gland.

Thanks

[Bren75]

Never thought about Pituitary issues.  I'll have to google that cause I have some issues similar to you.  

[goolarra]

Theoretically, TSH should climb as T4 drops.  However, TSH is very volatile, varying significantly even intraday, so it's often an unreliable diagnostic even though many doctors treat it as the gold standard.  

FT4 levels are really much more important, and yours is quite low since the rule of thumb for FT4 is midrange.  Unfortunately, your doctor is not testing FT3.  

It looks like you might want to ask your doctor about an increase in meds and insist that he test FT3 as well next time  you have labs.

I don't really see anything in your labs to indicate a pituitary issue, which doesn't mean there isn't one.  I'd just pursue the obvious before going there.