Need explanation of my tests...

[Chitown26]

I am a 22 year old male, and I was diagnosed with both hypopituitarism and hypothyroidism about 3 1/2 years ago.  My GH levels are normal with replacement therapy, but since I started taking these medications, my hair has been thinning.  I am ready to accept that it's MPB, but it would be nice if it was just low thyroid and my hair could grow back more certainly.  I have other symptoms of hypothyroidism like sluggishness, dry skin, and fatigue.  Anyway, I saw another endocrinologist and she thought maybe my hair has been thinning because my testosterone levels increased with my increase in GH.  She has decided that my Synthroid dose should increase from what it has been the past 3 years- 50 mcg- to 75 mcg.  Here are my tests.

ACTH         22   pg/mL <52
CORTISOL CMT       22  mcg/dL
FOLL. STIM. HORMONE CMT      3.6  mIU/mL
TESTOSTERONE,TOTAL        321   ng/dL 312 - 1240
FREE TESTOSTERONE        106   pg/ml 90 - 317
TE BINDING GLOBULIN         11      nM 7 - 51
THYROXINE        5.2  mcg/dL 5.0 - 11.6
FREE THYROXIN INDEX        7.3  6 - 10.5
GROWTH HORMONE   H     6.6   ng/mL 0 - 5.6 M19751
LUTEINIZING HORMONE CMT      2.0  mIU/mL  - M19751
SMC/IGF1 CMT      175   ng/mL 116 - 358 M19756
THYROTROPIN        0.6  mcU/mL 0.3 - 3.8 M19756
TRIIODOTHYRONINE   L      65   ng/dL 80 - 195 M19756

With my increased dosage, should my T3 and T4 levels increase and could they become too high?  Do these tests explain my diffuse hair thinning? Will I notice any changes in energy with a higher dosage? Thanks.

[GravesLady]

I am not all that well informed on hypopituitarism. However,  I am under the impression that in hypopituitarism with all three levels low, the F/T-3 would be quite a bit higher than the F/T-4, but yet still low.  That is why I didn't mention hypopituitarism as a possible issue, your levels even though low, look just about evenly low.

Symptoms of hypopituitarism/Secondary Hypothyroidism; puffy face, cold dry skin, coarse, brittle and sparse hair, flabby muscle, dilated heart with reduce C.O., lethargy.  Of course these can also be symptoms of other health issues.

Have you had a TRH test, tested for polyglandular deficiency syndrome, and/or checked into the possibility of Tertiary hypothyroidism.
Because the pituitary gland stimulates other glands, a deficiency in pituitary hormones often reduces the amount of hormones those other glands produce and that's why I suggested adrenals and possible other issues.

People deficient in thyroid-stimulating hormone (hypothyroidism - High TSH - Low F/Ts)
are treated with lowest effective dose of Levothyroxine that leads to normal thyroid function.
However, those deficient in ACTH are given adrenocortical hormones such as hydrocortisone. Those deficient in luteinizing hormone and follicle-stimulating hormone are given estrogen, progesterone, or testosterone and those with hypoadrenalism (underactive adrenal gland), steroid replacement which must be started before thyroid replacement is begun.

I am assuming your doctors have run test to rule out all related conditions before  treating you with Synthroid for thyroid-stimulating hormone deficiency (hypothyroidism - High TSH - Low F/Ts).

GL,

January is Thyroid Awareness Month, a month when various organizations put together informational efforts to help us all learn more about thyroid disease here in the U.S.

January is National Graves Disease Awareness Month
National Graves' Disease Awareness Week 1/7 thr 1/13

[Chitown26]

I have seen two endocrinologists and I believe one thought my hypothyroidism was related to hypopituitarism, thus secondary hypothyroidism.  Can this explain an ineffective pituitary gland that does not secrete enough TSH, and then my thyroid would not secrete enough T4 and T3?

[GravesLady]

With all your thyroid levels low indicates that something else might be going on other than just thyroid.  Some other health issues that might be interfering with your thyroid levels and therefore need to be corrected first or your thyroid levels will continue to be off. A start would be check for Adrenal Fatigue, your air loss and other symptoms could be from that or any other health issues you might be having. Thyroid symptoms are not exclusive to thyroid only.  your doctor needs to do her home work ;) or perhaps a specialist (?) in the specific areas of other health conditions..

Good Luck!

GL

January is Thyroid Awareness Month, a month when various organizations put together informational efforts to help us all learn more about thyroid disease here in the U.S.

January is National Graves Disease Awareness Month
National Graves' Disease Awareness Week 1/7 thr 1/13