Should I be concerned

[confusedresults]

I have been having hot flashes, wake up at night sweating profusely.  I am almost never comfortable unless the AC is set in the mid 60's.  Guy so it is not menopause.  Finally, after years of having doctors blow me off that I cannot be hypothyroid because I am a guy, I got a doctor to order TSH and freeT4 test in blood tests.  TSH was 1.14, T4 was 0.7.  Doctor says that TSH says I am not hypothyroid and I should not be concerned about the T4 as it is only 0.1 below low end of range.

Is this doctor correct that I should not be concerned or would you want to investigate further?  I guess I am asking if I am crazy.

[vino14]

Hi, just wanted to say that I am hypo and for many years before being diagnosed I froze to death most of the time...  About 6 years ago I started to feel hot and  full blown hot flashes. After 2 years of suffering through it got tested and was deemed perimenopausal at 35, since they only tested TSH and I was clueless at the time, my thyroid condition was not diagnosed. When I was finally diagnosed this year and got treatment for thyroid and hormonal imbalance, I would still have mild hot flashes in the first part of the day, every single day.(in my case if low estrogen was the case the hot flashes are on 24/7 so I got to know the difference really well by now) I could not stand to be outside if hotter than 75 degrees.  I didn't know that I could have hot flashes from hypothyroidism, my doctor told me that is very common. When I would have an increase in meds the feeling hot or hot flashes  would go away in about 4 days.  One has to write down  their symptoms and be aware of changes in their bodies. It can be confusing since I  am hypo but sometimes have( had) some of the symptoms in the hyper column.

[goolarra]

The symptoms you describe are more hyper symptoms than hypo symptoms.  Some of the most common symptoms of hypo are fatigue, despite getting (more than) enough sleep, weight gain, constipation, intolerance to cold, depression, hair loss, the list goes on.  Hyper symptoms include fatigue due to insomnia, weight loss, diarrhea, heat intolerance, depression, etc. Do you have other symptoms?

TSH is a very unreliable and indirect measure of thyroid status.  FT3 and FT4 are the direct measures.  Thyroid test reference ranges are very flawed, and many of us find that FT4 has to be at least midrange before we feel well.  So, what looks initially like only 0.01 below range is really a lot below midrange.  The whole bottom half of the FT3 and FT4 ranges should probably be considered hypo.

I'd investigate further.  The most important thing is to get FT3 tested.  FT3 correlates best with symptoms.  I'd repeat FT4 and TSH as long as you're doing it.  

Tell us about other symptoms, and we might be able to suggest other further tests.  

[des900]

he is a foolish doctor. get another opinion. tsh tells nothing regard thyroid function. instead look for actual thyroid hormones free t4 and free t3.

anyway do a fresh free t4 test, this alone will tell you whether you need t4 replacement therapy or not.

ideally you need the free t4 to remain in mid range in the reference range.