secondary hypothyroidism?

I went to the doctor over a year ago with complaints of weight gain, (40 lbs at that time), dry skin, and exhaustion.  I was having a hard time functioning in general.  As a nurse, I never really thought about hypothyroidism since my TSH was 0.89.  However, since my FT4 was 0.62, she started me on synthroid.  I eventually had the million dollar work-up with no clearcut answers.  
Although I felt better, I was by no means back to normal.  After continued weight gain and fatigue, I went back and was referred to an endocrinologist who said I shouldn't be on synthroid, and that because I have still have periods I could not have secondary hypothyroid.  So, my synthroid was decreased from 0.88 to 0.75 with a longterm plan to follow up with my regular doctor and eventually wean off.  My tsh was 0.32 and ft4 0.66
I'm now taking 0.75 of synthroid and provigil with a possible diagnosis of chronic fatigue.  I am not depressed or anxious, though I am quite annoyed with the whole thing.  Honestly, provigil doesn't help.  My recent tsh was 0.9 and ft4 0.62.  I have classic hypothyroid symptoms.  I recently started researching online, which I try not to do because I think it's a bad road for someone in the medical field to self-diagnose; however I'm tired of being fat and tired!  Total weight gain at this point is 50 pounds, I exercise, and eat a disgustingly healthy diet.
What bothers me is that about 2-3 months before I started feeling so horrible I had slipped and fell face first.  I knocked myself out, and had to sutures under my lip and bruised my cheek and forehead.  I had a normal CT scan during my million dollar workup which was normal, but could I have secondary hypothyroid due to head trauma?  Is having a period really an absolute contraindication of pituitary problems?
Anyone go through a similar scenario?
Thanks for any suggestions.

[ram381]

OMG! I saw something like this on Mystery Diagnosis! YES, YES, YES you damaged your pituitary when u fell!  OMG! I'm actually soooo glad I read your post, and that I watched that show that one time! The girl was in the passenger seat and her mom had an accident. She hit her forehead, and had sooooooooooo many health problems afterwards. If I remember correctly she had to keep drinking water or she'd start shaking. She had a glass of water wherever she went. She was so thirsty she couldn't stand it! But once she was in a car for 30 mins without water and had to be rushed to the hospital. She almost died. The doc said the constant water drinking for 4 yrs saved her life...I forget what her problem was, but I distinctly remember she damaged her pituitary in the accident when she hit her head! I hope your problems aren't as bad as hers were, but tell the doctor you hit your pituitary!!!!!!!!! PLEASE!!!

[stella5349]

Would you consider getting a Free T3 lab? That may tell a world of things.

Did you have an MRI on the pitutiary? Your TSH is swinging all over from what you say so there is function with the meds.

Here you wrote -

"I recently started researching online, which I try not to do because I think it's a bad road for someone in the medical field to self-diagnose; however I'm tired of being fat and tired! "

I know how you feel - but online learning saved my life. You get pushed into this type of situation on of desperation regardless if you are in the medical field or not.

What else can you share ?? Do you have any other labs.

[Catrionna]

In my million-dollar work-up, I've only had TSH and FT4 thyroid tests.  ANA, DS-ANA, RF all are normal.  My electrolytes are slightly low sometimes, except for my mag levels which stay around 1.5 no matter how much mag I take.  My total cholesterol was borderline with a high LDL over a year ago- both are great now- I just need to get my HDL higher.  I drink alot, and crave salt like crazy, but I had a cosyntropin test, and my cortisol went from 10 to 27 to 31, plus I can concentrate urine, so my adrenals seem fine.  I'm not sure about an MRI- if I do have secondary hypothyroid d/t trauma, and my other hormones seem ok there's not a tumor in there to see.  Ironically, I have had no headaches this past year, just brain-fog.  My HgB is in the normal range, though low for me, but that started before the thyroid symptoms did and it doesn't bother me.  

Isolated secondary hypothyroidism without other pituitary problems would be a rare thing, but looking at my low FT4 levels and my hypothyroid symptoms it seems that may be the case.  I could wean off of synthroid and see had bad it gets- but I really don't want to feel any worse then I do now.  

I saw the same mystery diagnosis show, lol, and I'm not that bad, thank God.  I don't know how that girl went so long- she was a classic case of hypopituitarism.  I am going to ask my doctor, though, if it's a possibility.  Honestly, I know I'm not crazy, but I can't spend all my free time tired or napping.  I save all my energy for work, and there's just none left over.  And on the bad days, I get through my shift thanks to provigil and sudafed, which is not a healthy way of life.  I don't visit friends and family more then a half hour drive away because I'm afraid to drive when I feel so tired..... or I'm afraid I'll get there and my energy will bottom out and I won't be able to drive home safely.  

So- that's why I was curious if anyone had experience with secondary hypothyroidism.  Thanks for the replys and any further advice.  :)

[Anna_LM]

Hi :) I see that it's been a while since you wrote; I really hope you got the help you needed! I have been having problems for several years now. I'm on thyroid medicine, but because my blood work is fine, my doctor seemed convinced that I'm a hypochondriac. So now I've FNALLY changed doctors and i've been doing research on my own. It could certainly be your pituitary gland, but there are other possibilities. You mentioned your adrenals, but adrenal fatigue is hard to diagnose with just one test. Weight gain, salt craving and fatigue are symptoms. Also you might want to check out your estrogen/progesterone ratio (estrogen dominance). High estrogen and low progesterone can be quite nasty.  Check out drlam.com, he's got some great articles on both subjects. Good luck! :) Anna