Understanding test results

[2horses4me]

An MRI in May 08 shows an enlarged pituitary gland. I have had several blood test, am seeing an endocrinologist but I am not getting answers as to what my blood test results mean.  My TSH is 7.097, FT4 is 1.10, TT4 is 7.4,  ACTH is 6, FSH is 47.1. I'm on hormone replacement and have osteoporosis, and Vit D level is 18.6.  Currently I am being treated for low Vit D level and that is all.  I have no idea what else all these levels mean?  It was suggested that I have hypothyrodism but after reading the symtoms, I really have few if any.  

[AR-10]

It is hard to comment on some of the tests without lab ranges.

Your TSH is high, suggesting hypothyroidism of some sort. Your TSH should be under 2.0 to be optimal. 7.097 is above any lab limit. However, some doctors won't treat until it hits 10.0.

Your ACTH may be low, which would indicate a pituitary problem.
The range is roughly 9-52, but it varies from lab to lab. The test should have been done in the morning, for best result.

The FSH test looks pretty normal, but taking hormones can affect the result. Your result looks normal though.

Your Free T4 is within range, but the range varies so without seeing where it is in the lab range, it is hard to say if it is low or normal.

The Total T4 is not a very good test.

It would have been better to run a Free T3 test to finish up the thyroid testing. You need to see what your Free T4 and Free T3 is. Both, not just one.

Then you will know if the thyroid is underproducing or if the pituitary is overproducing.  

Your Endo is sort of piddling around here, if that is the only testing that has been done in this time frame. Are you being treated for Osteoperosis?

[2horses4me]

Yes, I am taking Boniva and have been treated for osteoperosis since Jan. 05.  I am not too happy with my current Endo Dr. and am considering seeing someone else.  He has me on Vit D 50,000IU x2 amonth and wants me to get 3 hours sunlight daily.  I had previously told him that I am outside the majority of my time and take a multivitamin.  The original reason for my blood tests was for vertigo which I have experience since Nov. 07 and have yet to be told what is causing it.  When to an ENT and got the all clear but my Endo Dr. says vertigo has nothing to do with my pituitary.  Currently my vertigo has gone, but am now having joint and muscle pain.

[AR-10]

Joint and muscle pain can be a symptom of hypothyroidism, as well as vertigo.

There can be other causes for those symptoms, but muscle and joint pain is common to thyroid problems. Vertigo is not a common symptom, and many doctors would not associate it with a thyroid condition, but there are several members here that can verify that they have vertigo when their thyroid hormone levels are off.

You need to get a TSH, Free T4, and Free T3 all run from the same blood draw. Figure out if your hormones are low or not.

It seems the Endo has been testing your pituitary to check it's function, and the tests are coming up mixed. Whether or not your TSH is high due to your pituitary or your thyroid is up in the air. Your symptoms indicate it may be a thyroid problem.

A new Endo may not be a bad idea. This one should have run more tests by now.