If your TSH is still 4.5, then you will need a dose increase.
The American Thyroid Assn recommends it be between 0.5 and 2.0.
Is this a PCP?
Here is the ATA brochure:
http://www.thyroid.org/patients/brochures/Hypothyroidism%20_web_booklet.pdf
see page 18
Since you are just starting out - this was very wise of your doctor to prescribe this level of meds.
No - A track record with thyroid disease with a doctor is important.
Don't be impatient -- this process of very slow.