levels going down a little each month

[shirleygail]

I have had many signs of hypothyroid disease and have had tests done every few months . The test he does is TSH w/reflex to F4. Last year it was 3.50 then went to 2.32 and test of last week 1.91. My doctor said all of this is within normal limits but have been having more symptons as it goes down. Headaches, low blood pressure , constipation, dry eyes hair loss and most of all incredible fatigue. Is there any indication of treatment being needed? Thanks

[kevieb]

i have secondary hypothyroidism--or central hypothyroidism--don't know the cause--but i know that my TSH is totally unreliable.  The last test i had before I went to an endo had my Free T4 at .89 and my TSH at .89.  no way that they should have been on the low end of the scale together.

I had some other doctor test my thyroid, since I had not been to the endo for some time, so my thyroid had not been tested.  Both my TSH and my free T4 were flagged low. (I didn't see the test results)  this guy kept lowering my thyroid meds until my hair was falling out---in an attempt to get my TSH normal---he was totally ignoring that my Free T4 was flagged as low!!!      He got my TSH normal, finally--and finally another doc saw the test results and said --your thyroid is too low--it took about 2 years for my hair to recover.

I've seen too many articles that say that the TSH test isn't accurate for something like 97% of people with hypothyroidism.  Sometimes it takes years before the TSH will catch up to the fact that your thyroid levels throughout your body are low.

I have read an entire article, written by a thyroidologist, which explains why the TSH test is inaccurate.

[gimel]

One of the many fallacies with doctors diagnosing by TSH only is that they totally miss the possibility of secondary hypothyroidism, by which the pituitary function is impaired and the TSH shows artificially low, yet the patient still has hypo symptoms.  You need to request tests for Free T3 and Free T4, along with the TSH.  If the doctor resists, then you should insist on them and don't take no for an answer.  Free T3 largely regulates metabolism and many other body functions.  Scientific studies have also shown free T3 correlates best with hypo symptoms.  

While at the doctor's you should also request to be tested for Vitamin D, B12, ferritin, and a full iron test panel.  When test results are available, please post results and their reference ranges shown on the lab report and members will be glad to help interpret and advise further.