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TSH T4 Free levels?

I have been taking 88 mcg of levothyroxine daily for the last 5 years.  My most recent lab results are TSH 8.6 and T4 Free 0.9.   Lab results 5 months ago were similar and my doctor did not change my med level but rather said wait and see what happens in 6 months.  I have not been feeling like myself and I've gained 5 lbs.  I have other autoimmune issues such as vitiligo and low vit. D.
I'm thinking I need a second opinion.
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Avatar universal
I second Gimel's opinion.

you need to find an new Dr.!
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Avatar universal
I'd say that you need more than just a second opinion, you need another doctor.  Why the doctor would ignore your high TSH and low in the range Free T4, and even more importantly your symptoms, and say t wait 6 more months, is beyond me.  

What you need is a good thyroid doctor.  That does not automatically mean an Endo.  A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

While searching for a good thyroid doctor, you should request to be tested for Free T3, along with the Free T4.  TSH is pretty meaningless when already taking thyroid meds.  If your Free T3 shows as being in the low end of its range, as I expect, then that would correlate with you still having hypo symptoms.  I say that because scientific studies have shown that Free t3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  Further, many of our members say that symptom relief required Free T3 in the upper third of its range and free T4 at least at middle of its range.

When you get more tests done, I also suggest testing for Vitamin D, B12 and ferritin.  Hypo patients are frequently too low in the ranges for those and each is important.  
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