Why do I still have all the hypothyroid symtoms?

[Joetteka]

My TSH is 1.47, TT3 is 150, FT4 is 1.52, and I still am losing hair, can't lose weight, and fatigued all the time.  My doctor says I am in range, but my hypothyroid symptoms have not abated.

[gimel]

TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T4 and Free T3.  The symptoms you mentioned are frequently related to hypothyroidism and you were not even tested for Free T3, which is metabolized by every cell in the body to produce needed energy.  

There are two classes of hypothyroidism: primary, or Hashimoto's Thyroiditis, occurs when the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland.  It is characterized by higher levels of TSH, as the pituitary tries to stimulate output of more thyroid hormone.  The second type is central hypothyroidism,  caused by a dysfunction in the hypothalamus/pituitary system resulting in TSH levels that are too low to adequately stimulate the thyroid gland.  Doctors erroneously think central hypothyroidism is a very unusual occurrence, but in reality it is quite common, but commonly overlooked.  

The limited testing done so far does not reveal very much.  Your symptoms are indicative of hypothyroidism, but you need to get some additional tests done.  If you read at least the first two pages of the following link you can see that you need to test for Free T4, Free T3, Reverse T3, cortisol, Vitamin D, B12 and ferritin.  If you can get those done and then post results and reference ranges we will be glad to help interpret and advise further.  

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

As you proceed, keep in mind that a good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T# levels as needed to relieve hypo symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  When you see the doctor again, I suggest that you give him a copy of the entire paper and ask him if he is willing to treat clinically, as described.  If not then you will need to find a good thyroid doctor that will do so.