Have I gone hyper or pituitary prob?

[Sshaw823]

Hello, I was diagnosed with hypothyroidism in 2008. My TSH was 8.942 (.3 - 4.5) and FT4 was 0.9 (.89 - 1.8) TSH has always been all over the place but FT4 has been on the low side and 3x going under the range. I started off on levothyroxine but within 2 months my Dr let me switch to Armour which quickly made me feel normal again. I have been taking 120 mg for the last year. I have felt for the most part good at this dosage.

Because of my most recent labs my Dr says I have a pituitary issue and he raised my armour dose to 180 mg. I am concerned that if I start taking the new dosage and I don't have a pituitary issue, I will end up going hyper. He wants me to retest in a month but if he suspects pituitary, aren't there other tests I should be having done to confirm his diagnosis? I mean, you can't diagnose a pituitary problem by TSH & FT4 levels alone, right?
Or is it possible that I have gone hyper? I don't feel at all like I have hyper symptoms.

Here are my last two lab results:
9/5/2012
TSH= .016 (.3 - 4.5) Low but I have NO hyper symptoms
FT4= .76 (.89 - 1.8) Low

2/24/2012 - different laboratory
TSH= 7.060 (.450-4.50) High
Thyroxine= 3.8 (4.5-12) Low
T3 uptake= 28 (24-39)
Free Thyroxine index= 1.1 (1.2-4.9) Low

Thanks!!

[Sshaw823]

Ok, I will get FT3 tested this week and go from there.
I'm glad to hear that I'm not facing a pituitary issue. I didn't think that was the case.
Thanks for your help goolarra!

[goolarra]

FT3 and FT4 are much more important than TSH in determining thyroid status.  As i mentioned, your doctor should be monitoring your FT3, especially since the T3 content in Armour is quite high.  If I were you, I think I'd ask the doctor to run FT3 BEFORE increasing your meds.  (T3 is very fast-acting, so don't take your meds the morning of the draw before the blood is drawn.)  Your FT4 looks like you need an increase, but without FT3, everyone is flying a little blind.  Even if you do need an increase, going from 120 to 180 is probably way too much.  Considering your mild symptoms, a much more conservative increase might be best (you can always increase more in steps if necessary).

[Sshaw823]

Not so much. In the last month I did notice quite a bit of hair loss. That's a new symptom for me. Fatique at times, but other than that I've felt pretty good most of this last year.

[goolarra]

You are not hyper...your FT4 is below range, which indicates hypo, not hyper.  TSH often becomes unreliable once on meds, especially meds with T3 in them (and Armour has a lot of T3).  I doubt you have a pituitary problem...it's the meds suppressing your TSH.    

Your doctor should be testing FT3 as well as FT4, especially since you are taking T3.  Your FT4 is low, but that's often the case when taking Armour.  

Do you still have hypo symptoms???