low tsh, lowish t4 but hypo symptoms

[gv123]

Hi, I'm new here, but hope someone might be able to give me some clues as I am baffled!  I've been suffering with many hypo symptoms for some time (pretty much since the birth of my second daughter 2 years ago).  My 1st results, a few months after I had her, showed a tsh level of 0.33 (range 0.3-6.0) and there is apparently no record of t3 or t4 results.  I repeated the blood test a few weeks ago and results were tsh = 0.51, t4 13.2.  However my hypo symptoms have got much worse (tiredness, 7-9 lb weight gain/struggle, pains in back, feet, neck, carpal tunnel symptoms, sensitivity to temperature, constipation, fluid retention, hoarse voice etc etc)  My GP is unwilling to do a trial of thyroxine because he believes my tsh levels are within range so I must be ok and also because they have gone up over the course of the year.  I, however, think I should be given a trial of thyroxine to see if it makes a difference.  I've requested a urine test for tsh, t3 and t4 levels and am awaiting results.  My question is: can your levels change during the course of a day (second test was much later on in the day) and what should I do next?
Thanks
Gilly

[summeri56]

I would go to a specialist for thyroid if your concerned about it.I made the mistake of going to a regular dr. and he didn't help me at all.I have never heard of a urine test to check thyroid levels,it is a blood test freet4 and t3,these are the circulating hormones in your body.You need a copy of your tests for refernce ranges.Also have to allow for lab error as I was told when mine kept coming back normal,I had thyroid cancer and Hashimotos,(long story).

[gimel]

Yes, TSH levels vary during the day.  Lowest at 9 am and highest at 9pm, with a change as high as 70% reported.  However, this amount of change would not affect your result enough to impress your doctor, since he seems to rely on TSH as a diagnostic.  Unfortunately, TSH is a pituitary hormone that is affected by many variables and it does not correlate very well at all with symptoms like you described.  

In trying to diagnose your symptoms, it would be much more useful to have test results for the actual, biologically active thyroid hormones, which are FT3 and FT4.  These tests are not to be confused with total T3 and total T4.  Free T3 is actually the most important, because it is four times as potent as FT4 , and it correlates best with hypo symptoms.  TSH does not correlate with hypo symptoms very well at all.  So I suggest that you pursue getting blood tests for FT3 and FT4 as your first priority, then you can see if low levels of these hormones account for your symptoms.  Make sure you get a copy of the lab report, and post results and reference ranges so that our many experienced members can provide the bet response.

In the interim, I think you will  find this link to be very worthwhile reading for you.

http://www.hormonerestoration.com/Thyroid.html

[gv123]

As far as I know it doesn't say free, so I'm guessing total...

[goolarra]

Is that T4 and free T4 (FT4) or a total T4 TT4), and what is its reference range?  If it doeasent't say "free", it's probably total.