Your hypothalamus is responsible for making the hormone that causes your pituitary to produce thyroid-stimulating hormone - a marker for thyroid disease. The problem is that most docs treating the symptoms of thyroid problems (like weight gain and fatigue) treat based on a number that really doesn't make perfect sense. We docs should be looking at both forms of thyroid hormone (free T4 and T3 levels) as well as TSH levels.
Your TSH levels are from your pituitary; they're your internal dimmer trying to make the lights bright enough to read. So your TSH levels go up when your thyroid isn't pumping out enough T4 and T3, in an effort to increase your thyroid gland's production of T3 and T4. But sometimes your pituitary fails to succeed or the wires in your thyroid are frayed so you cannot produce all the T3 and T4 you need. So we docs try to help by giving you more - but many times we are guided by trying to return your levels to normal rather than addressing your symptoms. To boot, we often treat it with a drug that doesn't always help. But this issue is tough: There's a complex and delayed reaction to these drugs. (It takes four to eight weeks to get stable levels of these drugs after you make a change in doses.)
Many times, you need to help your doc know how you feel and maybe push to get treated with a bioidentical thyroid hormone that doesn't just adjust the numbers in your blood test, but helps the way you actually feel.
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