Thyroid Tests-what tests do you need yearly?

I have been on thyroid medication for 8 years (levoxyl). I have blood work done yearly. Today I realized that my doctor is only testing free t4 (1.02).

Is only testing free t4 enough?

I have been having increasing hypothyroid symptoms (fatigue, swelling face, fingers and toes, coarse hair, inability to lose weight with diet and exercise, etc)

Thanks for your help!

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    •Speak to your doctor about ordering a thyroid hormone test. Many doctors check a person’s thyroid levels as a part of their yearly physical. Thyroid hormone tests are typically ordered alongside a blood test that measures a person’s TSH. TSH is the thyroid stimulating hormone found in the body and it can also indicate a possible thyroid condition.

    Allow blood to be drawn. A thyroid hormone test is performed by taking blood from the patient and checking the T4 and T3 levels in the blood sample.

    Wait for the results. Thyroid hormone test results usually come back within a couple of days. Your doctor will receive a copy and discuss your options based on the numbers. If the hormone levels come back in an abnormal range, the doctor probably will prescribe a medication to improve the levels. You will repeat the blood test after you start on the medicine.

    The main problem with the TSH test is that the reference range for it is too wide at most labs. The upper end of the range at some labs goes as high as 6, but according to the hundreds of references that we’ve compiled, symptoms of hypothyroidism accompanied by a TSH level over 2, sometimes lower, are suspect. Whenever you get lab tests, ask for a copy of the results. Don’t just let someone tell you that your TSH level is "normal."

    Another problem with going by TSH levels is that because TSH is a pituitary hormone, sometimes it doesn’t tell the thyroid story. If there’s a problem with the pituitary gland, or the hypothalamus (which controls the pituitary), TSH could be at an optimal level, but your actual thyroid hormones (T4 and T3) could be too low, or too high. Using the TSH test to check for thyroid problems in this situation is like looking at the thermostat to check the temperature of a house when the thermostat itself is broken.

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