Tsh was 1.66 a year ago. 4.98 now, with free t4 of 0.8. symptoms of hypo (weight gain, hair loss, constipation, lethargy). doc won't treat. help!

It depends: Tsh has variability throughout the day so a definitive range is difficult to pin down with science. When someone is on therapy, I use the academy of clinical biochemistry range of 0.5 - 2.0 for tsh. You certainly seem symptomatic. Given the vary low risk of mild level thyroxine adjustments, i think aslightly higher dose my be appropriate.