Re: Subclinical Hypothyroidism
TSH shouldn't be the focus to determine a hypoT diagnosis. The free levels of T4 and T3 are most important. Mainstream medicine doesn't agree with that for the most part, so you're lucky to have a more open-minded MD.
T4 Free Direct - 1.1
Free T3 2.8
Without the lab's range for each of these tests, I can't say for sure... But these levels would be hypothyroid for the majority of the population. The center point of most common US ranges for FT4 would be 1.3; for FT3, 3.25. Yours are well below those. If you have symptoms that can be thyroid-related, you should benefit from optimizing those FT levels.
Most cases of thyroid disease are autoimmune in nature. That's what makes them familial. The AI process is thought to be the result of a genetic flaw; the trigger for the process is yet unknown, but lifestyle practices won't prevent it.
Cytomel is synthetic T3. Since your FT4 is just about as low as your FT3, Cytomel only is probably not the wisest choice of treatment. Almost all hypoT patients need T4, with T3 added later if the T4 proves insufficient to raise the FT3 level.
I would say... If you have a family history and FTs as low as yours are now, it's in your best interest to start treatment now. Your gland is failing, and your levels are not likely to improve on their own. Treating now will prevent a further slide into more severe hypoT that will be harder to recover from than a milder version.
Hope that helps in your decision.
"We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses." Abraham Lincoln