Insensitivity/intolerance to increased Synthroid doses

[jmidlife]

Hi,

I've had Hashimoto's for many years and was stabilized comfortably  on 125 mcg of Synthroid until my sudden hyperthyroid episode last spring.  After a swing to hypothyroidism,  I've since been having difficulty tolerating the medication.   I'm currently alternating between 88 and 75 mcg.  I've been increasing it very slowly but struggle with adverse effects i.e. sleep difficulties, every time I up the dose .The target TSH is 1 and it's now slightly under 3..

Why would I suddenly have difficulty tolerating the medication? The dilemma is that if I don't increase the dose, my hypothyroid symptoms persist but increases are problematic.

Any recommendations would be greatly appreciated.

Thank you in advance.,

[Mark Lupo, M.D.]

It is not clear why this happens to some people.  There many be some functioning parts of your thyroid that "acted up" either as a thyroiditis (temporary release of preformed thyroid hormone), Hashitoxicosis (Graves episode causing hyper in a patient who otherwise appears to have hypo due to hashi), or a functioning "hot" nodule.

First approach is to keep adjusting as tolerated, sometimes even switch to a different brand (in this case, try Levoxyl for examle).  As a last resort, some patients want surgery, but this does not consistently solve the problem.

[jmidlife]

Dr. Lupo,

Thanks so much for your help.  I really appreciate it.