Low T4

[Free Bird82]

I am currently taking 112mcg. Synthroid. Originally my TSH & T4 were classic Hashimoto (Low T4/High TSH with each dose they appropriately began going into normal ranges).  However, 6 weeks ago, my TSH was at 0.71 (0.34-5.60) & T4 was 5.8 (6.1-12.2).  Since T4 was "a bit low", doctor increased me to the 112mcg (from 100mcg.).  Just got back from getting my bloodwork back after re-checking it yesterday, & now my T4 is even LOWER than it was 6 weeks ago!!  It's 4.9 (same range as above).  My TSH has remained at 0.71.  What does this mean?  Why is it taking so long to get my T4 in the range?  Is this normal to have fluctuations?  Also, with all I'm reading from others, most people are on a much lower dose of Synthroid than I am.  Is there something wrong with my body that it's not absorbing it properly?  Has there ever been a case where someone simply does not absorb the Synthroid, and if so, what other options are there?  I take my meds FAITHFULLY on an empty stomach.  I don't eat or drink ANYTHING FOR AT LEAST 3-4 HOURS AFTER I TAKE THE MEDS (at 3:30-4am).  I have started taking B Vitamins, that are time-released (6 hours time release), but even those I take at noon which should be plenty of time in between.
I also still have my thyroid.  How high of a dose would I be taking if I had my thyroid "zapped" like others I hear about.  One more thing, I am not obese.  I feel I'm getting there, but I exercise faithfully & weigh approx. 148-150 at 5'8" so I don't think too much body weight could do it.  

PLEASE HELP ME!  It's been over 6 mos. now & I'm ready to start feeling good

[Mark Lupo, M.D.]

112 is an average replacement dose for those with ablation/surgical hypo and also those with Hashi whose gland has been nearly totally destroyed by the immune system.  

Would check a free T4 level - if this is normal, then the low total T4 may be indicative of a harmless low TBG (thyroid binding globulin) level.  If it's low then ask for an endocrine consultation to look into why.

[Lake Lover]

I have heard of people not absorbing Synthroid as well as some other replacement med's but don't have any medical documentation to that effect.    

You could try another brand, just be sure to test 6 weeks after changing brands.  Generic's are fine as well as alot cheaper.  You need to be sure when you get refills that the pharmacy fills with the same manufacturer of generic.  Most are very aware of this but you till need to check before you leave the counter. I've been on Unithroid which is considered generic for almost 2 years and have been happy with results.

My neighbor has a thyroid and is on the same dosage as me with no thyroid and we weigh about the same so it is possable.

[Dixie1]

PLEASE get your adrenals tested. From what you wrote, I would make an educated guess that you have low cortisol. Go to StoptheThyroidMadness.com, go to the section about the adrenals. Get started there.

T4 can be converted too much to T3 when you have low cortisol, which may explain your low T4. Cortisol is also need to transfer the thyroid hormones into your cells...contributing to the hypo.

All thyroid med info states NOT to put someone on them with untreated adrenal insufficiency.