Still not feeling well a year after RAI and having started Synthroid.

[Elva]

I was dx'd w/Graves in Jan 2006...had RAI in March 2006. By June 2006 I was severly HYPO. TSH was 83. Was started on Synthroid & a few months later TSH was 14. Synthroid increased & 2 months later TSH was down to 6. Synthroid was increased from 137 to 175mcg in November. Then I started having HYPER symptoms(palpitations, sweating,anxiety).My Synthroid was decreased to 150mcg. Then in December 06 had my levels checked again & my TSH was 0.26. Dr decreased my Synthroid back down to 137mcg. Labs were done again in January 2007. They were: Free T4: 2.16(.61-1.76)and Free T3: 4.3(2.3-4.2) No TSH was done but dr said I was still HYPER. So TSH was 2.2 and Free T4 was 1.52. I still didn't feel all that great but dr kept me on Synthroid 100mcg. Labs again in March 07 & only my Free T4 was tested.It was normal at 1.38(.61-1.76). Dr said stay on the 100mcg. NOW this is the crazy part.  Had labs done again in May 2007 and my TSH was 44!My Free T4 was "normal" at 1.17. My doctor was perplexed to say the least. Doesn't know what in the heck is going on. She basically said I was a "mess" because I told her I was feeling "pretty good". So she increased my Synthroid to 125mcg.And she scheduled me to come back in 12 weeks!I called back last week asking for more labs to see how I was doing & the dr didnt feel I should have labs down again so soon. It had been 7 weeks since I'd seen her last and I was not feeling "right". I got upset so I made an appt w/another Endo.

[Mark Lupo, M.D.]

The problem with looking at only free T4 is that a 2-fold change in T4 levels can cause a 100-fold change in TSH -- so that may help explain the TSH of 44 with the decrease in T4 from 2.16-->1.52-->1.17.   It's no wonder you aren't feeling right -- you have been on a roller-coaster this whole time.  Seems like 112-125 should be a reasonable dose but to check it every 6 weeks until the labs and your symptoms are reasonably stable.

[Elva]

I saw her last week and I am waiting to hear back about my levels. I asked her about checking my T3 she said that was not necessary. I asked about Armour she said it was no good.  I just don't know what else to do.  Should I demand my T3 be checked.  I feel lousy still.  I am so tired, my hair is falling out again, I am so irritable and have alot of anxiety issues.  Does anyone have any advice, insight, anything.  I thought I'd be feeling better by now.  Thanks in advance for any info you can give me.  

[dieGalaxis]

If it were me, I would request a full thyroid panel until everything gets straightened out.  Because my first doctor didn't request a full thyroid panel for my first test, I was misdiagnosed and placed on synthroid which made everything worse.  So in my opinion, if the doctors do not know exactly what is going on with your medicine, I would want everything checked so a more educated decision can be made.

[2wheelermom]

Sounds like maybe the large swings in your TSH are the result of the large jumps in the synthroid dosage (a increase from 137 to 175 when your TSH is only 6 seems extreme to me).  It also looks like your MD is trying to manage the FT4 and FT3 instead of the TSH.  You might consider looking for an endo that specializes in this area - sooner rather than later.

[hypogirl80]

I have had the similar experience, all you have to do is get your FT4 to 1.6 and FT3 to 4.0.  don't woory about TSH. I'll check the blood every  4 weeks so to get there quickly. Looks like 115-125 supplement is a good dosage for you.
Don't worry, it is not hard to get the correct level. There are blood test centers around the country that you can go without a doctor. they are quick and cheap. (around $100 for a complete  thyroid blood test)  Good luck to you..