Concerned about Dr's approach?

[Diana199]

I had a thyroidectomy in 3/99. At that time, I was put on Synthroid 200 MCG, and I have had no trouble until the other day. Lab test results showed that my TSH is 0.13. 6 months ago it was at 0.75, and I felt good. I've been having trouble losing weight, have achy joints, fatigued, and just not feeling myself. My doctor lowered my Synthroid to 175 MCG. Shouldn't it be increased? I questioned him and he said that the dose I was taking would increase my chance of bone loss and heart problems, his reason for lowering it. If my levels are low now, wouldn't lowering my Synthroid make them even lower?

[Diana199]

All I know is that at the level my TSH is at now, 0.13, I feel terrible. I can't lose weight, no matter how hard I try with diet and extreme excercise. My joints ache, have trouble sleeping and I'm freezing all the time. Very unusal for me because I tend to be on the warm side all of the time.

But, your saying its the norm that if your levels are low like mine, then they lower the Synthroid, in my case, he lowered it from 200 MCG to 175 MCG?

[Mark Lupo, M.D.]

A tsh of 0.75 seems fine.  Don't know why it was lowered.  Unless you have thyroid cancer the target is about 0.5-2.0.

[ella1]

I think you are right.  Everyone feels their best at different levels.  My TSH was 27 and I didn't feel the total exhaustion that everyone says they feel at 2 or 3, so I guess everyone has to reach their own level of "normal".  The raising and lowering of medication can be a confusing and Bananie22 is correct in trying to simplify it for everyone.

[ancientmariner]

Bananie22 said:
"if you're on the lower end of the TSH then they DEcrease your medicine...if you're on the higher end they INcrease your medicine to get you or keep you at the optimum levels."


What does optimum levels mean? To a doctor it means that your labs are where they want them, NOT necessarily where you FEEL best. Lab ranges are notoriously skewed, because to calculate the ranges, hypothyroid people were included in the sampling....

[Bananie22]

No...it's just the opposite.  If you're taking in more thyroid hormone your TSH will go even lower.  This just happened to me as well.  My TSH came in at .05 and I was jumpy and couldn't sleep(although some people feel good with their TSH at this level...I didn't).  The doc lowered my dose to 137 (from 150) and I feel much better.  I always thought being hyperthyroid would feel better than being hypothyroid...boy was I wrong.  They both stink!  Anyway, it's so confusing, but...if you're on the lower end of the TSH then they DEcrease your medicine...if you're on the higher end they INcrease your medicine to get you or keep you at the optimum levels.  (great...now I feel confused!)  Hope I helped and didn't confuse you even more!

[Bananie22]

I guess it varies for everyone...for me I felt good at around 1 or a little lower.  I think endos vary as well...I'm lucky to have an endo that listens and doesn't just go by my labs.  I know others who aren't as lucky.  I was only answering her question as to why her medicine would be lowered with a lower TSH.