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25mcg Synthroid for 3.6 TSH?
Hello Dr. Lupo,
I am a 31 year old woman who is in very good health. Four years ago, I went in for routine lab work: TSH 5.3 (0.465-4.68); free T4 1/12 (0.78-2.19). I was retested three months later: TSH 2.68 (0.34-4.82) and free T4 0.87 (0.77-1.61). Over the last year, I started experiencing extreme cold intolerance and very dry skin. I had blood work run 2 months ago and my TSH was 3.610 (0.450-4.500) and my free T4 was 1.02 (0.82-1.77). My GP put my on 25mcg of Synthroid since he said that a 30 year old woman should have a TSH of 1-2. So, it's been 2 months and I don't feel any differently. Since being on the Synthroid, I have experienced a lot of GI upset (watery diarrhea for the last week and a half that happens once each morning) and also, I feel like I may be a bit more tired on a day to day basis. I want to get off the Synthroid because I don't want to be taking a pill for no reason. Now, I'm worried that if I go off Synthroid that my TSH levels will be higher than they started and that it will push me into overt hypothryoidism. Should I stop taking Synthroid? How should I go about weaning myself off? Your recommendation would be greatly appreciated! Thank you very much!
I am a 31 year old woman who is in very good health. Four years ago, I went in for routine lab work: TSH 5.3 (0.465-4.68); free T4 1/12 (0.78-2.19). I was retested three months later: TSH 2.68 (0.34-4.82) and free T4 0.87 (0.77-1.61). Over the last year, I started experiencing extreme cold intolerance and very dry skin. I had blood work run 2 months ago and my TSH was 3.610 (0.450-4.500) and my free T4 was 1.02 (0.82-1.77). My GP put my on 25mcg of Synthroid since he said that a 30 year old woman should have a TSH of 1-2. So, it's been 2 months and I don't feel any differently. Since being on the Synthroid, I have experienced a lot of GI upset (watery diarrhea for the last week and a half that happens once each morning) and also, I feel like I may be a bit more tired on a day to day basis. I want to get off the Synthroid because I don't want to be taking a pill for no reason. Now, I'm worried that if I go off Synthroid that my TSH levels will be higher than they started and that it will push me into overt hypothryoidism. Should I stop taking Synthroid? How should I go about weaning myself off? Your recommendation would be greatly appreciated! Thank you very much!
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It takes at least 4-6 weeks for the medication to reach full potential in your blood, then it takes even longer for your body to get "well"...... It's not unusual for symptoms to worsen, as the body adjusts to having the hormones again.
Your FT4 is still too low in the range and as flyingfool said, you'll most likely need a dosage increase soon.
Your FT4 is still too low in the range and as flyingfool said, you'll most likely need a dosage increase soon.
That is a starting dose you likely need an increase. One explaination for why your T4 remained the same is that 100% of the T4 of your Medicine is being converted into T3. Without knowing your previous or most recent FT3 it is impossible to know. If you want a chance to get an increase you should tell your dr you feel a little better. That will give him comfidencw to know that you are on the right track. If you say you feel nothing he will say that it is not thyroid otherwise you'd feel better.
Thank you for your thoughts! When I was prescribed Synthroid, I decided to take levothyroxine instead since it was cheaper. I experienced constipation as well as lethargy. I switched immediately to Synthroid and felt better-no more constipation or lethargy. Apparently my most recent GI upset was due to a virus because it has completely resolved. The only hypo symptoms I experienced were cold intolerance and dry skin. This may have been due to dropping 15 pounds with exercise and a good diet. Anyhow, my GP based it off of those 2 hypo symptoms as well as my 3.61 TSH. He uses the new range of TSH, treating anything above 3. I have been taking my Synthroid 45-60 minutes prior to eating and I take it with at least 16oz of water. I don't take any sort of vitamins until the evening. I had my TSH and free T4 tested a few days ago (before I read your comment on testing free T3). TSH 2.180, free T4 1.01. I honestly don't feel any better than I did before starting the Synthroid over 2 months ago. My results 2 months ago were: TSH 3.610, free T4 1.02. What puzzles me is why my free T4 stayed basically the same??
You may be having reactions to the fillers and binders in the medication. It is possible that simply to a generic or different manufacturer of the medication may relieve you of those side effects. It is NOT because of the T4 hormone within the medicine. That is what your body needs and your body doesn't know the difference between the T4 that comes from the medication or the T4 that comes from the thyroid gland.
25 mcg is a pretty common starter dose. That however does not mean that it is the final correct dosage for you. Stating small and adjusting upwards and retesting blood work every 6 weeks or so until your symptoms go away is the general process.
What other Hypo symptoms do you have?
How or when are you taking your thyroid meds? Ideally they should be taken on an empty stomach with a large glass of water. Food for at least half hour. Vitamin supplements especially calcium should be separated for longer periods as it is know that calcium will reduce the absorption of the thyroid in the stomach and into the blood stream.
You should also be demanding that free T3 test be done in addition to the Free T4. Free T3 is ultimately the only hormone that your body uses at the cellular level. So why Dr's don't routinely test for this is totally beyond me!
I would also recommend you be tested for Hashimoto's. Which is the most common cause for Hypo in the developed world. it is an autoimmune condition. It is tested in the blood by looking for two antibodies. they are TPOab and TGab. If one or both are elevated that is indicated that you have Hashi's.
Treatment with Hashi's is the same. The importance of knowing this is knowing that your immune system will keep attacking and reducing your thyroid gland to produce hormone over time. Thus the level of dosage of medication has to be increased over time to match the reduction in the thyroid production by your gland. This of course after you get optimized in your dosage.
25 mcg is a pretty common starter dose. That however does not mean that it is the final correct dosage for you. Stating small and adjusting upwards and retesting blood work every 6 weeks or so until your symptoms go away is the general process.
What other Hypo symptoms do you have?
How or when are you taking your thyroid meds? Ideally they should be taken on an empty stomach with a large glass of water. Food for at least half hour. Vitamin supplements especially calcium should be separated for longer periods as it is know that calcium will reduce the absorption of the thyroid in the stomach and into the blood stream.
You should also be demanding that free T3 test be done in addition to the Free T4. Free T3 is ultimately the only hormone that your body uses at the cellular level. So why Dr's don't routinely test for this is totally beyond me!
I would also recommend you be tested for Hashimoto's. Which is the most common cause for Hypo in the developed world. it is an autoimmune condition. It is tested in the blood by looking for two antibodies. they are TPOab and TGab. If one or both are elevated that is indicated that you have Hashi's.
Treatment with Hashi's is the same. The importance of knowing this is knowing that your immune system will keep attacking and reducing your thyroid gland to produce hormone over time. Thus the level of dosage of medication has to be increased over time to match the reduction in the thyroid production by your gland. This of course after you get optimized in your dosage.
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