Finding correct dosage of Nature-throid

[mhanan4]

Hello! I recently just got my labs done after adjusting my medication.

My previous dosage about 12 months ago was 113.75 mg of Nature-throid, and here were my labs from 3 months on that dosage.

TSH: 0.40
Free T3: 2.9 (2.3-4.2)
Free T4: 1.0 (0.8-1.8)

I complained of still feeling very fatigued and having a stagnant weight regardless of my intense exercise and insanely healthy diet/mindfulness.
My doctor agreed to slowly titrate my dosages, and my numbers were all normal until my most previous visit.

I was titrated up to 3 1/2 grains which is where I've been for the past 3 months, and my fatigue greatly improved and I have no hyper symptoms. I just got my labs done for my new doctor (moved out of state, had to find new physician).

TSH: >0.01 (0.4-4.5)
Free T4: 1.91 (0.82-1.77)
Total T3: 230 (70-180)

She unfortunately didn't test my Free T3...

I also got my iron/B12/Vit D/Ferritin/Cholesterol/A1c tested, all were normal and well within range.

While my hemoglobin was great at 14.5, my ferritin was 37, my doctor requested I start an iron supplement to help with fatigue and stop the insane shedding I've had and I gladly agreed.

My doctor also advised me to cut my medication dosage in half. I'm really worried because although I know I am considered "Hyperthyroid" right now I've had no symptoms. I've just started feeling human again! I told her I would do the 113.75 dosage again and let her know how I feel.

My questions are

Will raising my ferritin help with my thyroid issue? Also- if I start feeling hypo on the half dosage should I ask her to help me slowly raise it again to where I feel comfortable and my labs are not too hyperthyroid? It has been so difficult for me to find the optimal dosage!

[gimel]

One last thought.  It would be a good idea next time you go in for tests to ask for a cortisol and Reverse T3 test, to document those levels.

[gimel]

Giving your doctor a copy of the link might change her mind.  It is worth a try.

From the above results the only one of concern is your ferritin.  It should be at least 70, and some sources say 100.  You can find that info in the link also.  It is Recommendation no. 12 on page 14.  Adequate ferritin is beneficial to good hair growth.

[mhanan4]

Yes, hopefully taking an iron supplement will help. My doctor has me starting on ferrous sulfate 3x per week. My ferritin has been low for a while.

That link is a great source, I'm reading through it now!

I asked my doctor if she would consider lowering it by 1/2 of a grain instead of cutting my current dosage in half. I guess I'll see what happens!

Thanks!

[gimel]

The doctor should have tested Free T3, not Total T3.  You should always make sure they test for Free T3 every time.  

From your Free T4 and Total T3 results being over range, it appears that 3 1/2 grains may be a bit too much, but a 50% cut makes no sense.  I suspect that your doctor was paying more attention to TSH being suppressed, and decided that you were hyper.  In reality you are hyper only if having hyper symptoms due to excessive levels of Free T4 and Free T3.  You have the excess FT4 and FT3 but report no hyper symptoms.  If you cut your dosage in half I am sure you will actually start having hypo symptoms again.  

There is no need to think that a suppressed TSH automatically means hyperthyroidism.  If you will read recommendation 10 on page 13 of the following link, it refutes that concern, and provides supporting scientific evidence.

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

What were your actual test results for D, B12 and ferritin?

[mhanan4]

Hi Gimel,  
Regarding the article, maybe I should try sending it to her. She was really adamant about me cutting my dosage in half and calling her in a month to see how I'm doing. I told her I really do not want to cut my dosage in half due to how symptomatic I was. I would rather lower it to 3 grains or 2.75 and see how I do.

Here are the exact #'s  for my other results:

Vitamin B12: 1105 (200-1100)
(I've been taking a supplement for b12)

Vitamin D, 1, 25 (OH)2 total: 56 (18-72 pg/mL)

Vitamin D, 25-OH, TOTAL: 67 (30-100 ng/mL)

Hemoglobin: 14.0 (11.7-15.5)

Iron, TOTAL: 76 (40-190)

Ferritin: 37 (10-154)

Thanks for your response!