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2086869 tn?1358362730

Don't know what to think?!

.I have had thyroid issues since the birth of my 2nd child back in 2006. When I was first prescribed 12mcg of Synthroid my family physician told me that I had HYPOTHYROIDISM. Throughout the course of the last several years my dosing has only been adjusted a little here and there. Recently, I had my followup lab work and my TSH was 0.02 and my T4 was 0.66 ... my family physician decided to up my dose to 75mcg and of course recheck in 6 weeks. At this time, I had decided that I wanted to do a little research to actually learn a little more about Thyroid diseases. I never realized how symptomatic I actually was! Fatigue,Weakness, Weight gain, Coarse/dry hair, Dry skin, Hair loss, Cold Intolerance, Muscle Aches, Constipation, Depression, Irritability, Memory Loss, Abnormal Menstrual Cycles, and Decreased libido .... I have it all!! However, I decided that I was going to wait out my 6 weeks to see if the medication adjustment helped any. I just recieved my results back and my TSH is 0.01 and my T4 is back up to 1.80. I actually have not heard from my family physician yet to see what his plans are ... but I am kind of lost. I still feel horrible. I am actually starting to get headaches more and more often. Should I be seeing an endocrinologist? I don't know what to do. Am I just over analyzing the symptoms? HELP!! .
Best Answer
Avatar universal
Seeing an endo doesn't always guarantee that they are good thyroid doctors.  Some of them are only interested in diabetes.  If you like your PCP and can work well with him, that's a huge plus.  If you do your own research and he's open to your suggestions, you should have a winning combination.

For example, I was impressed that your doctor raised your meds when your TSH was 0.02.  Many doctors (including some endos) believe that TSH is the gold standard in thyroid testing and would actually have lowered your dose at that point.  So, i wouldn't throw him out yet.

Your FT4 is still quite low in the range.  It's at 37% of range, and many of us find that FT4 has to be midrange (50%) before hypo symptoms are relieved.  So, hopefully, your doctor will want to increase your meds a bit.  If he doesn't you might want to start looking for another thyroid doctor.  

If he does, I'd probably stick with him and request FT3 next time you have labs.  As long as he's willing to accomodate you with FT3, he's probably teachable.  If he's not, then it might be time to move on.

Once FT4 gets to midrange, it's time to start looking more closely at FT3 to see if you convert well.  There's often a lag in FT3...once FT4 stabilizes, FT3 will continue to rise for a while as conversion ramps back up.  Symptoms can even lag both of those to some extent since your body needs time to heal.  It's all a process that, unfortunately, can't be hurried a lot.

If your doctor doesn't suggest an increase, I'd pre-interview doctors over the phone before I made an appointment.  I can make some suggestions if you'd like (of what to ask).  

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2086869 tn?1358362730
Oh that would be most wonderful!! Thank you so much for your input!
Helpful - 0
2086869 tn?1358362730
The FT4 range is (0.77-1.61).
My doctor did not test my FT3 ... they never test my FT3.
I really like my family physician ... I am just kind of getting the feeling that I should be working with a physician who deals primarily with thyroid disorders.
Helpful - 0
Avatar universal
What's the range on your FT4?  Ranges vary lab to lab and have to come from your own lab report.  

Did your doctor test FT3 as well?  Many people don't convert T4 (the "storage" form of the thyroid hormones) into T3 (the "active" form) well.  The only way to know if you do or not is to look at FT4 and FT3 levels together.

I wouldn't worry about TSH at all.  Often, TSH is suppressed once on thyroid meds.  It becomes a useless test.

It sounds like you need a further increase.  No, you're not over analyzing the symptoms.  



Helpful - 0
2086869 tn?1358362730
My T4 this time was 1.08 ... sorry I posted it incorrectly.
Helpful - 0
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