Help with NP thyroid dosage and test results

[Redamber7825]

Hello,

I switched from synthroid/levothroxine (tried both brand and generic and did not do well) a couple months ago to NP thyroid. So far I have been very happy with NP but still a little fatiqued, brain fogged, can't lose weight, cold hands and feet still etc... Here are my labs on 60mg then 90mg. I was not feeling well on 60mg so we raised to 90mg. My TSH is now very suppressed. I was feeling better after the increase then started not feeling as well. I am not sure if it is me getting used to the T3 and I need to go higher or my TSH is low and I need to reduce to 75mg. I think I need to go up to 120mg and see if I feel better since my FT4 is at only 22% of range and my FT3 at 45% range but my Dr is concerned about my TSH .089.  I don't have any symptoms of hyper that I can tell. They also tested my antibodies and some other things the last time as well if that helps with the big picture. Can someone help me... I am new at the dessicated thyroid and not sure what to do? So should I go down 75mg, hold at 90mg or go up 120mg? I am a 38 year old female.
Labs:

9/13/12 - 60mg- 8 weeks
TSH : 1.28  (range: .45-4.5)
Free T4: .85  (range .8-1.8)
Free T3: 2.6  (range 2-4.4)

11/6/12 - 90mg- 6 weeks
TSH : .089  (range: .45-4.5)
Free T4: 1.03  (range .8-1.8)
Free T3: 3.1  (range 2-4.4)
Thyroxin (T4): 7  (range 4.5-12)
T3 uptake: 31  (range 24-39)
Free Thyroxine index: 2.2 (range 1.2-4.9)
TPO: 13 (range 0-34)
AntiAB <20  (range 0-40)

[Redamber7825]

Hello,

Thank you everyone for the quick responses. I got lucky and my new Dr was GREAT. She understood how everything works without me explaining like the last dr. Her main concern with the low TSH was checking my heart out first. She did an EKG right then at her office and my heart was " text book perfect" so she wants me to up to 120 mg 4 days a week and 90mg 3 days a week so I don't have to bother with cutting the pills. NP only comes in 30, 60, 90 and they are very soft and crush easily, yes they are very sweet like old armour and I have always chewed them for those who asked. I was also splitting my dose in the beginning until I got up to 90mg because I would crash in the afternoon but once I got to 90 I was having trouble sleeping and now take it all in the AM and was doing well until the initial T3 boost caught up and my hypo came back. Hopefully this will get me where I need to be #'s and symptom wise keeping my fingers crossed.Thanks again to all for the support!

To flyingfool - I did not do well on Synthroid and levo because i had horrible side effects, each one a different set. On levo I had super high anxiety, panic attacks, social phobia so bad they put me on xanax, . Synthroid caused me depression, weight gain, headaches and bad lower back and neck pain. I also had elevated blood pressure and cholesterol on both.Since switching to NP my blood pressure is perfect and I will have to wait until later labs to check my cholesterol but hopefully that will come down as well. The list is actually more lengthy but those were the MAIN problems.

[flyingfool]

Some say they chew up the pills. Tastes terrible but if it makes you get better absorption and feel better I guess it's worth it.

And with ample advice from Ms. Mary Poppins; "A spoon full of sugar makes the medicine go down, medicine go down..."

Agree with those above.  When taking T3 TSH often goes to just about zero.  So TSH should be ignored.  Frankly other than screening to determine way out of whack condition, TSH should be ignored.

What didn't "do well" about taking straight T4?  Did you have sensitivities or reaction or was it just ineffective?

I agree an increase is in order.  What that increase should be is up to you and your Dr. to work out.

[LazyMoose]

Goolarras right on the money. As an additional comment, I have used dessicated thyroid by five companies and your lab values are quite normal to what one sees while using dessicated- not just by myself but many others here over the years. The low TSH and FT4 but with more FT3.

You might try splitting it fourths for fine tuning - no need for a different pill size when doing that. And maybe taking sublingually 2 or 3 times per day to see if you feel better before raising daily dose....? Many do that. I believe NP disolves like origional Armour and Erfa (Canadian) between the cheek and gum in 20 minutes (with no food in mouth), will absorb the T4 better than in your stomach that way. T3 does not get blocked by food protiens.

[goolarra]

Once we're on thyroid meds, especially, it seems, meds with T3 in them, TSH often takes a nose dive to close to zero and doesn't come back up.  It's then no longer a reliable indicator of thyroid status.  We have to ignore it, AND convince our doctors to do the same.

With FT4 at 23% of range and FT3 at 45% and lingering symptoms, I certainly wouldn't decrease.  Have you thought about asking your doctor to increase, but going to 105 as a first step?  Retest after 4 weeks, re-evaluate symptoms and go from there.  

Antibody tests were negative, so it looks like you don't have Hashi's.  

Total T4, T3 uptake and FTI are considered obsolete and a bit of a waste of money.  You might ask your doctor if he'd consider dropping those.