High TSH, Normal T3 & T4

[skoka123]

Hi,

I am from India. I used to suffer from Grave's disease for a long time. I used to be on medication of Carbimazole. Later, while living in US in 2001, I underwent Radioactive Iodine therapy and became Hypothyroid. I was prescribed Synthroid 100 mcg.

Since my return to India in 2003 I am on the following medicaiton.

Hypothyroid: Thyrox 100 mcg (Levothyroxine Sodium)
High BP: Adbeta-25mg (s(-) Atenolol) and Listril-5mg (Lisinopril)

I used to weigh 78 Kg (172 lb). I had lost 13 Kg (28.6 lb) weight by strict diet and moderate exercise about 15 months ago. I am 5' 4" tall (164 cms). I have now regained 5 Kg (11 lb) weight and my T3, T4 and TSH levels are as follows for the last six months (taken twice).

Test Value Low High Unit
T3 96 60 200 ng/dL
T4 7.46 4.5 12 Ug/dL
TSH 15.97 0.3 5.5 mIU/mL

I have been taking all these medicines after breakfast. I think I should be taking the thyroid medicine 30 minutes before breakfast and the BP medicine after breakfast. Is this correct?

Should I get my free T3 and T4 levels tested? As my TSH levels are high I am suspecting that the free T3 and T4 levels will be low or within the normal range. If that is the case, will taking the thyroid medicine before breakfast be sufficient or should I increase my thyroid medication after consulting an endocrinologist? Finding a good endocrinologist is a little difficult where I live. Would a family physcician be able to give proper medication?

Thanks,
Srikanth

[skoka123]

Thanks for your kind responses.

I generally wake up around 6:30AM and have coffee around 6:45 and breakfast around 7:45AM. Is it OK to take the medicine after having coffee or is it necessary to be on empty stomach to take the Thyroxine medicine and wait for an hour before drinking coffee?

It would be great to take the medicine at bedtime. What should be the ideal time gap between dinner and taking the medicine?  Can you please point me to a reference site with regards to taking Thyroxine at bedtime?

Thanks,
Srikanth

[Smilerdeb]

The thyroid medicine should be taken AT LEAST an HOUR before breakfast and no other meds taken at this time. The BP meds can be taken with breakfast but its important for the Thyroxin to be taken on an empty stomach to be able to absorb properly.
Doctors have recently said that it is ok to take Thyroxin at bedtime too...depending on your personal choice.
Hope this helps
Debs

[ChitChatNine]

I am not sure on the BP meds but other meds before bkfst by at least 30mins .. they make a med change to bring the TSH # more in line but you can try to make the change in your eating first for a few weeks before the test to get a more accurate idea of what the med is doing or if you continue to eat and then take the pill they will probably increase the med but ifyou modify your eating you need to be retested bcz of  consistency in your routine being essential.   Even if you are doing it wrong, you need to continue to do it wrong to get a true value .. does that make sense??

On the other ?'s I'm sure others will stop by!

Cheryl