Thyroid Disorders Community
How long does Synthroid take to work?
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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How long does Synthroid take to work?

I just took my second dose of Synthroid this morning (25 mcg). I still feel the same. When should I see improvement?

Thanks!
58 Comments Post a Comment
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2192208_tn?1346529432
What is your thyroid condition?? It takes several weeks before it is registered, however u may notice the effects sooner.
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Avatar_m_tn
The 25 mcg is a relatively small amount, probably a starter dosage.  With T4 meds it takes 4 weeks to build up to 90% of its total effect on blood levels.  Symptoms tend to lag somewhat changes in blood levels.  Also, the lag time depends on length of time you were hypo and the severity.   So a lot of patience is necessary for hypo patients.  

To try and give you a better answer we need to also know the results of thyroid related tests, and also their reference ranges shown on the lab report.  Another bit of info that would help is your symptoms.

Has the cause of you being hypo been determined?  

Have you been tested for Vitamin D, B12 and ferritin?

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Avatar_m_tn
My results:

TSH: 1.61 (0.50-2.50)
Free T4: 1.22 (0.89-1.76)
Free T3: 3.7 (2.3-5.0)
Total T3: 1.13 (0.60-1.81)

Anti-TPO AB 57.5 (0.0-28.0)

Although my results are within the normal ranges, my endo perscribed me Synthroid to treat my hypothyroid-like symptoms. (Headaches, lightheadedness, fatigue, dry skin, eyes, mouth, hair, lethargy, etc.)

My b12, iron, and ferritin are all normal. I have low D, which I am currently supplementing.

Thank you so much!!!
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Avatar_f_tn
It should take about 6 weeks for you to feel the effects of your synthroid.  Do you take it first thing in the am?  I try to wait about an hour to eat.  Also, taking supplements, you should wait about lunchtime to take any vitamins/minerals.  Eating a breakfast high in fiber could also reduce to absorbtion of synthroid.  Just some thing I have encountered.  How much vitamin D3 are you taking?  That can affect you as well, seeing how synthroid can deplete your D3.  My endo "prescribed" 5000 IU a day.  Hang in there!!  It will kick in and you will be feeling back to normal soon!! :)
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Avatar_m_tn
The TPO ab test shows thyroid antibodies consistent with Hashimoto's Thyroiditis, which is the most common cause of diagnosed hypothyroidism.  With Hashi's your autoimmune system produces antibodies that attack the thyroid gland until, after an extended period, the gland is destroyed.  Along the way, thyroid hormone output is gradually diminished and has to be replaced by thyroid meds.  

It is a very good sign that your doctor has prescribed meds for you already, apparently based on your hypo symptoms.  Many doctors treating Hashi's patients base their decision to medicate, or not, on TSH.  That simply does not work.  Other doctors will tell you that a thyroid test that falls anywhere within the range is adequate for you.  That is also wrong.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  

So it is very good that you were tested for Free T3 and Free T4.  Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  Many of our members report that symptom relief for them required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the middle of its range.  

I am also glad that you were tested for Vitamin D, B12 and ferritin.  Hypo patients are frequently low in those areas.  If you don't mind, I would like to see the actual results for those and their reference ranges as shown on the lab report.
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Avatar_m_tn
Vitamin D: 19.7 (30.0 - 100.00 ng/ml) I'm taking 2,000 IU Vitamin D for this

B12: 673 (211 - 946 pg/ml)

Ferritin: 96 ng/ml (30-400 ng/ml)

Thanks!
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Avatar_m_tn
I have hypothyroidism (was diagnosed about 15 years ago) and in the past year I started cutting back my synthroid dose because I was having uncomfortable symptoms which I associate with taking too much synthroid (such as feeling shaky and like I can't stay still and the only thing that can slow me down is eating a ton of food). I had my TSH checked in January (9.2), March (8.5) and August (last week) (7.5) and have been gradually upping my dose to get back into the normal TSH range without the yucky symptoms I had last fall. A few days ago I started having that familiar nausea of pregnancy and am now a day late on my period. It has been about 14 days since conception and now I'm very worried about going into the first trimester of a pregnancy with an elevated TSH. I have two normal healthy children but during those pregnancies my TSH was normal at the start and my OB continued to monitor it during that time. For years I was on 88mcg levothyroxine but since last December I cut my dose back a lot. In the past few months I have been taking 50mcg every other day and 44 mcg every other day. Now, I know I need to increase my dose but am wondering how much I should increase it to make sure that I lower my TSH as soon as possible for the pregnancy. If anyone has experience with this, please let me know. I have been reading all these articles about the effects of elevated TSH during the first trimester and mental retardation and low IQ in infants and it is making me feel pretty upset.
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Avatar_f_tn
I started experiencing transient side effects in the first week and it took me 3 weeks to notice a lessening of my symptoms.

The first thing to disappear was the cold intolerance.
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Avatar_m_tn
Hi ipad135, just wondering whether taking the synthroid helped with your symptoms when you had "normal labs". I have almost exactly the same thyroid levels but have very high Thyroid antibodies (close to 250). I've been having various hypo symptoms like cold intolerance, fatigue, muscle weakness and (most troubling) a swollen tongue (which apparently is a hallmark of hypothyroidism). I'm thinking of asking to be medicated. Did you feel better on the synthroid?
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Avatar_f_tn
I was wondering how everyone is doing now.  My endo just last week upped my synthroid from 112 mcg to 125 mcg because I was having bad symptoms ie dizziness nervousness pulps and headaches. Can anyone tell me how long it takes for the changes to be felt? Unfortunately I am feeling worse :(
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Avatar_m_tn
Please post your thyroid related test results and reference ranges shown on the lab report so that members can assess the adequacy of your testing and treatment.  
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Avatar_f_tn
I too was recently diagnosed with hypothyroidism and really do not understand the implications yet.  The results that I have is a TSH of 7.78.
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Avatar_m_tn
TSH is a pituitary hormone whose function is to signal the thyroid gland to produce thyroid hormone.  TSH is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T3 and Free T4.   That said, when the TSH is high like yours, it is frequently an indication that you are hypothyroid, even though you may not have clearly identified any hypo symptoms yet.  

In order to get a better idea of your status, I suggest that you should request to be tested for the antibodies related to Hashimoto's Thyroiditis, which is the major cause for diagnosed hypothyroidism.  Two tests are necessary, Thyroid Peroxidase and Thyroglobulin antibodies (TPO ab and TG ab).  With Hashi's, the autoimmune system erroneously determines that the thyroid gland is foreign to the body and produces antibodies to attack and destroy the gland.  This occurs over an extended period, resulting in diminishing ability to produce thyroid hormone, and increasing levels of TSH.  If you have Hashi's, it would be a good idea to start on replacement thyroid med, in order to minimize symptoms.

You should also request to be tested for Free T3 and Free T4 (not the same as Total T3 and Total T4), each time you go for tests.   If the doctor resists, just insist on it and don't take no for an answer.  Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.

Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, I also suggest getting those tests done as well.  When further tests results are available, please post results and their reference ranges shown on the lab report and members will be glad to help interpret and advise further.  
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Avatar_m_tn
My results show:
T4 6.8 ref range (4.1-12.1)
T3 total 1.01 (0.64-1.68)
TSH 2.52 (0.19-4.47)

Vitamin d 25 21.8 which is classified as insufficient
Ferritin 132 (17-400)
B12 607 (241-897)

I am always tired and have memory problems. Do I have hypothyroid? How quickly will I see effect after treatment?
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Avatar_m_tn
Your thyroid test results don't stand out as a hypothyroid problem; however, your T3 and T4 tets are for Total T3 and Total T4.  it would be far better to always test for Free T3 and Free T4, since they are the biologically active portions of Total T3 and T4.  Free T3 is especially important because it largely regulates metabolism and many other body functions.  Scientific studies have also shown that Free T3 correlated best with hypo symptoms.  

Having said that, in view of the symptoms you mention, and that your Total T4 and Total T3 are in the lower half of their ranges, I suggest that you should do some further evaluation starting with getting the Free T3 and Free T4 tests done.  If they also show to be in the lower part of their ranges, then it would be a good idea to discuss your symptoms and test results with your doctor and try to get your doctor to prescribe a therapeutic trial of thyroid medication, as necessary to raise your Free T3 into the upper part of its range and your Free T4 to the middle of its range.

In addition, your Vitamin D is way too low.  It would be a good idea to discuss with your doctor, supplementing with about 2000 I. U. of D3 daily, or as necessary to raise your Vitamin D level to around the middle of its reference range.
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6853719_tn?1385423850
hey I just got diagnosed with Hypo and my TSH results was 3.85. Some people say that is in a normal range, some have told me that the normal has changed to 3? I am so new to all this I just don't even know what to ask or say, can someone please make sense of all this to me, Thanks in advance :)
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Avatar_m_tn
Yes, the reference range for TSH was revised by the AACE, over 10 years ago, from .5 - 5.0 down to .3 - 3.0; however, it seems that most labs and doctors have not yet bothered to accept the new range.  Even more important is that TSH is a pituitary hormone that doctors like to believe accurately reflects levels of the actual thyroid hormones, but in actuality TSH cannot be shown to correlate well with either of the biologically active thyroid hormones, Free T3 or Free T4, much less correlate well with symptoms, which should be the most important consideration.  So please tell us about any symptoms you are having.  

Also, have you been tested for Free T3 and Free T4?  If not, then you should request both every time you go in for tests.  If the doctor resists, just insist on it and don't take no for an answer.  Free T3 is the most important because scientific studies have shown that it correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  In addition, if your TSH is indicative of hypothyroidism, the most likely cause is Hashimoto's Thyroiditis.  To test for that, you need to test for both Thyroid Peroxidase and Thyrlglobulin antibodies.  Those two tests are shown as TPO ab and TG ab.  

Since many hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, you should also request those tests.  Then when you have the suggested test results, please post results and reference ranges shown on the lab report and members will be glad to help interpret and advise further.  

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Avatar_m_tn
Sorry about my typing, that should be Thyroglobulin antibodies.
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Avatar_f_tn
I am also facing a similar problem, I went to see a doctor early Jan because of my irregular periods and some other symptoms such as tiredness, headaches every morning etc. I was diagnosed with Hypothyroidism and my test results are as below. It has been around 20 days that I have been taking Synthroid 88mcg but still did not get my period back(stopped 2months back). I am very worried as I am 26yrs old and do not have a baby yet which we were about to plan soon. How much time do you think it will take for me to get my period back and when will things be normal again?
Any advice would be helpful.
Thanks in advance.

Free T4 0.8-2.2 ng/dL 0.9
TSH 0.450-5.100 uIU/mL 12.300

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Avatar_m_tn
There is no good way to estimate those things, without further info.  You really need to make sure they always test you for both Free T3 and Free T4 each time you go in for testing.  Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  

Twenty days is not long enough for your serum T4 level to fully reflect the dose you started 20 days ago.  In addition, you can't know how well your body is converting the T4 to T3 without testing Free T3.  

When you do go back for testing, I suggest that you should also test for Vitamin D. B12, selenium and ferritin.  Hypo patients are frequently too low in the ranges for those as well.  

When you have further test results, please post them along with reference ranges and members will be glad to help interpret and advise further.
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Avatar_m_tn
Did your doctor test your FSH? Hashimotos and Premature Ovarian Failure (they have another name for it now) unfortunately often times present themselves at the same time-they did for me. I would find a reproductive endocrinologist pronto!
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Avatar_f_tn
I have had a number of symptoms of hypothyroid in the past year and a half. I have always wondered if I had thyroid problems because there are some symptoms I have always had, but since getting cold easily and cold hands/feet aren't a super serious issue, I have just dealt with it. BUT starting within the past year I have also had these weird headaches, feel tired, still sensitive to the cold, dry skin, REALLY BAD memory problems, at first my periods were heavy at times but now are half the length of time and light, retaining water, and I have gained just under 20 lbs in 18 months. For about a year I have been trying to lose/prevent more weight gain by exercising more and making diet changes, although I never really ate unhealthily, yet I keep GAINING weight and can't even stop that from happening. I currently am up to an hour in the gym lifting weights, biking, and walking the treadmill (interval training) almost every day except on the days when I feel so dead that I can't make myself go. I went to my doctor last week, and she tested my thyroid. Here are my results:

No thyroid antibodies,
Free T4, .81 (.52-1.21)
Free T3 3.08 (2.2-3.8)
TSH 1.35 (.34-5.66)
My metabolic panel was normal, CBC was normal, cholesterol and triglycerides all normal.
My doctor didn't request vitamin D this time, but in the past it was low-ish in August 2012, which for living in the south and being someone who loves being outside by the pool, is strange to me.

I do take a multi-vitamin, Stress B Complex, fish oil, biotin (my hair was falling out early on when this all started happening and taking this has helped a LOT even though it's already in the B complex and multi), and this week I added magnesium. I try to take them every day, but sometimes I forget.

I am wondering if my symptoms are thyroid related or may be related to estrogen dominance? From reading previous posts, it sounds like maybe my T3 should be a tiny bit higher, but I am confused between what I see posted on here and what the normal ranges are listed as being. A lot of the symptoms on estrogen dominance are similar to hypothyroid so I am wondering if I should have my hormones tested as well.

My doctor started me on 25 mcg of synthroid a couple of days ago, but I'm not sure if it will help or how long it would take to know it isn't helping, if there is something else going on...

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Avatar_f_tn
Hi. I've just been 'diagnosed' with hypo thyroidism & started synthroid.  I say this with  " ", because my Dr felt like my labs were normal although I've complained of symptoms associated  with it (sluggish, brittle nails,memory issues) & these were my labs at my physical:  

February 2014
TSH: .5 - 5.2. Mine is 6.09.
Free FT4: .8 - 1.8 Mine is 1.1

Past results were:
Sept 2012, TSH 2.15, FT4: 1.1

Sept 2011, TSH: 1.65, FT4: 1.3

July 2010, TSH: 2.03, FT4: 1.0

A jump from the 2.0 range to 6.0+ seems significant to me.
It also runs in the women in my family (grandmother , mother, mothers sister (aunt) and her daughter (my cousin).  I'm really hoping to start feeling better as I just started taking it. I go back in 6-8 weeks to check my blood work tested again.  Any thoughts are appreciated.  Thank you!
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Avatar_m_tn
Reading your post was like reading my story. I was wondering if the synthroid helped your symptoms (particularly the weight issue)?

I was told by my doctor that my thyroid was fine except for a cyst and a nodule they want to ultrasound every 6 months, but I don't know my actual numbers. I gained 25 pounds about 2 years ago. I half-heartedly tried to lose it, but since I am getting married this summer, I began working in ernest to get my bathing suit body back. I work out with weights and do 30 minutes on eliptical 3 days a week and do an hour long zumba class twice a week. I eat around 1,100 calories per day (which I SHOULD be working 3/4 of off at the gym) and I have lost 4 pounds in 3 months. This is crazy! I have so many symptoms, (but my (very conservative) doctor said he wouldn't prescribe synthroid because my numbers were not out of "normal" range. I too have a shedding problem and take biotin in addition to a multi, Super B complex, and recently I have added magnesium and a Thyroid support containing lots of iodine and L-Tyrosine. This helped a little, but I still don't see anywhere near the results I should for the way I'm working out.

Would like to hear how/if the Synthroid helped.

Thank you,
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Avatar_m_tn
I was on 175mcg, and then had it lowered to 150 mcg.  In November my levels were fine, now my levels are 10.4.  My doctor increased back to 175.  Has anyone had a strange fluctuation in blood this bad?  How long will it take for me to regulate?

My tsh 10.4
T3 uptake 38
T4 free 2.9

Thanks...chelle1313
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Avatar_m_tn
Maybe forever, if the doctor medicates you based on TSH.  TSH supposedly accurately reflects levels of the biologically active thyroid hormones, Free T3 and Free T4; however, TSH cannot be shown to correlate well with either, much less correlate well with hypo symptoms, which is the reason you are seeing the doctor in the first place.  When already taking thyroid meds, TSH is basically useless as a diagnostic by which to determine dosage.   So, please tell us about your symptoms.

Scientific studies have shown that Free T3 correlated best with symptoms, while Free T4 and TSH did not correlate at all.  Yet, your doctor is not even testing your Free T3.  You should make sure that you are tested for both Free T3 and Free T4 each time you go in.  If the doctor resists, just insist on it and don't take no for an answer.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

Since hypo patients are also frequently too low in the range for Vitamin D, B12 and ferritin, you should make sure to get those tested as well.  When you have new test info please post, along with ranges, and members will be glad to help interpret and advise further.

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Avatar_f_tn
I went to my gyn doctor in January for annual exam. They did lab work and I asked for them to send it to me but they did not. I had another issue last week which I needed to see her for so at that time I asked for my lab work, which they gave me. My tsh from back in January was .01. So I called them and asked them how they were planning to handle the low tsh and they said I needed to come in for more labwork. I went in last week and she drew tsh, t3, and t4. This time tsh is 12, t3 is 89 and t4 is normal. I am assuming the t3 was the total t3 not free t3 since they said it was normal. I was referred to endocrinologist and I have an appointment tomorrow. Can someone please shed some light on why I would have tsh of 0.1 back in January and how tsh of 12? I have had symptoms of hypothyroidism for years with extreme fatigue, weight gain even though I diet and exercise but I thought this was age/menopause related. I have also been in menopause since I was 48 and I am now 50, so Im starting to wonder if my somewhat early menopause could also been caused by hypothyroidism.

thanks
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Avatar_m_tn
Your symptoms and limited test results sound like you could possibly have hypothyroidism due to the most common cause, which is Hashimoto's Thyroiditis.  With Hashi's, the autoimmune system erroneously determines that the thyroid gland is "foreign" and produces antibodies to attack and destroy the gland.  This destruction takes place over an extended period.  Sometimes nodules will form on the gland, when then tend to periodically leak thyroid hormone faster than normal.  This will cause cycles of being hypo then hyper.  That could account for the low TSH, followed by the high TSH.  

The way to determine if Hashi's is present is to test for Thyroid Peroxidase and Thyroglobulin antibodies.  The tests are listed as TPO ab and TG ab.  Both are necessary, since Hashi's can be related to either or both.  

While at the doctor's, I also suggest that you test for Free T3 and Free T4, rather than Total T3 and Total T4.  Only the free portions of thyroid hormone are biologically active.  If the doctor resists, just insist on those tests and don't take no for an answer.  Free T3 is the most important because it largely regualtes metabolism and many other body functions.  Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.

Keep in mind that a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

Also, since hypo patients frequently are too low in the ranges for Vitamin D, B12 and ferritin, I also suggest requesting those tests as well.  When further test results are available, please get a copy and post results and their reference ranges and members will be glad to help interpret and advise further.
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Avatar_m_tn
I had my thyroid levels checked in May. I was diagnosed with hashimoto's thyroiditis. My sensitive tsh was 6.2 mIU/L; free thyroxine 0.9 ng/dL; TPO antibodies 528 IU/mL (normal range <9.0 IU/mL). I was started on 25 mg of synthroid. I havent noticed any changes. Does it take a while before I will notice any results?
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Avatar_m_tn
I am a 63 yo female and started with a TSH of 6.8 in December with a family history of hypothyroidism.  Doctor did not treat but retested TSH in March with a 8.1 level.  At this point, I started on 25mcg daily. I have gained 15 pounds during the Jan-March time period and am very frustrated.  My TSH was retested in June with a level of 4.5.  My dose was increased by 1 extra 25 mcg per WEEK.  This seems to have made no difference in my symptoms (fatigue, slow metabolism, joint pain).  I feel as though I am being treated too conservatively.  I am looking at this the wrong way and being too impatient?  I do not see an endocrinologist for this, should I find one to treat me for this?
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Avatar_m_tn
Sounds like maybe your doctor has the "Immaculate TSH Belief" and is using TSh to determine your dosage.  That absolutely doesn't work for many hypo patients.  TSH is a pituitary hormone that is affected by so many variables, that it cannot be shown to correlate well with either of the biologically active thyroid hormones, Free T3 or Free T4, much less correlate well with symptoms, which should be the main concern.  

If you have been tested beyond just TSH, please post results and their reference ranges, as shown on the lab report.  Also, if tested for Vitamin D, B12 and ferritin, please post those, with ranges also.

In the interim, for perspective, a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimatecriterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

Going to an Endo coes not guarantee a good thyroid doctor.  Many of them specialize in diabetes.  Many of them have the "Immaculate TSH Belief".  And many of them only use "Reference Range Endocrinology".  You need to be treated clinically, as described above and in the link provided.
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Avatar_f_tn
I am so frustrated. I have been on 88mcg of levothyroxin (levothyroxine) for the past 5 years. I was told I have  hypothyroidism with cyst on my thyroid. This past nov. I had neck surgery on 4 ruptured vertebrate (which i know sounds off the subject) but since then I have not been feeling well at all.. very very tired, sleep for days, losing hair, weakness in muscles,  hurting in my muscles some , day,walking around in a brain fog I call it, severe headaches daily, last week losing my voice and swollen neck tender to touch, cold intolerance, night sweats severs. My regular Dr. checked blood work said nothing she can do all my levels were normal. the next week (last week) had heart attack symptoms and went to er.. they admitted me, ruled out heart said had to be my thyroid. they tested:
TSH 5.22 (0.34-5.60 ulU/ml)
Free T4 0.7 (0.6-1.1ng/dl)
Free T3 not tested... my doctor states they still can not do anything I am discharged still having chest pains and feeling horrible.. i go to endo.. they say my TSH levels are normal and can not up my med. so, I decide to do so on my own I started taking 1 1/2 of my meds now.. my voice came back, my chest pain is gone, no headache no night sweats, increased energy in just 5 days! What do I need to do to get someone to listen to me and what I am telling them to get me on the right meds????
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Avatar_m_tn
One thing you can always do is to be very insistent on the testing you need and the treatment you expect, in order to relieve symptoms.   There is nothing that I know of that restricts a doctor from prescribing thyroid med even if your results fall within the so called "normal' ranges.  As I recall, even the very biased guidelines for treatment of hypothyroidism, published by the AACE, recognizes that the doctor is in the best position to evaluate a patient's signs and symptoms, along with test results, and treat accordingly.  So maybe we should all be asking our doctors what restricts them from prescribing thyroid med if the test results are at the bottom end of the range.  Would they prescribe med if the Free T4 was .59, but not do so if the Free T4 was .60?  It is a ridiculous situation.  So, you should always be ver firm in what you expect and insist that there is nothing that should prevent them from trying to relieve your hypothyroid symptoms.  

If all fails, then you should fire your doctor and find a good thyroid doctor that will treat clinically.  

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Avatar_f_tn
Hi,

I am recently discovered with Hypothyroid with positive Antithyroid Antibodies microsomal. MY TSH level was: 17, Free T3: 3.5 (0.5 less than the normal range) and Free T4: 12 (min level of the range) and Antityroid antibodies microsomal were greater than 1/100 (positive).

My doctor have prescribed me with 25mg of Synthroid. Will it help me out in getting my all level back to normal and making the antithyroid antibodies negative??

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Avatar_m_tn
i changed my diet to inlude kale.asparugus,spinach,brocoli.cauliflower,strawberries,.
also outmeal, fiber one ceareal, peas, beans,daily, all these stop or slow down the absobtion rate of synthroid according to maker.
tsh level in march 14was 1.10 april 5.1 sept 14 8.2 stopped all vegtables,and fiber one till i get my tsh checked in a coulpl week 7 days after stopping feel a lot better
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Avatar_m_tn
i changed my diet to inlude kale.asparugus,spinach,brocoli.cauliflower,strawberries,.
also outmeal, fiber one ceareal, peas, beans,daily, all these stop or slow down the absobtion rate of synthroid according to maker.
tsh level in march 14was 1.10 april 5.1 sept 14 8.2 stopped all vegtables,and fiber one till i get my tsh checked in a coulpl week 7 days after stopping feel a lot better
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Avatar_m_tn
i changed my diet to inlude kale.asparugus,spinach,brocoli.cauliflower,strawberries,.
also outmeal, fiber one ceareal, peas, beans,daily, all these stop or slow down the absobtion rate of synthroid according to maker.
tsh level in march 14was 1.10 april 5.1 sept 14 8.2 stopped all vegtables,and fiber one till i get my tsh checked in a coulpl week 7 days after stopping feel a lot better
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Avatar_m_tn
i changed my diet to inlude kale.asparugus,spinach,brocoli.cauliflower,strawberries,.
also outmeal, fiber one ceareal, peas, beans,daily, all these stop or slow down the absobtion rate of synthroid according to maker.
tsh level in march 14was 1.10 april 5.1 sept 14 8.2 stopped all vegtables,and fiber one till i get my tsh checked in a coulpl week 7 days after stopping feel a lot better
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Avatar_m_tn
i changed my diet to inlude kale.asparugus,spinach,brocoli.cauliflower,strawberries,.
also outmeal, fiber one ceareal, peas, beans,daily, all these stop or slow down the absobtion rate of synthroid according to maker.
tsh level in march 14was 1.10 april 5.1 sept 14 8.2 stopped all vegtables,and fiber one till i'll get my tsh checked in a couple week 7 days after stopping feel a lot better
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Avatar_f_tn
Gimel,

You speak so knowledgeably regarding Hashimoto's Thyroiditis and hypothyroidism.  I recently had an ultrasound and extensive bloodwork performed but my endocrinologist said my bloodwork looked fine other than my Vitamin D levels were low.  My ultrasound showed a goiter with multi nodules and multi cysts.  I am extremely fatigued, I have gained 25 lbs this year, muscle aches without exercise, nail lifting (very bad), I am losing hair and eye lashes, dry skin, and I am 42 years old.  I have Crohn's but it has been in remission for several years and I do not take any medications other than Topamax for migraines.  Normally, I am a go-getter, but lately I can barely keep up.  I have the results of my bloodwork, is there something I can look for?  Thank you for any advice you can give me.  
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Avatar_m_tn
How about posting your blood test results and reference ranges shown on the lab report and let us make an assessment.  
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Hello, I'm really glad I found this community! I've been having consistent hypothyroid symptoms for the last 4-6 months, and now knowing my DX, I've probably been symptomatic for years. I recd my blood test results today. My doc put me on synthroid (50 mcg), vitamin D (5000 IUs), omega 3 fish oil (2-4 capsules 600 mg each),probiotics and magnesium glycinate. She said to start off with just synthroid, vitamin D & fish oil. My results:

TSH 6.360 (.450 - 4.50)
T4 free, direct 1.08 (.82 - 1.77)
T3 free 3.3 (2.0 - 4.4)
HDL 53 (> 39)
LDL 149 (0 - 99)

I had more blood drawn today to check RT3.

My doctor is not an endo but was incredibly knowledgeable and explained everything to me. I'm starting synthroid tomorrow AM following the empty stomach guidelines. My primary symptoms have been horrific migraines, memory loss, brain fog, weight gain and no matter what I do I can't take the weight off.

Is it likely that I'll need to be on synthroid for the rest of my life? I feel like my body is betraying me. 90% of the time I eat a clean diet and I exercise 4-5 times/week.
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Avatar_m_tn
My family Dr. Took my dosage March 13 from 50mcu to 75mcu because I had been complaining of tiredness and my
TSH was 4.29, T4 Free 0.7 and T3 Free 2.8 taken 3/5/15.

I began to have very serious anxiety attacks towards the end of the month and stopped Levothyroxine April 6 for 5 days. I also during the 24 days of the increased dose to .75 had taken 3 extra pills which further messed up my situation, having a dosage effective value of .83

Finally saw an Endo Dr April 16 by chance there was a cancellation and got right in. She put me back on the 50mcu Levothyroxine and added Cytomel 5mcg because I told her I liked the feeling I got while on the Armour, which I was only on for 4 days before my visit with this Dr. She took me off the Armour immediately, so I'm not so sure about the Cytomel as its been 5 days now and I'm concerned about my Anxiety.

My Question is, how long might this take for this overdose situation take to reverse to get me back to feeling like I was before March 13? When the doses started ramping up?

The Anxiety is awful and debilitating.
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Avatar_m_tn
I would not automatically assume that your anxiety is due to hyperthyroidism from the med increase.  There are other possibilities.  One consideration is that anxiety can be a symptom of hypothyroidism as well as hyperthyroidism.  Your lab results above were indicative of hypothyroidism.  The dosage increase was relatively small considering your levels.  You mentioned still being tired at that time, so an increase was in order.  Serum thyroid hormone levels are a sum of both natural thyroid hormone and thyroid med effects.  Frequently hypo patients find that their serum levels don't really increase with small increases in dosage because their as a result TSH decreases and natural thyroid hormone output decreases.  You would know if that is the case only by re-testing your Free T4 and Free T3 after the dose increase, which it appears your Endo did not do.  Also, do you still have the tiredness along with anxiety?

Another possibility I have read about is that hypo patients taking meds sometimes get reactions to increases when their ferritin level is too low.  This is info I ran across previously.  As I understand it, the reaction described can also occur when increasing thyroid med dosage.  

"Low ferritin can cause negative reaction like palpitations, nervousness, and anxiety in someone starting thyroid hormone replacement.  Someone described it like being shot out of a cannon.  It is therefore imperative that ferritin not be at the bottom of the range before starting thyroid hormone medication."

So, unfortunately with all the dosage changes you have gone through recently it will be a few weeks before you could re-test and get a good idea of your current level for Free T4, and about a week after any change in T3 dosage; however, I suggest that you plan to get those done so your status will be a bit clearer.  Also, while re-testing Free T4 and Free T3 I also suggest that you test for ferritin, and Vitamin D, and B12.  Hypo patients are frequently too low in the ranges for each of those.  
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Avatar_f_tn
Hi,

I was put on Synthroid and started this morning.

TSH - 5.9
T4 - .8
T3 - .1
Antibodies present

My vitamin D is also low so I take extra for that.  I also take some other vitamins at night.  If some of the vitamins are still in my system in the morning, is it OK to take the Synthroid right when I wake up?  I probably take my other vitamins at 7 or 8 at night.  I ask because my pee is still vibrant in the mornings from taking the vitamins.  
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Avatar_m_tn
Most hypo patients taking T4 meds seem to prefer taking in the early morning before eating.  That helps absorption.  

Couple of questions for you.  What dosage of Synthroid?  What are the reference ranges for those T4 and T3 tests?  Please double check the result you posted for T3.  
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Avatar_m_tn
Man.. everybody is all over the place.. I can't believe doctors dont have a set standard on the numbers so u can simply do the math in regards to dosage.. well they do.. but they base it on TSH.. useless

the only one that comes close to understanding this is drrind.com he came up with a chart on where you need to be..

Basically forget TSH, and focus on Free t4 and Free t3. He figured this out by running thyroid labs on HEALTHY people with NO thyroid issues.. gee what a concept

here is the sweet spot..

FREE T4  = 1.22
FREE T3  =  3.2

anything higher or lower and you are hyper or hypo..  there are other factors like RT3 and adrenals.. but u have to read up if u really want to get nitty gritty.

I stopped all meds to see where i would land.. and i was at

FREE T4  1.06
FREE T3   2.7

definitely a conversion issue.

I took 7mcg of  t3 only to see where i would land.. hopefully not disrupt my FREE T4...

well my  FT4 crashed to .85 and FT3 went to 2.9   better

so now i'm starting on 50mcg t4 and continuing with 10mcg of t3 to get into that sweet spot..

my only concern is I have no idea how much 50mcg will raise my ft4 and since very few of u guys have before and afters of X amount of T4 med = x bump in ft4 levels.. then it's hard to calibrate..

oh well.. i'll just figure it out myself.. next month when i rerun labs

In any event.. stay in the sweet spot. forget TSH..  

again.. Ft4 1.22 and ft3 3.2   this is where healthy people are with no thyroid issues..

when i looked at some old labs before i got sick.. i happen to had my thyroid tested and sure enough this is pretty close to where i was.. so i trust what drrind is saying, and i'm shooting for that number.. I tried dessicated by the way and never felt right.. and since that is loaded with t3 you really have to completely hijack your thyroid and pituitary cuz it shuts off with all that t3.. so u end up running 100percent on pig hormone..

i on the other hand want as little assistance as possible..  i definitely have t4 to t3 conversion issues from lyme disease/inflammation.. but that's another story.. so i need the xtra t3

good luck


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Avatar_m_tn
I totally agree about ignoring TSH.  I do have a different slant on the "sweet spot".  Other info concluded that healthy adults with no known thyroid pathology usually have Free T4 in the 1.3 - 1.6 level.  Also, Free T3 usually needs to be in the upper half of the range, as necessary to relieve symptoms.  Since each hypo patient can have a different set point for thyroid levels at which they feel their best, I don't think you can establish a single value for  Free T4 and Free T3 that works for everyone.  And of course the objective for all of us hypothyroid patients is to become clinically euthyroid, rather than just biochemically euthyroid.  :)  

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Just wanted to thank you for the head's up on drrrind.com. Very interesting to ponder. No wonder "everybody is all over the place" as you mentioned given the many different scenarios of his Thyroid Scale Matrix. This is definitely not a one fits all!
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Avatar_m_tn
yes I agree with you for the most part..Although, relieving symptoms can be somewhat ambiguous.

for example, I've been slightly hypo..  ft3 3.1 and still feel pretty great, still in the upper half yet my cholesterol and triglycerides will start to elevate, which can be a silent killer..  when i hit 3.2 - 3.3 they come down. So it's important to define "symptoms" when you look at the broad, seemingly unrelated implications from a dysregulated thyroid

And yes, that number could be different for some people, but upper half of the range could still not be spot on.

I have lyme though.. so maybe I have less room for error.

I just found it quite interesting that I had labwork for a bad flu prior to getting lyme and going hypo.. and my thyroid was spot on with dr rinds thyroid chart. I was healthy as the proverbial horse.











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Avatar_m_tn
wow wish my levels were like some of these I had a baby 5 months ago, my TSH is 45.39!! My Dr. put me on 100 mcg of synthroid last Thursday, I still feel horrible hope it works soon!
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Avatar_m_tn
That is a pretty hefty starting dose.  Usually it is more like 25 -50 mcg of T4.  Please post your thyroid related test results and reference ranges shown on the lab report.  

Did you have thyroid issues before the baby?

Also, be aware that it takes about 4 weeks for T4 meds to build up to 90% of their final effect on serum levels.   Hopefully you may get some relief sooner, but symptom relief tends to lag changes in serum levels.
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Avatar_m_tn
TSH is 45.30 range is .35-4.94
T3 free was 1.7 range is 2.4-4.2
T4 free was .64 range is .70-1.48
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Avatar_m_tn
sorry and NO thyroid issues before baby my thyroid has always been 2-2.6
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Avatar_m_tn
I can see why you would be feeling horrible.  Your Free T3 and Free T4 are actually below range.  People frequently have hypo symptoms when their Frees are even in the low end of the range.  It is very infrequently that we see patients with Frees actually below range.  

As mentioned, T4 takes a while to build.  Since your Free T3 is so low and since it largely regulates metabolism and many other body functions, I  think I would ask the doctor to go ahead and add some T3 med to your dosage.  The doctor may disagree and tell you that the T4 med will adequately convert to T3, but that is only a possibility, not a foregone conclusion.  Since scientific studies have shown that Free T3 correlated best with hypo symptoms, I would push for adding maybe 10 mcg of T3.  Then for a week or two I would start on only 5 mcg split into morning and afternoon doses, and then increase to 5 mcg in the morning and 5 in the afternoon.  By then it would be time to go back for testing again.  

Of course that is only my opinion, you need to discuss with your doctor.  And when you do, you should emphasize how horrible you are feeling, and your Free T3 level being even farther below the reference range than Free T4, which indicates some problem with conversion of T4 to T3.  

Since hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin, those need to be tested and supplemented as needed.  D should be about 55-60, B12 in the very upper end of its range, and ferritin about 70 minimum.
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Avatar_m_tn
I'm hoping it's a postpartum thing! I have NO family history of any thyroid problems and my baby is less than 6 months old which can contribute. I'm getting blood work again in 6-8 weeks so we will see. Probably doesn't help my husband gone for a month and me working full time with 2 little ones;)
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Avatar_f_tn
I had the same issues 3 years ago.had a baby and after 5months i started feeling horrible.cough was bad.musscle aches,no energy,hoarse voice,dizziness,and alot otber things.i was tested for thyroid and belive me my number was 204.since then i m on synthroid 125mcg.i feel great now.
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Avatar_m_tn
o lord how did you function at 204! poor thing I'm sorry:( so how long did it take for you to start felling great? I am on week 2 and still feel horrible, and so crazy mine started 5 months after baby as well!
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