Hypo for years, want to do something about it.

[PopeShawnPaul]

I've had hypo symptoms for years and just thought I was not tough enough or had to work out more to keep weight off.  Dry hands, brittle nails, lack of energy, weight gain, arthritis in hands, etc. has plagued me and I'm a 38 yo male.  Finally, on a routine blood test a year ago they found my TSH level was ~7.  I was put on Levo 88mg, Levo 100mg, Syn 112mg, Syn 125mg, and now Syn 150mg.  The lowest my TSH got was 2.07 but I still had active symptoms.  My last test result a few days ago was TSH 5.2 so the doctor upped my Syn dosage to 150mg.

My doctor ran a full lab on me about 10 months ago and these were the results with ranges listed afterwards:
Free T4 1.0 (0.8-2.2)
TSH 2.07 (0.45-5.10)
Thyroxine (T4) 7.6 (4.7-11.3)
Thyroid Peroxidase Auto Ab 255.3 (0.0-9.0)

I just found the STTM website and ordered the book.  I'm ready to move on from my general practitioner to a doctor that knows this stuff better.  My friend has had great success on NDT.  I'm ready to start NDT and I don't want to wait until we get a high enough dose of the Syn to "work".  Even when my TSH was 2.07, I was very symptomatic and my doctor was happy with that and wanted to stop.  I asked about NDT but she said it was too hard to regulate and advised against it.  I feel like she is open and cares so I could talk to her about it and get her to change to NDT but am I better off going to a endo now?  She hinted maybe we were ready for an endo at my last visit.

Anyone know or have thoughts on a local doctor in the Bellevue/Seattle area?  I'm ready to get aggressive with this but am lost on my next move.  Thoughts?

[gimel]

I am a bit confused by your mention of both hyperthyroidism and then hypothyroidism.  Please post your thyroid related test results from 4 months ago and any that are more recent.  Please include reference ranges as shown on the lab report.  

What symptoms were you having 4 months ago?  what symptoms do you have now?

[Ashden2010]

Pls give some advice, what is the best thing to do about this , I confused .

[gimel]

From your test results and symptoms it appears tht you have the most common cause for diagnosed hypothyroidism, which is Hashimoto's Thyroiditis.  With Hashi's the autoimune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland  Along the way to destruction, the output of natural thyroid hormone is gradually diminished and requires increasing amounts of thyroid med.  

Your doctor has at least been willing to increase your dosage, in trying to reieve symptoms.  Unfortunately you haven't been tested for the most important thyroid test which is Free T3.  Free T3 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.  In fact when taking thyroid meds, TSH is basically useless  as an indicator of thyroid status, and is worthless as a diagnostic by which to medicate a hypo patient.

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

So you need to always make sure they test you for both Free T3 and Free T4 each time you go in for tests.  Many of our members say that symptom relief required Free T3 in the upper part of its range and Free T4 around the middle of its range.  You might also give a copy of the link to your doctor and ask if she is going to be willing to treat clinically, as described.  If not, then you will need to find a good thyroid doctor that will do so.  That does not automatically mean an Endo.  They seem to be more rigid about the "Immaculate TSH Belief", and use "Reference Range Endocrinology"  more often than regular doctors.

Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, I also suggest having those done.  They are very important to help in relieving symptoms.