Hypothyroid change in dose 75-50 mcg

[andread123]

Hello,

I currently reside overseas,I have taken Synthroid 100 mcg for almost 12 years. After blood tests in June 2012 the doctor switch my dose to 75 mcg, I felt okay no big changes in my body. Until December 2012 when he switched from Synthroid to Thyradin-S only available in Asia. Started at 50 mcg then switched back to Synthroid 88mcg after 7 days. After taking Synthroid for 3-4 days, I started feeling numbing on my left leg, arm and little discomfort on my face. In addition, I also experience cramping, heavy head and burning sensation in the body and head.  Most recently less than two weeks ago tried taking Thyradin 75 mcg  3 days (effects: burning on my head and body) skipped one day and went back to Synthroid 88 as was told by doctor 75 and 88 are the same thing. After 3 days, I started having numbing in my left side and cramps plus the heavy head and low blood pressure.  Now the doctor has asked me to stop taking the medicine for a couple days until the symptoms go away. Two days now, I still have numbing, heavy head,cramps and burning in the back of my head,arms, legs and pulse on the side of my head. Thank you for taking the time to help.

[andread123]

Thanks for all the help, I might just start with a lower dose and go from there.

[goolarra]

You've been switching meds a fair amount, so It's really difficult to say what's doing what.  It takes any dose/meds change 4-6 weeks to reach its potential in your blood, and both blood levels and symptoms are therefore the product of everything you've taken during that time.  

Your December labs were very low, so it's quite possible the numbness, etc. are because you are hypo.  

You've been on 75 or 88 with a couple of complete breaks in meds, correct?  Considering that, I wouldn't think you'd have to start out low and increase slowly.  However, if you're gun shy at this point (and I can completely identify with that feeling), you could start out at a lower dose and work up.  I'd stay away from the Thyradin-S if I were you.  You have a track record with Synthroid...no reason to rock the boat.

Also, be aware that it's not unusual to feel a bit worse when starting meds or increasing.  Consistency is all important in treatment.  Assuming that you are hypo and that is causing your current symptoms, the longer you are off meds, the worse they are apt to get.  I don't think they're going to go away as your doctor predicted.

[andread123]

I understand and appreciate the feedback. I last took 88 mcg for 3 days and felt awful( side effects mentioned) just before stopping meds. I am worried about taking a higher dose which might worsen my current symptoms. Do you think the numbness on my  leg and arm is related low thyroid? I had been on 100 mcg for almost 11 years.

I have a couple more months before heading back to the states. The system works differently in Asia.
Do you recommend I start with a low dose and increase gradually?. Hope that by doing so my side effects are less.

Greatly appreciated
Andread123

[goolarra]

Your FT4 is VERY low in the range.  It's at 16% of range, and many of us find FT4 has to be around 50% to feel well.  In addition, FT3 is even lower in the range.  It's at 5% of range, and the target for FT3 is upper third (66%+) of range.  You are hypO, not hypER (overmedicated).

Once on thyroid meds, TSH often becomes unreliable as an indicator of thyroid status.  Your doctor is looking at your TSH only, not FT3 and FT4.  As a result, he is telling you to lower or temporarily stop your meds when you actually should be increasing.  

Please, talk to your doctor, or better yet, find one who nows more about thyroid.  On 75 mcg, until 12/4/12, you were very hypo.  You need to get back on meds, and it doesn't look like 75 mcg is enough for you.  

[andread123]

Thanks for your quick reply.
My last lab work as follows:
(Also tested for Anemia)
1/8/12    TSH        0.80
           WBC       60       (4.0 - 9.0)
           RBC        438     (3.80 - 5.00)
           HB             9.9   (12.0 - 16.0)
           HT           31.3    (36.0-47.0)
          MCV         71       (82-99)
          MCH         22.5     (28.0-34.0)
          MCHC       31.5     (32.0-36.0)
          RDW         16.4     (11.5-14.5)
The above THS is after I had skipped my Synthroid medicine for 4 days

12/4/12  TSH        0.16   (0.54 - 4.54) ( Synthroid 75 mcg 6/12-12/12)
             Free T3    2.2    (2.1 - 4.2)
             Free T4    1.09  (0.97 - 1.72)
CK (CPK)              178   (30 - 172)

Today is my third day of no medicine, I would like to know what dose is safe to start with and how soon?  

Many Thanks
AndreaD123

[goolarra]

Do you have the results of your most recent labs to post?  If so, please do with reference ranges (vary lab to lab).

Thyradin is a form of levothyroxine, which is the same as Synthroid.  So, unless the doctor has some information on the relative potency of Thyradin vs. Synthroid, no, 75 and 88 would NOT be the same thing.  75 of one would be equivalent to 75 of the other, etc.