Aa
Lab results
Oct 2012
Free T4 13.9 (range 7.9-17.0)
TSH 1.52 (range 0.40-4.50)
Dose at 125 micrograms
Jan 2013
Free T4 21.1
TSH 2.5
Dose left
Sept 2013
Free T4 20.1
TSH 0.59
Dose lowered to 100micrograms
Oct 2013
Free T4 13.6
TSH 4.07
Dose left
June 2014
Free T4 10.7
TSH 11.06
Dose increased back up to 125. Micrograms
July 2014
Free T4 18.3
TSH 4.51
Dose left with retest in 6 weeks
Rachel
Free T4 13.9 (range 7.9-17.0)
TSH 1.52 (range 0.40-4.50)
Dose at 125 micrograms
Jan 2013
Free T4 21.1
TSH 2.5
Dose left
Sept 2013
Free T4 20.1
TSH 0.59
Dose lowered to 100micrograms
Oct 2013
Free T4 13.6
TSH 4.07
Dose left
June 2014
Free T4 10.7
TSH 11.06
Dose increased back up to 125. Micrograms
July 2014
Free T4 18.3
TSH 4.51
Dose left with retest in 6 weeks
Rachel
If the peaks and troughs are difficult to manage, you might discuss RAI or surgery with your doctor. Also, there's a technique called "block and replace", where they give you anti-thyroid meds to halt your thyroid function, then replace with thyroid hormones.
It looks like you've been testing about every six months??? Since your levels are bouncing around, yes, I'd want to test more often, perhaps every three months, with a retest 4-6 weeks after meds were changed. However, your doctor seems to be very slow to react. In Jan 2013, your FT4 was already well over range, and it took him until Sep to adjust your meds.
FT3 is not tested regularly in the U.K., and it can be hard to get tested in the U.S. as well. T3 is the active form of the thyroid hormones and correlates best with symptoms. Doctors have been taught that "if FT4 is good, FT3 will be, too." I'd say the most frequent complaint we hear here is from people whose FT4 is just fine, but FT3 isn't. If you want FT3 tested, you'll most likely have to go private.
Brand name meds are mainly recommended for the sake of consistency. If you're prescribed a brand name, it will always come from the same manufacturer. The pharmacy can switch who they buy their generics from at any time. During that time period, did you notice any change in the tablets or a change in manufacturer?
Stress, general health, diet, exercise, trauma, surgery, etc. can all affect how much thyroid hormone we need.
Your doctor also seems to like to in/decrease in 25 mcg increments. Rather than increasing 25 mcg, only to have to decrease the same a while later, might it be a good idea to perhaps in/decrease less at a time? Perhaps 112 would be your perfect dose and keep you on a much more even keel?
It looks like you've been testing about every six months??? Since your levels are bouncing around, yes, I'd want to test more often, perhaps every three months, with a retest 4-6 weeks after meds were changed. However, your doctor seems to be very slow to react. In Jan 2013, your FT4 was already well over range, and it took him until Sep to adjust your meds.
FT3 is not tested regularly in the U.K., and it can be hard to get tested in the U.S. as well. T3 is the active form of the thyroid hormones and correlates best with symptoms. Doctors have been taught that "if FT4 is good, FT3 will be, too." I'd say the most frequent complaint we hear here is from people whose FT4 is just fine, but FT3 isn't. If you want FT3 tested, you'll most likely have to go private.
Brand name meds are mainly recommended for the sake of consistency. If you're prescribed a brand name, it will always come from the same manufacturer. The pharmacy can switch who they buy their generics from at any time. During that time period, did you notice any change in the tablets or a change in manufacturer?
Stress, general health, diet, exercise, trauma, surgery, etc. can all affect how much thyroid hormone we need.
Your doctor also seems to like to in/decrease in 25 mcg increments. Rather than increasing 25 mcg, only to have to decrease the same a while later, might it be a good idea to perhaps in/decrease less at a time? Perhaps 112 would be your perfect dose and keep you on a much more even keel?
Hi. Thanks for the reply, it's been a difficult 18+ months. Is there any way of avoiding/combating the peaks and troughs if it is my thyroid spluttering? Should I be asking for more regular tests do think? I don't think I have ever had my T3 measured. Does anybody know if this is done in the Uk as standard and should I be requesting it? Not really sure what it shows either? I have been tested for celiac and addis ones as they thought maybe as absorption issue but these came normal. I am considering requesting a branded Thyroxine at my next prescription as currently taking a generic. Any advice is greatly appreciated as are any comments from anybody who has suffered anxiety etc due to the same problem. Best Wishes Rachel
It's very possible that overmedication caused the problems you had in 2012. Your FT4 in 2012 was 66% of range, which is high of the 50% recommendation. However, note that until Sep of 2013, it went much higher still, went back to 2012 levels in Oct and continues to drop.
You have Hashi's, so perhaps you've been losing thyroid function rapidly in the past couple of years. That would explain the instability. Other life and lifestyle changes could also be affecting your levels by increasing or decreasing demand for thyroid hormones.
You have Hashi's, so perhaps you've been losing thyroid function rapidly in the past couple of years. That would explain the instability. Other life and lifestyle changes could also be affecting your levels by increasing or decreasing demand for thyroid hormones.
I just saw your other thread and I'm going to copy it here so everything is in the same place. If you want to add comments, please add to this thread so everything will be in the same place for everyone to see. Thanks.
Posted by RachT 4 hours ago:
"Hi. I was diagnosed hypothyroid 2008 with Hashimotos. Slowly had Levothyroxine dose raised to 125micrograms over first year and had stayed at that dose for 5 years. In Sept 2012 I began to experience chest pressure, palpitations and dizziness. This came to a head one afternoon where if felt I was having a heart attack. Long story short I underwent cardiac investigation and was given all clear and began during that to have anxiety and panic attacks. That event was put down to a panic attack. I began psychotherapy for 8 months, prescribed SSRI's (took for short period and stopped) Valium. August 2013 I had my annual thyroid bloods and the result came back medically induced hyper. My dose was lowered to 100 micrograms. At that point I googled symptoms and requested my blood results from Oct 2012 and discovered the symptoms were identical to Anxiety and Panic disorder and that my bloods had been Hyper in Oct 2012! So fast forward on dose change bloods in normal range within 6 weeks so left on dose. Retest June 2014 and results Hypo so dose increased back to 125 micrograms. Now waiting for bolls tests in next two ekes to see result of dose change. My question is did the medically induced hyper cause my problems in 2012 and ongoing? Why would my Thyroid suddenly become so unstable? Will my anxiety and panic symptoms subside when my dosage gets balanced again? Thanks Rachel
Posted by RachT 4 hours ago:
"Hi. I was diagnosed hypothyroid 2008 with Hashimotos. Slowly had Levothyroxine dose raised to 125micrograms over first year and had stayed at that dose for 5 years. In Sept 2012 I began to experience chest pressure, palpitations and dizziness. This came to a head one afternoon where if felt I was having a heart attack. Long story short I underwent cardiac investigation and was given all clear and began during that to have anxiety and panic attacks. That event was put down to a panic attack. I began psychotherapy for 8 months, prescribed SSRI's (took for short period and stopped) Valium. August 2013 I had my annual thyroid bloods and the result came back medically induced hyper. My dose was lowered to 100 micrograms. At that point I googled symptoms and requested my blood results from Oct 2012 and discovered the symptoms were identical to Anxiety and Panic disorder and that my bloods had been Hyper in Oct 2012! So fast forward on dose change bloods in normal range within 6 weeks so left on dose. Retest June 2014 and results Hypo so dose increased back to 125 micrograms. Now waiting for bolls tests in next two ekes to see result of dose change. My question is did the medically induced hyper cause my problems in 2012 and ongoing? Why would my Thyroid suddenly become so unstable? Will my anxiety and panic symptoms subside when my dosage gets balanced again? Thanks Rachel
How have you been feeling through all this, especially when your FT4 was over range?
Noticeably missing is and FT3 test.
It's apparent that your doctor, even though he orders FT4, is not paying any attention to anything but TSH. In Jan, '13, dose wasn't changes despite the fact that FT4 was ell over range. In Sep, FT4 was still over range, but he lowered your dose because TSH was getting low.
As you can see in your current labs, TSH is not tracking FT4. FT4 is once again over range, but TSH is still on the high side. This dilemma is almost surely an FT3 issue.
Noticeably missing is and FT3 test.
It's apparent that your doctor, even though he orders FT4, is not paying any attention to anything but TSH. In Jan, '13, dose wasn't changes despite the fact that FT4 was ell over range. In Sep, FT4 was still over range, but he lowered your dose because TSH was getting low.
As you can see in your current labs, TSH is not tracking FT4. FT4 is once again over range, but TSH is still on the high side. This dilemma is almost surely an FT3 issue.
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