More hypo?!?!

[ACNSC]

I don't have my levels yet, but my levo was increased a few weeks back to 100mcg..and my latest blood work shows my levels have ~increased~...WTH?!?! How is this even possible? I got a call from my endo's office last night asking the standard "what brand, when taking, with what, how long before eating/drinking...every day the same time?" I religiously take my levo (generic synthroid) @ 6AM, and have another alarm @ 6:30AM to wake up and get my coffee..and by 6:45ish drink it. They just called me back and said he will increase/change meds/add something to it at my next appt in 2 weeks, that they usually do it over the phone but he wanted to see me. I have also found that taking synthroid (was given sample packets) makes me ~extremely~ ill, but levo (generic synthroid) I do fine..go figure.

I'm still trying to wrap my head around the "high=hypo / low=hyper"..should be the other way around if you ask me.

[gimel]

I think the best answer is that after a TT your thyroid hormone levels don't go to zero immediately.  They gradually diminish over about 8 weeks.  When you start on a replacement dosage, you have to start low and re-build up levels over time.   At any point in time, if your this dosage is not enough to offset the ongoing loss of natural thyroid hormone then your total levels will drop.  This continues until the effect of your dosage is greater than the loss of natural thyroid hormone.  Then it will increase to eventually reflect the full effect of your daily dosage.  A low starting dose and gradual increases are the best approach, so that you don't unexpectedly flip over into being hyper.  

[ACNSC]

I'll have to go and look at that one on the vitamins. I do have low B-12, vitamin D, and calcium if I don't take my pills daily. So, I'm guessing that my endo is wanting to add/change my meds because the levo is just T4 and not helping? That is what the weird thing I can't wrap my brain around; if my levo is increased, then how can my T levels be decreasing..as they should be increasing aka increased meds should elevate hypo and slow start to become normal or hyper..not decrease to become even ~more~ hypo.  

[gimel]

The answer is yes.  Increasing meds will increase your T3 and T4 thyroid hormones and reduce your TSH (which is a pituitary hormone ).   Increasing your T3 and T4 levels causes TSH to go down.  Increasing T3 and T4 levels will improve and eventually relieve symptoms when you reach your optimum level.  

I would also like to say that hypo patients also frequently have deficiencies in other areas, as well.  For that reason it is a good idea to be tested for Vitamin D, B12, and iron/ferritin.  I also noticed a post from one of  our knowledgeable members, Thyroid Hunter, this morning where he recommended the following.

"B-6 is great for metabolic help, B-12 & D can help with related issues. Focusing on thyroid supplements only, they would be Vitamin A first (almost all thyroid disease and dysfunctionals need vitamin A supplement to assist in nutrition), B-6, C, E (I'm a male and want to keep my hair), and Zinc. All of these can positively affect your health and attitude."  

[ACNSC]

Thank you for being patient with me...I'm having "a moment". Let me see if I got this all correct.. I had TT, which would of course cause me to be hypo (no thyroid=no thyroid hormones)..taking levo (generic synthroid) which is T4 only med, which should decrease my levels (from hypo to more normal/hyper), but instead my levels have increased (from normal/hypo to more hypo/hypo/hypo). <-That is where I'm getting confused. In theory, by increasing my levo it should ~hypothetically~ increase my T hormones to cause me to be more "normal" or hyper..correct?

[gimel]

Definitely qualifies as "hypo hell'.  Increasing your Levo is not making you hypo.  You are hypo because of low thyroid hormones.  Both T4 and T3 test results are below the range, consistent with being hypo.  I disagree with your doctor about FT3.  It is adequately accurate and a lot more informative than total T3.  Keep insisting on testing for it, rather than total T3.

As explained above a good thyroid doctor will treat you by adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by TSH levels.  I suggest that you ask your doctor if he is willing to treat you clinically in this manner.  

If you have any question about this, then I suggest that you read this link.  It is a form letter  written by a good thyroid doctor.  For patients consulting with this doctor from a distance, the letter is sent to the patient's PCP to provide direction for treatment.  

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

[ACNSC]

I wish there was a way to keep your status, maybe a signature of sorts. I know it's hard to remember everyone's ordeal, history and all..which is why I keep forgetting that y'all can't remember who I am, and such..*thunks forehead* b/c I can barely remember,lol.

OK, I don't have the latest blood work that was taken 1/6/2011, but I do have a few from before.  I had my TT 12/3/2010, no hashimotos (per endo..but have had symptoms of both hyper and hypo)

Labs before TT 10/27/2010:
I was on 25mcg of generic synthroid

TSH: 0.12 (0.34-5.60)
T3, Total: 1.79 (0.80-2.05)
T4, free: 1.18 (0.58-1.64)

Labs after TT 12/17/2010:
I was on 50mbg of generic synthroid

TSH: 0.78 (0.34-5.60)
T3, Total: 0.75 (0.80-2.05)
T4, free: 0.55 (0.58-1.64)

Increased to 100mcg of levo, and blood work drawn, and got the phone call. So, increasing my synthroid is making me hypo. Yes, I have asked that he include the T3, free in all future bloodwork, and he agreed..but said "it's not as accurate"..I told him to humor me. ;)

My symptoms ATM are:
Extreme bloatedness
constipation w/ diarrhea (yeah I thought the same thing *blink*)
edema from hell (I take HCTZ for this..but it's not helping)
stomach cramps
increased urination
my face is breaking out (a few cystic pimples..the ones w/ no "head" one them)
not sweating (except feet)
fingers and toes like ice..skin literally cold to the touch
aches in all my joints (feels like I have the flu, but without a fever)
cold to the bone (only steaming hot bathes aid this)
weight gain (water and who knows what else)
hair falling out (not in clumps, but more in my hair brush..and I have to wear a bandanna to cook now)
dry hair (think crunchy, too much hair spray hair)
a ~lot~ more silver white hairs (not sure if this is a symptom, but I'm "graying" earlier than any family member in known history)<-not fretting this one..love the white hair!
Low libido..not that I don't ~have~ one..just "takes longer" KWIM?

I'm a week late for my TOM (not that it's regular anyway), not pregnant..had tubal ~years~ ago.

I guess this is the "Hypo Hell" everyone was talking about?

[gimel]

If your doctor is medicating you based on TSH alone, that just isn't going to work for you.  TSH is a pituitary hormone that is affected by so many variables, including the time of day when blood is drawn, that at best it is only an indicator, to be considered along with more important indicators such as symptoms, and also levels of the active thyroid hormones, free T3 and free T4, (not the same as total T3 and total T4 tests).  FT3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown FT3 correlates best with hypo symptoms, while FT4 and TSH did not correlate very well at all.  

The reason you are having trouble understanding about "high=hypo" is that TSH is the pituitary hormone that signals the thyroid glands to produce thyroid hormone.   When TSH is high, the pituitary is calling for more thyroid hormone (T4 and T3) output.  When thyroid hormone (mainly free T3) is low, you become hypothyroid.

If you will post your thyroid test results, along with reference ranges shown on the lab report, that will help members assess your status.  It will also help if you will tell us about what symptoms you have.  If you have not been tested beyond TSH, then you should request testing for FT3 and FT4 at your appointment.  If the doctor resists those specific tests, you should insist on it and not take no for an answer.  Remember that you are the customer.  

In my opinion a good thyroid doctor will treat you clinically by testing and adjusting FT3 and FT4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief is what should be all important, not TSH level.  If your doctor has a problem treating you in this manner, then ultimately you will need to find a good thyroid doctor that will do so.