Question regarding dosing and labs

[kelly505]

Hello Everyone,
I was diagnosed with Hashimoto's this summer. TPO antibodies >1000 and thyroglobulin antibodies at 32.
I have a goiter and the thyroid US showed microcystic and hetrogeneous parenchyma. At that time I was having
hair loss, extreme fatigue, sudden weight gain of 10lbs, and other symptoms.  TSH was 2.22, Ft4 1.2(0.8-1.8)and Total T3 150(97-219).
no FT3 checked.  The first Endo I saw told me that my symptoms were in my head and to loose weight.
I went for a second opinion and that Endo started me on Synthroid 50mcg. After 6 weeks my TSH was .99 and FT4 was still 1.2. I was still having symptoms--he increased the dose to 75mcg. After 6 weeks my labs now show
TSH 0.03, FT4 2.1, Total T3 257.  I have not been able to speak to to my Dr.  I think now this dose may be too high?I have been feeling my heart faster than usual at times.
I was wondering if anyone has any thoughts? and will I ever find a dose that I will feel well at?  Just tired of feeling bad everyday.   Thanks

[TamraW]

Welcome to the Hashi club!

Eventually, as the thyroid is eaten by the antibodies, and as we are trying to get the pituitary to tell the thyroid to shut down, those of us with Hashi will need to be on a strong enough dose of thryoid meds to do that.

You may find in a few months that 75 mcg is not enough. However, right now, it sounds like you are having some hyper symptoms. I think you should call his office and let him know what's happening.

Your FT4 is high. I have no idea why the doc isn't testing the FT3 levels.

I was feeling terribly hypo after taking 75 mcg, so my doc bumped me to 88, and then I got bad heart palps, shaky hands, ear ringing, etc. I went back to the 75 mcg and called him to let him know that I just couldn't take the bump. Very strange, considering how hypo I was before.

I am still on the 75, but he started me on a low dose (5mcg) Cytomel. I am splitting my Cytomel half in the morning, half an hour before dinner.

So far so good...

My wonderful endo, who I found after firing the first three, said that eventually, I will need more thyroid meds.

I chose my new endo because he believes in testing and treating FT3 levels. Too many docs refuse to consider FT3 levels in treatment.

Here's where I found him: http://www.thyroid-info.com/topdrs/

The list isn't a guarantee. I saw my mom's clueless endo on this list. I called his office and spoke to his receptionist. I found out that he sees 75 percent thyroid patients and he tests and treats FT3 levels.

:) Tamra

[kelly505]

Hi Tamra,
Thanks for your response.  Yes, what happened to you is probably what is happening to me. I feel somewhat relieved now.
I still felt hypo on 50mcg but I don't think I can tolerate the 75mcg yet.  I have also been feeling shaky hands etc...,  and yet still tired,muscle/joint aches,hair loss etc... Very strange--sometimes I'm wondering if I am loosing my mind??
I am going to try to talk to my Endo about the Ft3--that is different than the Total T3 right?   I had an appt. with my PCP this week and tried talking to him about it but he had no idea what I was talking about.
Thanks again!

[goolarra]

The increase from 50 to 75 appears to be too much for you.  You might try asking you doctor to increase your dose to 62.5 mcg (a 50 mcg tablet plus half a 25 mcg tablet, or alternate 50/75 every other day).  When you report your hyper symptoms, he might advise you to discontinue meds for two or three days to get your levels back down, then resume at the lower dose.  A 50% increase in one fell swoop is a big increase.