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Questioning the lowering of my synthroid dose
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Questioning the lowering of my synthroid dose

I had a total thyroidectomy 30 years ago when I was 24 years old for encapsulated single nodule papillary cancer with no metastases.  I received the  i131 radiation ablative dose 8 years later.  Normal scans and lab work since, although the specific lab tests ordered have varied for some reason through the years so it has been slightly frustrating to track changes in these levels over time..  I have been on .2mg of synthroid daily for at least 20 years and have felt good and maintained my typical weight. I have been followed by my family physician yearly (and occassionally have seen an endocrinologist - as recently as 3 years ago, who thought my labs were good).

Recently my family physician said he thought my T4, free  was getting too high (2.1).   - having a reading of TSH that remains consistent at around .04 -.06) .He decided  he wanted to reduce my synthroid to .175.  I am now experiencing noticeable constipation, feel a bit more sluggish and am frustrated at this dose change.
My recent lab work (August 2009) was as follows:  T4 (free) - 1.6      TSH remains at .05.
My question is whether using just the T4 free and TSH are the best lab tests to measure whether my dose is accurate.
I prefer to remain on the .2mg as I felt fine.

Up until 2005 I was getting the following lab tests ordered, but for some reason my family physician is no longer checking these and instead just does the T4, free and the TSH.

T3 uptake,   T4 total,   T4 Index T4 free, calculated       (NOT the T4,free  test)

What exactly are the best lab tests to get annually to be sure my synthroid dosing is not excessive? (I am no longer worried about any recurring cancer)


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