TSH level low but was feeling fine until my dosage was lowered

[JoanieV]

I had total thyroidectomy in april due to nodules continually getting larger and began compressing against esophagus. My thyroid levels were normal T4  1.02 and TSH 1.76 before surgery, After going through having these nodules drained every 6 months was only putting off the inevidable. With that said, when I had my blood work done after the surgery and started on the synthroid .125 my tests came back that my T4 was 1.92 and my TSH was 0.475. But I was feeling fine, no symptoms that my endo expected I might feel from what the numbers showed. I had no palpitations or problems. I felt very good.  So we gave it a month to see how the next blood work would be. Turns out I was still feeling great but my T4 was now 1.82 and my TSH was 0.165 which had gone down. So she suggested we change the dosage so she lowered it to 112. Because I still had some of the 125 left, she said to just skip one day which would bring it down to the dosage of 112 in order to bring that TSH level up. After doing this for 2 weeks I have begun to feel extremely tired, with no ambition or energy, difficult falling asleep and difficult waking in the morning, I also have begun experiencing dizziness and light headedness after I eat.  I tend to shrug it off as im just tired but the symptoms are not going away...I am hoping we can get these leveled out because the lower dosage doesn't seem to work. I am going for blood work tomorrow to see what that shows since I have been on this lower dosage for 2 weeks. Has anyone else had this experience of feeling great when the numbers say you shouldn't?

[gimel]

Many doctors don't understand that the body evolved  with a continual flow of a small amount of thyroid hormone during the whole day.  When you take a full daily dose of med at once, it will suppress the TSH for  a day or so.  In addition, there are several scientific studies that have shown that frequently the TSH becomes suppressed when taking doses of thyroid med adequate to relieve hypothyroid symptoms.  So having a suppressed TSH does not mean that you are hyper and need to have your meds decreased, unless you have hyper symptoms due to excessive levels of the biologically active thyroid hormones Free T4 and Free T3.  You haven't even been tested for Free T3 and it is the one that correlates best with hypo symptoms.  You should make sure they always test for both Free T4 and Free T3 every time you go for tests.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results.  TSH is basically a useless test when already taking thyroid medication.  You can get some good insight from this link written by a good thyroid doctor.  

http://www.hormonerestoration.com/Thyroid.html

So tomorrow you should emphasize your symptoms that have returned since med was decreased.  You should also point out that a suppressed TSH is meaningless when taking significant doses of thyroid med, unless you have hyper symptoms due to excessive Free T4 and Free T3, which you will not have when tested.  

Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  I highly recommend that you should get those tested and supplement as needed to optimize.  D should be about 55, B12 in the upper end of its range, and ferritin should be about 70.