Total Thyroidectomy & Synthroid Dosage

[lilypad300]

I know it's different for everyone, but what is the average dose of synthroid for people who have has a thyroidectomy?  
My doctor started me off on .175 and then I had an anxiety attack the other day (see journal)  today he said my numbers were good, but reduced me to .137 and gave me some .150 samples as well.  He said to start on the .137 and if I felt sluggish to take the .150's .  How will I know the difference between general fatigue and not enough synthroid.  Would the .175 have caused my anxiety attack?  

help!
thanks!

[annie_2013]

these are so far the results I have, still waiting for the freeT3 , which I think is the one the doctor said was slightly high.

T4,Free(Direct) 1.38      ng/dL      ref. range 0.82 − 1.77

TSH 1.260      uIU/mL                 ref range-0.450 − 4.500

Thyroxine (T4) 11.5      ug/dL      ref. range 4.5 − 12.0

Triiodothyronine (T3) 90     ng/dL      ref. range 71 − 180

[annie_2013]

oh and i will insist on the Free T4, I dont think this doctor requested that test

[annie_2013]

So I got the call from endocrinologist nurse saying they got the first results which were the T3 T4 and TSH and they were normal, the nurse told me to stay on  synthroid.1mg.  She said to keep taking it until they get the freeT3 and other results. Later my obgyn called (he has also been checking my tsh hormones and  I called him to tell him about my symptoms 2 days ago so  he called the lab and requested a copy of the results to be sent to him.   He said before he went home he checked and found that my free T3 level was slightly elevated and asked me to stop the medicine until monday, he will talk to my endocriologist.  I havent gotten the numbers of lab results on my email...but his call made me nervous, my pulse has not gotten to the 100's  unless I walk the whole day...but still Im scared about my heart , I've read about atrial fibrillation and I did make an appointment with the cardiologist this monday... Im wondering if not taking the medication will make any positive changes soon? Now im thinking what you have said in other posts, that doctors base their decisions on the t3 t4 and tsh results this is what this endocrinologist did she told me to keep taking the same dosage before getting the free t3 numbers...I will start to look for another one ASAP. i will still post my results and I would appreciate any info or advise you could give me on those...thank you so much for every single reply you make to all of us on this thread...God bless you

[annie_2013]

thank you so much for all your information and advise, I will definitely ask my doctor to send me to have these tests done...I am anxiously waiting for my results today or monday and I cant wait to show them to you too.  =)

[gimel]

After having a TT, and taking 125 mcg of T4 med, I am somewhat surprised that your T4 levels are as high in the range.  That is not such a huge dose as to account for your experiences.  Which makes me wonder even more about your Free T3 levels and also your ferritin/iron levels.  Low ferritin/low iron can affect in several ways, including adversely affecting the conversion of T4 to T3.  Also, from what I have read, ""Low ferritin can cause negative reaction like palpitations, nervousness, and anxiety in someone starting thyroid hormone replacement.  Someone described it like being shot out of a cannon.  It is therefore imperative that ferritin not be at the bottom of the range before starting thyroid hormone medication."
I think this can also apply if your ferritin/iron levels get too low while already taking thyroid meds.    

Following are some of the symptoms of low ferritin.

Minor aches
    Fatigue
    Weakness
    Heart palpitations
    Increased pulse
    Loss of energy
    Loss of libido
    Confusion
    Irritability
    Shortness of breath

So just be aware that it is recommended that ferritin should be about 70-80 for women.  All the above is why I recommended that you should be tested for Vitamin D, B12 , ferritin and a full iron test panel.  One other I want to add is magnesium.  

When your Free T3 result is available, please post with reference range.  When additional tests are available, please get a copy of the lab report and do the same for those.   If those don't reveal anything then you will need to do some further testing.   But let's wait and see what we find out from these tests.
  

[annie_2013]

by the way they are also checking thyroglobulin to make sure there is no cancer tissue producing tsh hormones