Unstable TSH while on medicine

[1_wondering_mom]

I have been on thyroid medicine for over 15 years and have need adjustments to my medicine at times. My levels usually get in range after 2 or 3 months of medication changes.  I was a kidney donor in March.  Since December my TSH has not been in the normal range.  In the last 3 months my TSH continues to go up despite medication changes.  I feel tired all the time, am moody, and have had a sore throat during the last few weeks.  My physician seems unnerved by my blood tests result but I am not comfortable with how I am feeling and the instability of my lab work.  Should I be concerned or is it common for it to take so long to get  "normal"?

[1_wondering_mom]

Thank you for this information.  I have an appt. with an endo dr. next month and have no idea what I should be asking or what to expect.  I have always trusted in my primary dr. and his course of treatment but this latest change is concerning and I am not comfortable with settling for his course of treatment without further investigation.

[gimel]

Based on those test results, the doctor is adjusting your meds based on TSH only.  This is not a good idea.  TSH is a pituitary hormone that is affected by many variables and edoes not correlate very well at all with hypo symptoms.  You need to insist on being tested and treated based on your levels of the actual, active thyroid hormones, which are free T3 and free T4 (FT3 and FT4).  Free T3 is the most important because it is four times as potent as free T4, and it largely regulates metabolism and many other body functions.  Free T3 also correlates best with hypo symptoms.  In my opinion, the very best approach to treatment is to treat a patient's symptoms, by testing and adjusting FT3 and FT4 levels with medication, as required to alleviate those symptoms.  

In addition, I suggest that you get tested for thyroid antibodies, to determine if that is a cause for your fluctuating TSH levels.

[1_wondering_mom]

Most recently I was on 150 of levothyroxin then went to alternating 150 with 112-now back to just 112(which I was on in March to no avail). My labs were 4.5 in April then 9.9 in June and now 13.99.  My hypothyroidism was discovered by my ob/gyn when I couldn't get pregnant a second time.  I have never had anything other than a blood test when it comes to my thyroid.  I have other family members on thyroid meds as well but no one in my family has this much instability with their meds/levels.

[gimel]

For members to give you the best response, more info is needed.  Please post some of your  latest lab test results and reference ranges.  Also, please indicate what brand and amount of medication you were on at different times over the same period as your test data.  What was the cause identified for the original diagnosis of hypothyroidism?