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499534 tn?1328707778
Update on starting Tirosint! Barb are you in too??
Hi ALL!  I am starting my 6th week of Tirosint.  I have to say that I feel great and no longer have that foggy feeling I use to get about 2 hrs after taking my synthroid.  I will be going in at the end of this week for labs to see how they look.  I feel pretty darn good!  I am working ....going to college full time....raising my daughter....etc....etc!
All I can say is how THANKFUL I am to feel good again!!  
I am on 125 mcg Tirosint and 20 mcg Cytomel.

Barb- How are you doing on this med??
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649848 tn?1484935765
If your doctor refuses FT3 test, you can order it online.  I've  had good luck with healthcheckusa, but there are other sites, as well.  With healthcheckusa, you order the test online, they send (via e-mail) a lab order for a reputable lab in your area, you go get the blood drawn - choose the option for the TSH, FT3 and FT4 (cost me $85, which insurance did not cover (yours might), but well worth it).  About 2 days after the blood draw, you are e-mailed the results, followed with a hard copy mailed to you.  You can then take this to your doctor; if he still refuses to consider the FT3 result, it might be time to find a different doctor.

Your doctor is sort of right about the antibody issue - I had (notice I said HAD) a doctor who thought that way too, because a Hashi dx doesn't usually change the treatment, but Hashi can make hypothyroidism harder to control, due to inflammation, etc.  It's advantageous to know what's causing the hypothyroidism.  Refusal to test the antibodies is one more reason to find a different doctor, because that indicates that he may not be well versed in thyroid issues.  

There are things you can do to help, such as some vitamins/minerals, etc.

Stella is right - changing from synthroid or levo to Tirosint, could mean that your dosage would change.  I actually raised mine when I switched, but that's because my levels were way too low to begin with; but, because of the better absorption, I think most people would be better off going to the next lower dose for a few weeks, then retest, going up slowly.

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She/we have been struggling to find any Dr in our HMO that our insurance plan will pay for.  This has pissed me off more than any single thing.

Tried to get to see an endo.  The endo clinic said they needed a referral from a PCP.  Got the referral.  Endo wrote a letter back saying they would not see my wife because the PCP is treating her appropriately.  Yet was I think only doing TSH.

We begged, and begged to get the frees and the anti body test and as you see in my post above we got FT4 but TOTAL T3 and refusal to do the antibody tests.

This is absolutely maddening!

All that being said, her current Dr. has been open to continuing to raise her med dosage and my wife seems to be pretty much symptom free.  So in one aspect we are upset, on the other hand she (the Dr.) has treated her to relieve my wife's symptoms.  It would be nice however to know what the Free's are so that we have a baseline as to where my wife feels good.  So that if it is Hashi's or some debilitating thyroid condition where the thyroid continues to be less and less effective, then we at least know where to adjust to get back to where she is today.

Maybe that $85 private lab will be the way to go.  I doubt my insurance would cover that but having the baseline may be worth every penny of that $85.
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649848 tn?1484935765
I will credit your doctor for being willing to treat symptoms, many will only treat labs......

In your situation, I'd highly recommend the $85 test ordered online.  If the FT3 is not where it should be, that would show a reason to either increase med again, or try a low dose of T3 med........

Get the test........... then post the results and reference ranges in a separate thread; we'll try to help you from there.  BTW - have her B12 and vitamin D levels been tested?
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My name is Ladydi0denise I  started  tirosint. 11/1 . Ifedl like a new person like my old self. I had Thyroid Ca in 10/10. I was told this new med was great for Ca patients that had surgery . This past yer I have been up and down with the doses.I am on150mgc daily blood work in 8 weeks. I hope this feeling lasts.
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649848 tn?1484935765
Hi LadydiOdenise, good to have you aboard.  

I'm happy to hear that Tirosint seems to be working for you.  What med had you been on prior to the Tirosint?
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Do you take the Tirosint and Cytomel together?
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I am currently on 112 of synthroid, with an additional 1/2 pill on sundays--- so my endo says roughly 120 average---

I am switching to Tirosint--- she is trying 125--- testing blood in 6-8 weeks.

Current TSH is 1.41  and  FT4 is 1.5

Do you think this will be too high of a dose??

I hope I can figure out a dosage that will work for me.  I really don't want to continue synthroid b/c of the fillers and dyes.  :/
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4201995 tn?1350996441
My levels are T3- 54 and T4- 2.4  TSH 139.76  I just started Tirosint 150mcg, tomorrow will be a week.  I have become allergic to all my Thyroid meds synthroid, Armour all of it.  I do feel better I have been on thyroid meds 20 years becoming allergic was upsetting to me it has never been under control at all I just deal with it.  I am sick of feeling bad all the time.  I sure hope this Tirosint will be the pill I needed.

Pam
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I just started taking Tirosint after being on Levothroid for many many years.  Only after a few days, I felt totally different.  For the better.  Will wait to see how it is as time goes on, but feeling better than I have in a very long time.  I was on  Levothroid137mcg 2 days in a row and 125mcg on the third day, repeating that pattern. My doctor started me out on the same with Tirosint, however, my very first dose of 137 Tirosint was too much.  I knew that within an hour.  Each day since, I have just taken the 125.  Be aware that you may not be on the same exact dosage amount as you have previously taken.  Good luck to all!  Very Happy on my end!
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Can you please let me know if you are you still happy with Tirosint?  I was also on Levothroid 100mcg for many years.  I was upset when they discontinued it considering it took me about a year to get my dosage right. I'm taking Synthroid 100mcg now - since December.  My endo wanted to increase it to 112mcg because he wants my TSH around 1.00 but it's above 2.00.  Within a couple of days of starting the 112mcg dose, I had a bad reaction which may be due to the red dye.  He wants to switch me to Tirosint now because it doesn't have artificial dyes.

I'm hoping for a smooth transition.  
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649848 tn?1484935765
Because Tirosint is so much better absorbed, you may want to start at a lower dose than your previous T4 dosage.  Be sure to test after 6 weeks and make sure your doctor is testing FT3 and FT4, along with TSH.
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I am a Levoxyl patient and am being forced to change meds due to the current recall. Curious for updates from the people who have been on Tirosint for a while and if they stayed on it/how it worked for them long-term. My endo is switching me over to Tirosint at my request when my supply of Levoxyl runs out.

Thanks in advance.
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649848 tn?1484935765
I started on Tirosint when it first came out in 2009 and am still on it.  It's working great for me.  We've  had some members who didn't do well on it; sometimes, I suspect it might be because they started at too high a dosage or didn't give it long enough to get used to it.

Because Tirosint is a gel cap and is more completely dissolved and more readily absorbed, some people find that they need a lower dose than they were on with pill type medication.  You might want to talk to your doctor about starting on a lower dose, then bumping up, as needed, to make sure you don't react adversely.

Most of the previous posters on this thread are no longer active with the forum.
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I had RAI 4yrs ago and was put on synthroid the endo i had told me not to try anything else being new to this i didnt for 3 yrs then i went on a mission to feel better ,and i have tried ARmour (we didnt get along at all ) so then i went to Nature throid and did better however my t4's drop like crazy so we added synthroid to the mix however i have such swelling in my hands face feet, body  due to synthroid I was taking 50 along with 65 NT  but made me a little hyper so my ?? is should i start with 25 of triosint  ??
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649848 tn?1484935765
What are your current thyroid hormone levels?  You should be getting tested regularly for TSH, Free T3 and Free T4.

Swelling is symptom of hypo, not the Synthroid.

Please post your hormone levels and be sure to include reference ranges, which vary lab to lab and have to come from your own report. That will help us better assess your situation.
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Hi Barb and thanks for responding try to make this short about 4yrs ago i had RAI done due to my graves so at that time they put me on synthroid i have always had problems with swelling while taking it so after 3yrs of it i went on a mission to feel better  and i tried Armour not good for me at all  so then i moved on to Nature throid  and the swelling went away but my t4's droped ,so she droped my NT to 65 and a half one along with 25 synthroid  and here are my labs my TSH was 0.164 (range o.450-4.500) and my T4 was 99 (0.82 -1.77) triiodothyonine free serum mine was 6.0 (2.0-4.4) reverse T3 mine 14.3 (9.2- 24.1) and i was not feeling good at all dog dead tierd and my mind was racing like crazy along with my heart . so  at this point im on 65 Nt and 50 synthroid but still feel hyper its been about three weeks since change .Im super sensitive to drugs alittle goes along way for me and i believe the fillers in the synthroid are causing my swelling because on 25 synthroid its not to bad but at 50 and higher im swollen from it . so that is why im checking into Triosint because it has no fillers and i think it may  be a good fit for me . at this point i had to drop down to 25 of synthroid with 65 NT and i feel i need more t4 but not 50.  this can get cazy at times :) but im on a mission to feel good i have had all other female hormones ,cortisol vit d  checked as well and im treating them !   thanks for any input :)
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Im super sensitive to most meds .
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SO awesome ! I just started taking it today :) Im on a low dose of it along with NT (Nature throid .
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I would say if it's NOT broke, don't fix it!  I switched meds because of the Levoxyl recall and my life is a nightmare.  Enjoy feeling okay....don't chance it. Just my two cents.
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I have the opportunity to start Tirosint and have been very sick since I started on Synthroid and Levothyroxine.  I am a Levoxyl recall "cast off" and I feel horrible.  The worst is the 24/7 dizziness in my head and I mean 24 hours a day with NO break since the beginning of April.  I am allergic to corn and I am told that these other meds I have tried are loaded with fillers.  I just feel totally whacked out of my mind.  My "levels" were in the acceptable ranges but I feel like I am totally drunk.  My vision is NOT right either.  Anyway, My doc said I could try Tirosint.  I read online about people NOT feeling good on it.. which can be with ANY meds and I don't feel good on this Levothyroxine either.  I read where people are warning do NOT start on the dose you used with Synthroid or Levo because Tirosint is WAY stronger... start at the lowest dose and work up!  My doc sent a script for the same dose that I take now in the Levothyroxine and I am scared to start it!  
What dose did everyone start at when they started Tirosint? Should I go for it?  I feel awful now, but all my symptoms are in my head, haha.. I mean LITERALLY... dizzy, whacked out eyes... lights are too bright, etc.  From the neck down I am great.  I am afraid of heart palps and all that stuff.

Any advice?? Did everyone start out LOW on their dose and work up or did you just start at your "regular" dose that you took on another T4 med?? I'm so scared to start this.. I know that sounds stupid but I can at least function right now.. I don't feel good while I am functioning, but I can work, drive, etc.  HELP!!!
Signed,
Shakin' in my Boots.  
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Did you start Tirosint as the regular dose you took in your "old" meds?  I am due to start Tirosint and I am prescribed the 100 , the same as I am in Levothyroxine.  I heard you need to start low, not at your regular dose and I am afraid to even start it! Thanks.
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649848 tn?1484935765
There's no need to be scared of starting the Tirosint.  Tirosint is NOT stronger than other forms of T4 med.  Because it's a gel cap and is easier dissolved and absorbed, some people (not everyone) find that they need a lower dose.  

I actually started at a higher dose than I'd been on.... I had been on 88 mcg levo and started Tirosint at 100 mcg.  It ended up being a bit too much, so I backed down to 88 and added more T3.

If you have a copy of your current labs, please post them, and we'll try to give you more information.  Be sure to include reference ranges, which vary lab to lab and have to come from your own report.
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Hi.  I was just looking through my mess of paperwork... and labs I have had done since this whole mess started.  I don't think I have EVER had any T3 test..at least it's not in my copy of labs.  The most recent I have had was back  on May 15. That was during my Synthroid nightmare.  My labs were this:

T4 Free 1.33 with a range of  0.76-1.46
TSH      .37   with a range of 0.36 - 3.74

So WHO knows, my T3 may be non existent for all I know.   Last time I asked her about it she shushed me with her hand and said No.. vee dunt need dat.  (that's her accent).   Okay , now I don't know anything about any of this, but I KNOW from being on here "dat vee DO need dat".  So right there I was like " Okkayy???"  My ENT also said " Nah" when I asked if I need to know that.

WHO are these people?? Don't they teach this in school??? I shouldn't have to go in there with a list of things THEY need to test me for.  
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I was diagnosed last year with Hasi's and it's been quite the challenge finding a medication that is good for me. I started on Synthroid then switched to Armor in March. I was taking Armor 60 for 3 months but still was having horrible mood swings etc. Last week my dr put me on Triosint 88.. I can say that my mood swings and attitude have most definitely improved however despite working out 4+ times a week and eating a 1200 calorie a day diet I'm not loosing nor gaining weight. Typically I cheat on the weekends might go up 2lbs or so but drop it within a few days and the only thing that has changed is my medication.. Please help. Does anyone experience weight gain on this med?
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I should say that I'm slowing gaining.**
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649848 tn?1484935765
Sorry, I missed your message from the 19th.  This is a very old thread and new posts sometimes get lost in the shuffle.  

Your labs (FT4) from May 15, indicates that you might have been heading toward hyper, since your result was very near the top of the reference range, at 81%....... This is where it would have been nice to have an FT3, because if your FT3 were low, we'd consider that you have a conversion issue, if you still have hypo symptoms.  Without FT3, we simply don't know.

There's a history behind it, but doctors are taught in med school that TSH is the gold standard for diagnosing and treating thyroid conditions.  The idea is that if TSH is high, one is hypo, if TSH is low, one is hyper.  In a perfect world, that's the way it should work.  Unfortunately, we don't live in a perfect world; too many of us don't fit that tidy little mold and doctors simply refuse to admit that what they learned might not be completely accurate.

Yes......"vee DO need dat". LOL   If you can't get either of your current doctors to run it, you should look for a doctor who will; otherwise, you can order it yourself online; only problem is that insurance doesn't cover the tests you order online.  You could go to a site, such as healthcheckusa, order the test.  They send you a lab order and tell you which local lab to go to (usually LabCorp).  You go get the blood draw, then a couple days later, you receive the results, from healthcheckusa.  You can get a TSH, Free T3 and Free T4, for about $85 (they should all be run together).  Sometimes, if you have labs in hand, you can go into your doctor's office and get them to listen, sometimes not.  The problem is that you will have to continue to fight for the right tests.  A doctor who orders them without hassle is much better.
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649848 tn?1484935765
Do you have current labs that you could post, so we can see what your actual thyroid hormone levels are?  Be sure to include reference ranges, since those vary lab to lab and have to be posted with results.

Typically, the weight gain is caused from being hypo, not by the medication.  You might also look into insulin resistance, which is quite prevalent.  Insulin is the hormone that determines how your body handles sugar/simple carbs. Insulin is often called the "fat storage" hormone, because if the cells won't let the sugar in, for energy, insulin shuffles them off to the fat cells. Try eating a low glycemic diet, which is one that contains very little sugar and simple carbs, and lots of protein, vegetables, good fats, etc - things that won't spike the blood sugar.  Even if you don't have insulin resistance, the low glycemic is a good diet to be on.

Your profile says you're male; is that correct?
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My TSH is 0.018 - Normal is 0.400 - 4.000
My T3 was normal
My T4 was 1.84 - Normal is .89-1.76

Opps, I just changed that. No I am a female .. 25. other than low sugar oatmeal for breakfast and a piece of whole wheat bread for lunch I don't eat any other carbs. When I overload with carbs or sweets I feel like i'm in a trance and its horrible so I try my best to stay away.

I just called my dr and asked if I can up my triosint to 100mcg from the 88.
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649848 tn?1484935765
With your TSH at 0.018 and T4 (was that Free T4?) at 1.84, which is above the range, I doubt your doctor will give you an increase in med; in fact, s/he will probably want to decrease it.  

Please post the "normal" T3 result, reference range and specify whether it was Free or Total.  Free T3 and Total T3 are not the same tests and don't give us the same information.  I have to wonder if you are having an issue converting the T4 to T3.

There are 2 types of carbs - simple, such as those found in sugar, pastries, white bread, white rice, potatoes, etc. and complex, which are those found in veggies, fruits, whole grains (your oatmeal and whole grain bread would fall in this category).  The complex veggies are the "good" ones........ their fiber doesn't allow them to be broken down quickly, so they don't spike the blood sugar.

Now that we've established your gender, would you mind telling me if you are at an age where you might be close to peri-menopause or menopause, or whether you are younger and might have PCOS?
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I just turned 25. I haven't had a period sine 5/17. I first discovered this disease due to a stopping of my menstral cycle.i was told that I had trouble converting my t4 to t3, I now have my labs in front of me and I have them from last month also...

This month
Free t3 4.08 normal is 1.80-4.70 last mth it was 7.78
Free t4 .75 normal is 0.89-1.76 last mth it was 1.63
Tsh 0.182 normal is 0.400-4.000 last mth it was 0.005

I've never been told I had pcos.
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649848 tn?1484935765
It looks like you might have been in a hyper phase last month, with your FT levels very high. You may be cycling between hyper and hypo, which sometimes happens with early stages of Hashimoto's.

When were these tests taken?
"My TSH is 0.018 - Normal is 0.400 - 4.000
My T3 was normal
My T4 was 1.84 - Normal is .89-1.76"

These are the ones you posted originally, but don't match either of those in your last post.

Have you had an ultra sound to determine if you have nodules that may be leaking hormones, independently of the thyroid?  If not, you should.

PCOS is Polycystic Ovarian Syndrome......... it can cause irregular/lack of periods, weight gain and other thyroid like symptoms.  
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Yes I do have hasimotos, despite my levels I have hypo symptoms currently. But I sometimes have hyper also. I really hope this medication will help. Yes I've had 2 ultrasounds no nodules are present. The results I initially posted we're from my memory... Upon coming home and looking at the levels clearly I was way off.. Sorry about that.
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5946397 tn?1391455333
The posts here have been helpful.  I will be changing to a new thyroid replacement, due to Levoxyl recall; soon, as I am almost out of pills.  

I am sensitive to meds in general.  I have never taken a T3 drug.  Endo was concerned about my anxiety symptoms.  My symptoms have been up and down over the years.  Now, compounded by perimenopause (getting closer to menopause).  Had long bout of Synthroid poisoning (felt near death for months), several years ago.  So...I prefer to avoid escalated anxiety symptoms.

I am thinking of going to TIROSINT.   I have alternated with Levoxyl doses of .137 and .125.  I am anticipating having to suggest a dose to my doctor (local, not Endo), but not sure which one to start on.  Otherwise, I may have to go on a generic.  Not sure yet.

Appreciate suggestions.  

debGardenia7
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649848 tn?1484935765
Anxiety is often a symptom of hypo.  I had it horribly bad when I was hypo.

What do you mean "Synthroid poisoning"?  Were you over medicated?

Of course, I'm not a doctor so I can only make suggestions for you to discuss with your doctor.  

The first thing I recommend is getting tested for TSH, Free T3 and Free T4; that will give an idea of what your actual hormone levels are.  

Many people find that they have to start Tirosint at a lower dose than they were on, with another medication, because it's dissolved and absorbed better than pill type meds.  Since you've been alternating 125 mcg and 137 mcg, and are sensitive to med, you might discuss with your doctor about starting at 100, or maybe even 75 of Tirosint, test TSH, FT3 and FT4, after 5-6 weeks, then adjust based on those results and your symptoms, if any.

If you've had TSH, Free T3 and Free T4 tested recently, please post your results and we might be able to comment further.  Be sure to include reference ranges with your results, since ranges vary lab to lab and have to come from your own report.
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5946397 tn?1391455333
I get my labs done in couple days. Will get: TSH, Free T4 & Free T3 (and misc other).  I had total thyroidectomy, so I do not want to any lower dose than have to.  Maybe 112 mcg Tirosint.  Eek!  I hope this goes well!  
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649848 tn?1484935765
Be sure to post your labs when you get them, so we can see where you're at.
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5946397 tn?1391455333
I will post my labs in about a week.  Thanks for your replies!  
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649848 tn?1484935765
You're welcome.  Will look forward to seeing your labs; you might like to start a new thread with them, in order to separate from this old thread.  Be sure to post reference ranges, as well, since ranges vary lab to lab and have to come from your own report.
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Hi, is this thread still active? I just started Tirosint a week ago and was on Levothyroxine(137mcg). I started having carpal tunnel, tarsal tunnel, joint pain, and muscle aches 4 months ago(the muscle pain a year ago.) Had thyroidectomy 20 years ago and did well on Levoxyl. I did go off all medicine for a year a couple years ago(financial problems.) My symptoms are worse on Tirosint and my doctor didn't do a complete thyroid blood work, just TSH, T3, T4. What blood work do I need and should I demand to try a T3 medication?
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649848 tn?1484935765
Yes, the tread is still active as long as someone posts on it.

You went off thyroid med, after you had a thyroidectomy?  

It's not unusual for symptoms to worsen when starting a new med or when adjusting dosages.

Were those T3 and T4 tests, Free T3 and Free T4 or were they Total T3 and Total T4? They aren't the same tests... Can you please post the results, with reference ranges so we can better assess your situation?
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I was off generic levothyroxine for nearly two months and switched to WP THYROID 65 MG. I felt better than I had in years and then some symptoms returned. I no longer had body aches and pains, eye problems, fatigue issue, insomnia and actually dropped a few pounds. And then my labs came back, so my doctor took me off of WP and put me on Cytomel 5mg and Levothyroxine 100 mcg. Within a day, the brain fog returned, fatigue, eye problems and body pain were present again.

My brand of generic Levothyroxine is made by Lannett, so I checked the inactive ingredients. I have Hashimoto's, so two ingredients caught my attention: corn starch and a form of potato starch. I am highly intolerant to corn in particular and learned that corn, rice and sesame is cross reactive which causes the body to trigger an immune response as if one consumed gluten.

I called my doctor and waited a day for a call back. I explained to her I suspect that the corn and potato starches (potato being in the nightshade family) is triggering an immune response and that I must get off this stuff pronto. She said I could try compounding my medication but was open to my suggestion of trying Tirosint before going that route.

I loved WP Thyroid and felt good, not perfect, but bearable, however my doctor was not happy with how my numbers changed so dramatically. She said I was getting too much T3 and my T4 was way too low. She did not want to lower the dosage on WP, so here I am. Below are my latest lab results from my WP Thyroid trial (6 week period) reported on 10/31/15:

TSH 2.79 (was 3.36 on 9/5/15)
T4 Free: 0.09 (was 1.3 on 9/5/15)
T3 Free: 4.5 (was 2.7 on 9/5/15)
B12: 1419 (was 332 on 9/5/15) - now I take my B12 every other day to lower this number

I hope that I tolerate Tirosint. I adjust to medication very quickly and rarely have side affects. I just wish as a Hashimoto's patient that I knew that the levothyroxine that I was on for the last 5 years was doing more harm that good due to the fillers by contributing to my symptoms and exacerbating my disease state. I would have had better results prior to finding my current provider had I known,

Did not make the connection until trying both synthetic and natural desiccated medications. I am curious to know if other Hashimoto's sufferers have made a connection with medication fillers aggravating their symptoms.
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649848 tn?1484935765
What are the reference ranges for your FT4 and FT3?  Reference ranges vary from lab to lab and have to come from your own reports.  

These labs posted are when you were taking the WP?  

We've had some members that have reactions to fillers/dyes in the meds, but that's really quite rare.

Most people tolerate Tirosint quite well, because there's really nothing in it to be allergic to - that's why it's considered hypoallergenic.  The biggest problem with Tirosint is that Tirosint is better absorbed than other T4 typr meds, and doctors often try to start patients on too high a dose. Another problem is that many patients don't stick with it long enough for it to work.  

I was on it from the time it came on the market in 2009 until August of 2014 and I did great on it.  I hope you do, also...
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My apologies. I had my labs drawn at Quest and their reference ranges are as follows:

T4 Free: 0.8-1.8 (ng/dL)
T3 Free: 2.3-4.2 (pg/mL)
TSH: 0.40-4.5 mIU/L

Yes, you are correct,the labs were posted while I was still on WP. I discontinued WP and switched over to the synthetics on 11/14. I am hoping in combo with the Cytomel that I can find a balance because dealing with the symptoms is affecting me in all areas of my life. I have a 5 year old son to chase after, so I'd love to be more of an active participant  in activities with him than being an observer. That's how tired I've been for awhile now, especially before my Hashimoto's diagnosis in August 2013 :(
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I agree with your doctor that your FT3 was too high and FT4 was too low... it would have been very simple to lower your WP dosage and add a bit of T4 vs starting all over, but you're into this regimen now, so I do hope it works for you.  

The advantage of taking synthetics is that you can adjust them individually, whereas with desiccated hormones, you can't.

You said you'd been on 100 mcg levothyroxine... is that the same dose of tirosint she put you on?
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Yes, she is putting me on the same 100 mcg dose for Tirosint.  She did not feel that I would benefit from lowering the WP dosage and still end up with FT4 numbers that would still be low.

We're doing a trial run with Tirosint and Cytomel and checking levels again in 6 weeks. She did mention that if I'm still having issues with the synthetics then we can try compounded medication in which she's had experience with. I am happy that I found a doctor who is open to different options which was a struggle for the last 5 years.
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Hello.  I started on Tirosint about 13 weeks ago.  Prior to that I was on Levothyroxine 88MCG.  I first started on 75 MCG and after 6 weeks my endo checked my blood work.  Here are my numbers from 10/16.
Free T4 1.3 (Range .8 - 1.8)
Total T3 86 (Range 76 - 181)
TSH 4.77 (Range .4 - 4.50)
My endo is looking at both symptoms and numbers.  My TSH was high enough for him to ask if I was even taken Tirosint.  He then upped me to 88MCG and last week he checked the TSH level and it is now at 3.19.  He wants it 1.0.  I see him tomorrow and I am guessing he is going to up my dosage to 100MCG.  I am hoping it helps because I am always feeling tired and warn out so much so that I have been also been diagnosed with moderate depression and prescribed an AD for it.  I do have Hasimoto's and some nodules which they are monitoring closely.  They check the nodules every three months.  It appears I am a rarity on the boards because I am male but this stuff runs on my mom's side of the family.  She had her thyroid removed when she was a teenager.  I am also going to ask him why he switched me to Tirosint.  I didn't ask initially, I just accepted that he knew what was best for me.  This is the first endocrinologist I have seen and he was highly recommended to me by my ENT doctor.  
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As I guessed previously my dosage was pushed up to 100MCG.  Hopefully this gets me where I need to be.
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From one hypothyroid male to another, yes we are outnumbered by somewhere between 5-8 to one.  

You seem lucky to have found your Endo on the first try, since he is looking at both symptoms and numbers; however, his focus on getting your TSH to1 worries me.  There are scientific studies that show that TSH is usually suppressed when taking adequate thyroid meds.  I can supply links if you want.  Treatment for hypothyroidism should be based on symptoms first and test results for Free T4 and Free T3 second.

Looking at your test results, with that med/dosage, your Free T4 is fine, but you were tested for Total T3, not Free T3.  You should make sure they always test for both Free T4 and Free T3.  If your Free T3 is comparable to your Total T3, relative to position in range, then your Free T3 would be too low and likely to cause hypo symptoms.  Also, since your Free T4 is at 50% of its range, but your Total T3 is only at about 10% of its range, which indicates that you may not be adequately converting the T4 med to T3, and may need to add some T3 to your meds.  You can tell more when tested for Free T3.  You will also know more about your doctor when you ask about clinical treatment, as described, and willingness to prescribe T3 meds.  

A good thyroid doctor  will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve hypo symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH when already taking thyroid med.  

Also, hypo patients are frequently too low in the range for Vitamin D, B12 and ferritin.  Low levels can cause symptoms that mimic hypothyroidism.  Low D or ferritin can also adversely affect metabolism of thyroid hormone.  D should be about 55-60, B12 in the upper end of its range and ferritin about 70 minimum. If not tested for those you should do so and supplement as needed to optimize.  
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TZT
Thanks for your reply.  I will bring up free T3 with my endo doc before my next blood draw which is in six weeks.  I take a D3 and B12 supplement daily.  I just want to feel normal again.  I am sluggish all the time.  
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Ferritin is very important also.  Be sure to test for that.
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I had my thyroid removed on 2/16 and things are going smoothly so far.  I am just tired.  It will take some time to get the meds right.  I am also switching to a new endocrinologist because my current one just doesn't seem interested in hearing my thoughts on my own body.  My ENT doctor is awesome and is the doctor that removed my thyroid.  I received the pathology report back on Wednesday and my nodules were benign but growing.  It also once again was confirmed I had Hashimotos. The report stated "Significant Lymphocytic Thyroiditis".  I started on 112MCG of Tirosint the day after surgery and I will get check in about 4 weeks.  
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