Aa
advice on level of levothyroxine
background - excess sweating, hitting energy wall, lack of thirst
initial blood work - August 5, 2012
TSH 11.933 0.400 - 4.200 mcU/mL
FT4 0.6 0.6 - 1.5 ng/dL
endo started on 75 levothyroxine
October 30, 2013 blood work
TSH 17.000 0.400 - 4.200
FT4 0.6 0.6 - 1.5
so free T4 hasn't changed but TSH has risen even higher.
endo is recommending 88 levothyroxine
question - since 75 didn't do anything positive, is 88 levothyroxine sufficient or is a higher dosage of levothyroxine or even synthoid warranted? many posts i have seen are arguing that levothyroxine doesn'gt work for them, but synthoid does. any advice appreciated - i am so confused - don't want to doubt endo but someone who has been thru this disagrees with endo's level.
initial blood work - August 5, 2012
TSH 11.933 0.400 - 4.200 mcU/mL
FT4 0.6 0.6 - 1.5 ng/dL
endo started on 75 levothyroxine
October 30, 2013 blood work
TSH 17.000 0.400 - 4.200
FT4 0.6 0.6 - 1.5
so free T4 hasn't changed but TSH has risen even higher.
endo is recommending 88 levothyroxine
question - since 75 didn't do anything positive, is 88 levothyroxine sufficient or is a higher dosage of levothyroxine or even synthoid warranted? many posts i have seen are arguing that levothyroxine doesn'gt work for them, but synthoid does. any advice appreciated - i am so confused - don't want to doubt endo but someone who has been thru this disagrees with endo's level.
I agree with ahmee. Your FT3 was adequate in August. I don't see adding more T3 (desiccated has a lot of T3 in it) as a solution. It's your FT4 that needs to come up. I also agree that TGab should be tested. Some people with Hashi's are only TGab positive and not TPOab.
Since your FT4 didn't change at all with the addition of 75 mcg of T4, I'd look to absorption issues. Some of us get away with drinking our coffee right after our meds, but since absorption is a question at this point for you, I'd play by the rules and see if the coffee is interfering with absorption.
Since your FT4 didn't change at all with the addition of 75 mcg of T4, I'd look to absorption issues. Some of us get away with drinking our coffee right after our meds, but since absorption is a question at this point for you, I'd play by the rules and see if the coffee is interfering with absorption.
tnx for taking the time to read and respond. i am going to try to convince my endo to switch to a desiccated thyroid protocol, rather than a T4 protocol. the T4 is just draining me too much of energy.
tnx.
m
tnx.
m
I would say you should really hold off on the coffee for 30 minutes if at all possible-- though I know some people like Barb will say that some just can't wait! As long as you are consistent in what you do... it might affect your absorption somewhat to drink the coffee early, but if you have to, you have to. Personally, reaching the right dose of thyroid meds has supplanted the need for coffee for me!
Your Free T3 was at 65% of range, so it looks like you are converting T4 to T3 properly. But your T4 is still very low, so you do need more medicine. Starting with 88mcg is good. Be sure to re-test in 6 weeks like goolarra mentioned.
As far as Hashi's goes, it would be prudent to test for TgAb in addition to the TPOAb test you already had. Either can indicate Hashi's. Also testing for iodine insufficiency could be a good idea, as that may be the cause if Hashi's is not.
I have heard of excessive thirst as a symptom of hypothyroidism. If you can't bring yourself to drink enough water, you are probably retaining fluid for some reason. I would not be surprised if it is tied in to the hypothyroidism, especially if that symptom began to appear at the same time as other hypothyroid symptoms.
Your Free T3 was at 65% of range, so it looks like you are converting T4 to T3 properly. But your T4 is still very low, so you do need more medicine. Starting with 88mcg is good. Be sure to re-test in 6 weeks like goolarra mentioned.
As far as Hashi's goes, it would be prudent to test for TgAb in addition to the TPOAb test you already had. Either can indicate Hashi's. Also testing for iodine insufficiency could be a good idea, as that may be the cause if Hashi's is not.
I have heard of excessive thirst as a symptom of hypothyroidism. If you can't bring yourself to drink enough water, you are probably retaining fluid for some reason. I would not be surprised if it is tied in to the hypothyroidism, especially if that symptom began to appear at the same time as other hypothyroid symptoms.
yes, i take my levo first thing in the morning without food upon rising. but i do drink my coffee w/in 30 minutes - if that a problem?
back at the august 5 results;
T3 FREE 2.8 1.5 - 3.5
but wasn't retested in october. will request that at the next draw - 8 weeks from now.
as for the Hashimoto's thyroiditis, my endo say this test rules that out;
THYROID PEROXIDASE ANTIBODIES (TPO) 6.1 0.0 - 9.0
yes - 88 is better than 75 - course, i would like it to raise my FT4 and lower my TSH.
is lack of thirst an issue to any of this?? i STRUGGLE to drink even 32 oz of water whereas previously, i was downing 3 quarts/day easily.
TIA to all who have responded and others who might respond. i appreciate your taking time too look and comment.
T3 FREE 2.8 1.5 - 3.5
but wasn't retested in october. will request that at the next draw - 8 weeks from now.
as for the Hashimoto's thyroiditis, my endo say this test rules that out;
THYROID PEROXIDASE ANTIBODIES (TPO) 6.1 0.0 - 9.0
yes - 88 is better than 75 - course, i would like it to raise my FT4 and lower my TSH.
is lack of thirst an issue to any of this?? i STRUGGLE to drink even 32 oz of water whereas previously, i was downing 3 quarts/day easily.
TIA to all who have responded and others who might respond. i appreciate your taking time too look and comment.
At your next blood draw, you will want to request the test for Free T3 in addition to the two other tests. Patients often find Free T3 levels best correlate with their symptoms. You will want to monitor it in conjunction with your Free T4, which, as you have noted, is at rock-bottom. More medicine needed. 13 mcg is a pretty conservative raise, but something is better than nothing at this point.
Some people are more sensitive to different brands, but I am not sure I would change brands at this point-- just another variable to add to the equation, and it might make things confusing. It may be that you are not absorbing the medicine well due to digestive issues, or your body is producing even less hormone than before in response to the new incoming medicine. Do you take your medicine first thing in the morning on an empty stomach? Keep in mind you should not eat or drink anything for at least 30 minutes after as well.
Have you been tested for Hashimoto's? Would be listed as TgAb and/or TPOAb on bloodwork.
Some people are more sensitive to different brands, but I am not sure I would change brands at this point-- just another variable to add to the equation, and it might make things confusing. It may be that you are not absorbing the medicine well due to digestive issues, or your body is producing even less hormone than before in response to the new incoming medicine. Do you take your medicine first thing in the morning on an empty stomach? Keep in mind you should not eat or drink anything for at least 30 minutes after as well.
Have you been tested for Hashimoto's? Would be listed as TgAb and/or TPOAb on bloodwork.
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Your doctor should be testing FT3 as well. FT3 is the biologically active thyroid hormone, so key to how you feel.
Your FT4 is way too low. Rule of thumb for FT4 is midrange, and yours is on the floor.
It's always best to increase slowly. I doubt that 88 mcg will bring you to optimal levels, but it's best to increase that much, retest in 4-6 week, re-evaluate symptoms and increase more then if necessary.
For me, personally, I see absolutely no difference between Synthroid, Levoxyl and generic levo. Other people have different experiences.
I'd try to get my FT4 to midrange, ask my doctor to test FT3 every time labs are drawn and go from there.