My levels of tsh, 3rd generation w/reflex to ft4 are 36.98
and the t4, free are 0.7
I currently take synthroid 112 mg.
Do i need to take a higher dose or a lower dose of the synthroid????
and what further testing should i have done?
You need to increase your dose. You are hypo. High TSH and low FT4 indicate hypo.
FT4 should always be tested regardless of TSH level (w/reflex to FT4 is an instruction to the lab to test FT4 only if TSH is out of range). You should also request FT3 regularly. This is the most active of the thyroid hormones and correlates best with symptoms.
Do you know the cause of your hypo? If not, it might be a good idea to test thyroid antibodies (TPOab and TGab) to see if you have autoimmune thyroid disease (Hashimoto's).
I have hypo for 33 years after I gave birth to my first child. It has been pretty much under control but for some reason it has not been stable for a couple of years. I also have a small nodule that he checks every year. Last year it had grown a little bit more, but he feels that he will just keep an eye on it for now.
What I meant to say is that your hypo is no longer corrected adequately by your meds. You need an increase to bring your levels back into line. I can imagine that you must not feel too well. Not only is your TSH very high, but your FT4 is low, too. Are you going to see your doctor about an increase , or has he already suggested one?
Three months is a long time to wait. When meds are being adjusted, the usual time for labs after a dosage change is five to six weeks. Of course, if you're feeling better, it's not a big problem, but if your symptoms persist, you'll be wasting six weeks.
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