Aa
maximum dosages?
I've been patiently waiting for the past year to get back on track and feel good since having my son and having Postpartum thyroiditis, and i think i've had only a few brief times that i've actually felt good "meaning no thyroid symptoms" for the past year, but then my levels haven't been "in range" either, but are closer now.
I'm mostly hypo symptoms, but have "brief episodes" of hyper symptoms like right now... they just increased my dosage again too so that explains that.
I was diagnosed hashimotos 3 years ago, i've fluctuated hypo/hyper and been thru hell with it especially after having my son a year ago, so it's been a long road for me. but me and my doc both think this is the end of the road for my thyroid, She believes that i'm almost at what my max is going to be, meaning i'm almost 100% synthroid with very minimal function of my thyroid gland.
My doc thinks that 125mcg is going to be my max based on my height and weight which leads me to my question..
i know that people who have no thyroid gland are on synthroid in the 200mcg dosages, why would i only need 125mcg at max dosage? does this actually mean that my thyroid gland is not producing AT ALL? if so why wouldn't i need an even higher dosage to meet the needs that my thyroid gland is not producing?
is the height and weight maximums accurate?
my most recent labs:
March
TSH - 26.6 (0.3 - 4.5)
FT4 - 1.0 (0.7 - 1.4)
Hypo symptoms increased dosage to 112mcg
May
TSH - 7.43 (0.3 - 4.5)
FT4 - 1.3 (0.9 - 1.7) "different lab from last time"
Hypo symptoms doc said no changes in dosage because my FT4 was "within range"
June
TSH - 14.8 (0.3 - 4.5)
FT4 1.2 (0.7 - 1.4)
Worsening hypo symptoms and so i was increased to alternate 112mcg/125mcg for an average of 118.5mcg..
I"m feeling some "HYPER" symptoms after 7 days of alternating.. do you think it's because i have to metabolize the new dosage or do you think my FT4 was close enough to norm and now the addition of the synthroid has pushed me too far? I was feeling HYPO before the increase and my TSH was indicative of HYPO which makes sense, but my FT4 was close to upper limit and now i'm feeling HYPER after 7 days of increase.. I'm confused...
I'm mostly hypo symptoms, but have "brief episodes" of hyper symptoms like right now... they just increased my dosage again too so that explains that.
I was diagnosed hashimotos 3 years ago, i've fluctuated hypo/hyper and been thru hell with it especially after having my son a year ago, so it's been a long road for me. but me and my doc both think this is the end of the road for my thyroid, She believes that i'm almost at what my max is going to be, meaning i'm almost 100% synthroid with very minimal function of my thyroid gland.
My doc thinks that 125mcg is going to be my max based on my height and weight which leads me to my question..
i know that people who have no thyroid gland are on synthroid in the 200mcg dosages, why would i only need 125mcg at max dosage? does this actually mean that my thyroid gland is not producing AT ALL? if so why wouldn't i need an even higher dosage to meet the needs that my thyroid gland is not producing?
is the height and weight maximums accurate?
my most recent labs:
March
TSH - 26.6 (0.3 - 4.5)
FT4 - 1.0 (0.7 - 1.4)
Hypo symptoms increased dosage to 112mcg
May
TSH - 7.43 (0.3 - 4.5)
FT4 - 1.3 (0.9 - 1.7) "different lab from last time"
Hypo symptoms doc said no changes in dosage because my FT4 was "within range"
June
TSH - 14.8 (0.3 - 4.5)
FT4 1.2 (0.7 - 1.4)
Worsening hypo symptoms and so i was increased to alternate 112mcg/125mcg for an average of 118.5mcg..
I"m feeling some "HYPER" symptoms after 7 days of alternating.. do you think it's because i have to metabolize the new dosage or do you think my FT4 was close enough to norm and now the addition of the synthroid has pushed me too far? I was feeling HYPO before the increase and my TSH was indicative of HYPO which makes sense, but my FT4 was close to upper limit and now i'm feeling HYPER after 7 days of increase.. I'm confused...
Is the 300 mcg adequate to relieve all symptoms of hypothyroidism? The reason I ask is that frequently hypo patients taking large doses of T4 (I assume) med find that their body does not adequately convert the T4 to T3. Since Free T3 largely regulates metabolism and many other body functions, It is vital that the level of Free T3 is high enough to relieve symptoms.
So before getting into anything further right now, please post your thyroid related test results and related reference ranges shown on the lab report so that we can assess the adequacy of your testing and treatment.
So before getting into anything further right now, please post your thyroid related test results and related reference ranges shown on the lab report so that we can assess the adequacy of your testing and treatment.
Hi! I have some questions about my thyroid. I started taking levothyroxin at the age of three because my thyroid never developed. I have to take it for life now. I'm extremely heathy and athletic and have tried to make up for all the side effects. I have slowly had my dosage go up through the years. I am now 36 and I am now taking 300mcg's. I believe this is max dosage and it worries me. I don't know what comes next or what I can do to try to keep it there or lower it. Any suggestion would be great. I don't know anyone in my situation and it's frustrating.
COMMUNITY LEADER
Whew, I'm certainly glad there wasn't anything about u/s in your first post - that would have really made me look "foggy".............lol
A goiter is an enlarged thyroid, so yes, if your thyroid is swollen, that means there's inflammation, which can make you feel "yucky". At least your doc acknowledges the fullness in your throat - my "former" pcp kept telling me, it was all in my head. No, it wasn't; it was in my throat!!!
I hate to sound like a broken record, but until you get an FT3, to go along with the FT4 and TSH, you are pretty much shooting in the dark. It's very possible that you aren't converting the FT4 to FT3, but you can't know without an FT3. And there's a chance that you will need a T3 med; again, you can't know that without an FT3. Sorry, but you just gotta have that test!!
You should always get a copy of your lab report and it's a good idea to jot down your symptoms/how you feel at those levels; that way, when you DO get labs done and you are feeling well, you will know that those are the levels to shoot for.
Can't argue that the days of being symptom free are certainly appreciated, once you've been through the he// of being hypo or hyper..........
A goiter is an enlarged thyroid, so yes, if your thyroid is swollen, that means there's inflammation, which can make you feel "yucky". At least your doc acknowledges the fullness in your throat - my "former" pcp kept telling me, it was all in my head. No, it wasn't; it was in my throat!!!
I hate to sound like a broken record, but until you get an FT3, to go along with the FT4 and TSH, you are pretty much shooting in the dark. It's very possible that you aren't converting the FT4 to FT3, but you can't know without an FT3. And there's a chance that you will need a T3 med; again, you can't know that without an FT3. Sorry, but you just gotta have that test!!
You should always get a copy of your lab report and it's a good idea to jot down your symptoms/how you feel at those levels; that way, when you DO get labs done and you are feeling well, you will know that those are the levels to shoot for.
Can't argue that the days of being symptom free are certainly appreciated, once you've been through the he// of being hypo or hyper..........
haha i know it was a long post of mine and lots of info, mention of u/s was not included :) sorry you re-read all of that...
I HAVE had 2 ultrasounds however and the findings are below:
December 2008 - u/s of thyroid indicated. Right lobe 5cm.. Left lobe 4.4.. Echo texture is heterogeneous without focal dominant mass.
September 2009 - u/s of thyroid indicated. Right lobe 5.3 x 1.4 x 1.6.. Left normal 4.1 x 1.7 x 1.6 cm.. Dimensions stable. Heterogeneous echo pattern but no discrete masses or other pathology. Changes most likely related to goiter.. Findings stable.
I don't know if any of that is indicative of nodules or not.. I know i feel a "fullness" in my throat alot and my doc said when my TSH gets high i can feel that. Which is true because my TSH is now 14.8 and i am having hypothyroid symptoms despite my FT4 level. (fatigue, constipation, dry skin, hair loss, heavy menstrual, PVCs, carpal tunnel, water retention) it's like clockwork "the symptoms" and they seem to come in that order every time i start to go hypo with a few weeks between each symptom before the next symptom appears....
I know the TSH isn't the end all be all, but as mentioned before it ironically has coorelated to my symptoms at least to some degree better than the free's ever have, maybe coincidence i dunno.. Guess i won't find out definitely for sure until my TSH gets into somewhat of a normal range and then go from there.
I think i want to get labs done when i'm actually feeling good and see where they are and then base future labs on the "feeling good" lab and see what kind of results i get.. hmm.. knowing my luck, i can feel good one day with the same labs that i feel like crap on the next time around.. seems so unpredictable and inconsistent that it's madening..
If this recent dosage increase doesn't make me feel better within 6 weeks then i'll discuss the T3 stuff with her...
anyway... just hurry up and wait and whither the storm, it defintely makes you appreciate the times that you are symptom free "no matter if it's for month, a week, a day, an hour or even just a few minutes :)
Thanks for the information :)
I HAVE had 2 ultrasounds however and the findings are below:
December 2008 - u/s of thyroid indicated. Right lobe 5cm.. Left lobe 4.4.. Echo texture is heterogeneous without focal dominant mass.
September 2009 - u/s of thyroid indicated. Right lobe 5.3 x 1.4 x 1.6.. Left normal 4.1 x 1.7 x 1.6 cm.. Dimensions stable. Heterogeneous echo pattern but no discrete masses or other pathology. Changes most likely related to goiter.. Findings stable.
I don't know if any of that is indicative of nodules or not.. I know i feel a "fullness" in my throat alot and my doc said when my TSH gets high i can feel that. Which is true because my TSH is now 14.8 and i am having hypothyroid symptoms despite my FT4 level. (fatigue, constipation, dry skin, hair loss, heavy menstrual, PVCs, carpal tunnel, water retention) it's like clockwork "the symptoms" and they seem to come in that order every time i start to go hypo with a few weeks between each symptom before the next symptom appears....
I know the TSH isn't the end all be all, but as mentioned before it ironically has coorelated to my symptoms at least to some degree better than the free's ever have, maybe coincidence i dunno.. Guess i won't find out definitely for sure until my TSH gets into somewhat of a normal range and then go from there.
I think i want to get labs done when i'm actually feeling good and see where they are and then base future labs on the "feeling good" lab and see what kind of results i get.. hmm.. knowing my luck, i can feel good one day with the same labs that i feel like crap on the next time around.. seems so unpredictable and inconsistent that it's madening..
If this recent dosage increase doesn't make me feel better within 6 weeks then i'll discuss the T3 stuff with her...
anyway... just hurry up and wait and whither the storm, it defintely makes you appreciate the times that you are symptom free "no matter if it's for month, a week, a day, an hour or even just a few minutes :)
Thanks for the information :)
COMMUNITY LEADER
I'm sorry, I missed the Hashi's dx - my mistake. I don't see anything that indicates you had a thyroid ultra sound? Please don't tell me I missed that too, in spite of going back and reading again...........LOL
It's possible that you have nodules that are leaking hormone independently of the thyroid gland itself. This can swing you from hypo to hyper very quickly.
Although, I know height and weight are considered in the initial dose of thyroid med, I don't think there is a "maximum" thyroid med dosage based on those parameters. Once you are on the med(s), they are then based on lab results of FT3 and FT4, along with symptoms (if your doctor is worth a hoot), which, in your case, apparently no one is considering.
You don't really know all of the demands your body is putting on your thyroid because no one testing FT3, which is the "usable" thyroid hormone. T4 must be converted to T3 in order for the body to utilize it. A certain amount of each of these is going to bound by protein; therefore unusable - that's why we test for the Free's........
The only alternative I can offer is to go to an online site and order your own labs, independently of your doctor. One you might check out is healthcheckusa.com. I recently ordered an FT3, FT4 and TSH for about $85. The same day I purchased the tests, I was sent a lab order, via e-mail, to very credible, nationally known lab, which happens to have a branch near my home; with which I was able to make an appointment online, get the blood draw the next morning and the results were e-mailed to me 2 days later.
If you can do this and take the labs to your doctor, showing that you have an issue, hopefully, you would get somewhere with further testing/med(s).
It's possible that you have nodules that are leaking hormone independently of the thyroid gland itself. This can swing you from hypo to hyper very quickly.
Although, I know height and weight are considered in the initial dose of thyroid med, I don't think there is a "maximum" thyroid med dosage based on those parameters. Once you are on the med(s), they are then based on lab results of FT3 and FT4, along with symptoms (if your doctor is worth a hoot), which, in your case, apparently no one is considering.
You don't really know all of the demands your body is putting on your thyroid because no one testing FT3, which is the "usable" thyroid hormone. T4 must be converted to T3 in order for the body to utilize it. A certain amount of each of these is going to bound by protein; therefore unusable - that's why we test for the Free's........
The only alternative I can offer is to go to an online site and order your own labs, independently of your doctor. One you might check out is healthcheckusa.com. I recently ordered an FT3, FT4 and TSH for about $85. The same day I purchased the tests, I was sent a lab order, via e-mail, to very credible, nationally known lab, which happens to have a branch near my home; with which I was able to make an appointment online, get the blood draw the next morning and the results were e-mailed to me 2 days later.
If you can do this and take the labs to your doctor, showing that you have an issue, hopefully, you would get somewhere with further testing/med(s).
I indicated above that i was diagnosed hashimotos 3 years ago and have fluctuated hyper/hypo..
I am unable to get FT3 from my doctor, from any doctor that i have been to. I have exhausted my options for doctors to treat my hypothyroid. My insurance only covers a limited number and my GP has to refer me. I have "used up" my referrels and my GP trusts what my endo says and doesn't feel there is a need for a new referrel and even if they did ALL the doctors that my insurance covers say the same exact thing.. FT3 is not neccessary.. I'm not agreeing with them but i unfortunately am stuck with their treatment and sorta "on my own" with this.
with all of that said - I have fluctuated in the FT4 range for the past 3 years I've had FT4 of 1.2 and a TSH of 102 and been Hypothyroid.. I've been on the total opposite end of that had a FT4 of 1.2 "same as above" a TSH of 0.9 and been Hyperthyroid.. so this has been determined on my symptoms and my TSH because my FT4 has been the same in both scenerios.
My most recent labs indicate high FT4 and high TSH AND i'm having Hypothyroid symptoms... This tells me i can't count on the FT4 numbers to coorelate with my symptoms as they have not been consistent. my symptoms are more consistent with my TSH then my FT4 or the FT3 that i've had in the past.. I've been all over the chart with both Free's and not been able to coorelate them to my symptoms, so the only thing i do have to go on is my symptoms.
if i was to say that i am HYPER based on being in the upper range of FT4 would mean that my symptoms would coorelate with that "and they don't" I am hypothyroid.
I get frustrated with coorelating symptoms to any lab values becaue NONE of them have been consistent not either Free's and if anything the TSH has been more predicatable of my symptoms than anything "ironically enough"
I am unable to get FT3 from my doctor, from any doctor that i have been to. I have exhausted my options for doctors to treat my hypothyroid. My insurance only covers a limited number and my GP has to refer me. I have "used up" my referrels and my GP trusts what my endo says and doesn't feel there is a need for a new referrel and even if they did ALL the doctors that my insurance covers say the same exact thing.. FT3 is not neccessary.. I'm not agreeing with them but i unfortunately am stuck with their treatment and sorta "on my own" with this.
with all of that said - I have fluctuated in the FT4 range for the past 3 years I've had FT4 of 1.2 and a TSH of 102 and been Hypothyroid.. I've been on the total opposite end of that had a FT4 of 1.2 "same as above" a TSH of 0.9 and been Hyperthyroid.. so this has been determined on my symptoms and my TSH because my FT4 has been the same in both scenerios.
My most recent labs indicate high FT4 and high TSH AND i'm having Hypothyroid symptoms... This tells me i can't count on the FT4 numbers to coorelate with my symptoms as they have not been consistent. my symptoms are more consistent with my TSH then my FT4 or the FT3 that i've had in the past.. I've been all over the chart with both Free's and not been able to coorelate them to my symptoms, so the only thing i do have to go on is my symptoms.
if i was to say that i am HYPER based on being in the upper range of FT4 would mean that my symptoms would coorelate with that "and they don't" I am hypothyroid.
I get frustrated with coorelating symptoms to any lab values becaue NONE of them have been consistent not either Free's and if anything the TSH has been more predicatable of my symptoms than anything "ironically enough"
I was on 200mcg for 10yrs. I was 5'2 115lbs. My doctor never went by my height & weight, just my TSH level. Now I am on 125mcg for the last four years & I weigh 115lbs.
I had graves/hyper/toxic goiter back in 1994; had the RAI, then TT. My symptoms started about 5-6 months after the birth of my son.
I had graves/hyper/toxic goiter back in 1994; had the RAI, then TT. My symptoms started about 5-6 months after the birth of my son.
COMMUNITY LEADER
You need to get an FT3, to see where that is within the range. Your FT4 is high, which indicates hyper; yet your TSH indicates hypo.
It's possible that you may not be making the proper conversion from FT4 to FT3, which is keeping you hypo. You might do well with a small dose of a T3 med, such as cytomel; however, you must have an FT3 first in order to know.
Have you been tested for Hashimoto's?
It's possible that you may not be making the proper conversion from FT4 to FT3, which is keeping you hypo. You might do well with a small dose of a T3 med, such as cytomel; however, you must have an FT3 first in order to know.
Have you been tested for Hashimoto's?
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