one doc says up meds , the other says decrease them

[blondee028]

I have had Hashimotos for 5 yrs now> I have been on synthroid for the past year I have been taking 112mcg. This past month I have started getting the joint pain hands and feet. also they feel like ice all the time. I am also always tired.  I just got my labs back and they are as follows. t4 free 1.83  range 0.61-1.76
tsh  0.037   range  0.450-4.500  , t4 13.1  range 4.5-12.0  t3 127  range 85-205,t3free 2.7 range 2.3-4.2  sed rate 4 range 0-30
I happen to work in a doctors office.  I got my results and showed  a doctor here. He said how much levothyroxine are you taking I said 112 he said you should be at 125 even maybe 137.
So then I called my doctor and asked him if he got my results, he said he hadn't so I faxed them to him and he said , you are taking too much levothyroxine you are going to have to cut back.
Ok so what doc is right. one is a D.O. the other OBGYN.. I am confused. any suggestions? I also have 10 lbs I can't seem to get rid of> no matter what


This discussion is related to Levoxyl or Levothyroixin Problems?.

[AR-10]

Your Free T4 is too high, indicating that you are over-medicated. Your TSH concurs with that conclusion.

Your Free T3 is too low. It should be around 3.7 or 3.8. So you need more T3. Normally you would get more T3 by taking more medication, but your body is not converting T4 to T3 correctly.

T3 is the hormone your body uses. It is the fuel your cells need.

You need to talk to one of the doctors about lowering your Levothyroxine a little and adding a bit of Cytomel (synthetic T3), or try a combination T4/T3 med like Armour or Unithroid.

Just my opinion.

[blondee028]

I received the rest of my tests today my antithyroglobulin ab is 55 range 0-40. Other than the cold hands and feet. this is the first time in years that I have lost 7 lbs. ( i just weighed myself) and my hair deels like silk.  Now my doctor told me I am over medicated and wants to lower my dose of  levothyroxine and did not mention anything about adding Cytomel.  He said he wants me to come in. I really can't get there until the end of December. So I guess I have to keep taking the same dose till then. Is it better to be hyper than hypo? It sure seems better in the weight department. Also I am 65 years old, if that makes a difference.

[AR-10]

Going three months with your hormones out of whack is not a very good idea, if you can avoid it. We all have done it, but...

Even though your TSH and Free T4 say you are fairly hyper, you are lacking the T3 that you need to balance your metabolism.

Sometimes it is a temporary condition that lasts a month or so. There is a condition that may develop where you are converting T4 to reverse T3 rather than T3. It usually rectifies itself.

Sometimes it is a permanent situation and you have to take some sort of T3 medication as well as a T4 medication.

Levothyroxine, whether it be generic or a name brand such as Synthroid or Levoxyl, is a T4 medication. Your body is supposed to take that T4 and turn it into T3 as it needs it. For some people this is how it works, and it works quite well.

Some people cannot convert T4 to T3 in sufficient quantities, and these people need to take a small ammount of synthetic T3 (Cytomel) in order to properly balance their hormones.

Armour is one of three or so brands of a natural T4/T3 combination med. Many people who have a conversion problem do better on Armour, although some find taking synthetics such as I described above works as well.

If the doctor wants to lower your medication, try to get him/her on the phone and discuss the Free T3 issue. If they still want to lower your dose, do it and retest in six weeks.

In six weeks you will know if your Free T3 issue is temporary, or if you need to look at altering your medication further.

Do not settle for "normal" if your Free T4 is below upper limit and your Free T3 is at the bottom of normal. Your Free T4 has room to move around and still be adequate. Your Free T3 must be in a very tight range close to the upper limit, as I stated in my first post.

There is no reason to continue taking the wrong dose for three month when the doctor knows it is the wrong dose. He can call in a new scrip after a phone conversation with you.

If the doctor feels lowering the dose is correct, do it and retest in six weeks. Then get the Free T3 issue addressed if it is still an issue.

Your antithyroglobulin antibody test (TGab) shows you positive for thyroid antibodies, but at a very low titer. It may go up over time. As low as it is, it may go down below limit again. It is hard to say.

Were you also tested for TPOab? Thyroid Peroxidase antibodies, or antimicrosomal antibodies, or antithyroid microsomal antibodies, or Thyroid Peroxidase autoantibodies.

It has four different names, but it is the same test. It is another thyroid antibody that is common to test for.