shud i increase my dose

[mubi542]

Hi, before 2 months my tsh level was 6.8 and now its 6.2, we are wishing to have a baby soon as i had an early miscarriage 7 months back because of my unknown hypothyroidism, that time my level were 40. So i would like to know whether ivshud increase my dose, at present im taking 75 mcg thyronorm.

[gimel]

If at all possible I suggest that you get the testing done before starting the increase, otherwise you won't be able to get a good test result for at least 4 weeks, in order for the T4 to have most of its final effect on blood levels.   The recommended tests are those I listed above.  

Many hypo patients find they are unable to conceive until their thyroid levels are adequate.  Of course you also want to be sure of optimum conditions for the fetus, when you are successful.  So, in my opinion,  I would get those tests done, with emphasis on Free T3, and have a close look at all the test results.  Then you might be better able to figure out the best timetable for everything.

[mubi542]

Thanks for the response, my ft4 level before 2 months was 16 and now its 13, i consulted my doc and he adviced me to increase the dose to 100 mcg and to again check after 4 weeks. He also said to plan for conception only after that, im totally confused my periods are on now and we wish for a baby soon. Will it give a correct result if  i take blood test 2 weeks after taking the meds because my ovulation date will be after 2 weeks. Thanks i advace

[gimel]

TSH is a pituitary hormone that is supposed to accurately reflect levels of the actual, biologically active thyroid hormones, but it cannot be shown to correlate well with either  Free T3 or Free T4, much less with symptoms, which are more important.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So, yes you should ask your doctor for an increase in your meds.  Before any increase; however, I also strongly suggest that you should request to be tested for Free T3 and Free T4, along with the TSH they always insist on.  In addition, since hypo patients are frequently too low in the range in other important areas, you should test for Vitamin D, B12, ferritin, and a full iron test panel.  When you have results from these tests, please post results and reference ranges shown on the lab report and members will be glad to help interpret and advise further.