thyroxine medication question

[Sally707]

Recently my doctor wanted to perscribe me thyroxine, but I had told her not to because I still had some I was perscribed but never look last year. The medication has been sitting in the fridge for nearly a year and doesnt expire thill october this year. I have been taking it for nearly a month and a half but really haven't notice any change, Im wonder if maybe its because its been in the fridge for such a long time? Is this likely even tho it hasnt expire yet? Im still gaining weight and its driving me crazy cause Im hardley eating and Im exercisng as much as I can.

[gimel]

I really can't predict what your FT4 might be after being on the thyroxine.  It depends somewhat of the cause of you being hypothyroid.  Has the doctor determined the basic cause?  

As for when you would reach 16-17 on that dose, the answer might be never.  This is if it is an inadequate dose, or if your body reacts to the dose by reducing the level of TSH and thereby reducing your natural thyroid production, or if your hypothyroidism is due to Hashimoto's Thyroiditis which will cause a gradual reduction your output of thyroid hormone.  

Sorry I didn't give you much encouragement with the above.  The key thing is to get the additional testing done and determine your FT3 level, and also find out if your doctor is going to be willing to treat you clinically as described previously.  If not, then you are going to need to find a good thyroid doctor that will do so.

[Sally707]

HI
Thanks for the info. Yes these are the FT4 results. I started taking thyroxine after I got these results. I'll try to arrange my appointment earlier, its just that I have to have my blood taken on day 21 of my cycle cause Im having my female hormones tested as well. Can I also ask since I have been on 50mcg daily should for about 2 months can you estimate what my FT4 might be? And how long on 50mcg would it take for my FT4 to reach16-17 on that dosage?
Again thanks for the help :)

[gimel]

First I wanted to ask when the tests were done.  Was it before you started on the thyroxine?  Next, I am assuming that the T4 test is for Free T4, not Total T4.  There is a big difference.  Only the portion of Total T4 that is not bound to protein molecules (thus called free T4) is biologically active.  So the FreeT4 test is much more useful info.

I agree with the doctor that middle of the range is a good target for FT4.  It is unfortunate that you were not also tested for Free T3.  FT3 is the most important thyroid hormone.  It largely regulates metabolism and many other body functions.  Scientific studies have also shown that FT3 correlated best with hypo symptoms, while FT4 and TSH correlated very poorly.  

Many doctors don't want to bother running tests for FT3 because they mistakenly believe that since T4 converts to T3, if FT4 is adequate, then no need to worry about FT3.  This is frequently incorrect when the patient is not converting T4 to T3 adequately, which occurs a lot when taking significant dosages of T4 meds.  So, in view of the importance of FT3,
why not just test and be sure?  

So, the first thing I suggest is that you request to be tested for Free T3, along with Free T4 and TSH.  If the doctor resists, then you should insist on it and don't take no for an answer.  I would even go to the extreme of asking the lab personnel what tests they are doing, just to make sure they are going to run FT3 for you.  I say this because frequently they run on auto pilot and end up doing the tests they always run, and overlook FT3.  Since hypothyroid patients frequently are low in Vitamin A, D, B12, iron/ferritin, zinc, magnesium, and selenium, you might also ask the doctor about testing for those as well.

When test results are available, please get a copy and post results and reference ranges shown on the lab report so that members can help interpret and advise.  What I expect we will see is that your FT3 level is in the lower end of the range.   Even though within the range, the range limits are so broad that many members report that symptom relief for them required that FT3 was adjusted into the upper part of the range and FT4 adjusted to at least midpoint of its range.  And symptom relief is what it is all about, not just test results.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  If you want to read more about clinical treatment, this is a good link.  

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

[Sally707]

My last results were tsh 2.5, and T4 13 (9-25). My doctor said optimal T4 should be 16. Ive taken 50mcg for nearly 2 months now and still feel the same, is that crazy? ANd I hate to say it but becasue Ive been so frustrated and gained 2kg within the last 4 days, Ive taken more, a couple times I look 150 and another day I took 200mcg, I know thats bad and thats why Ive stoped. I just dont think they're doing anything for me, and I dont get to see my doc till August. I also wait 30 mins before I eat anything. Do you know how long on 50mcg a day should my t4 reach 16-17? This has been going on for over a year.
Thankyou

[gimel]

I doubt that the extended storage has anything to do with your symptoms.  Much more likely is that you have not reached levels of the biologically active thyroid hormones, Free T3 and Free T4, that will relieve symptoms for you.  In addition, symptoms tend to lag blood test results, dependent on the severity of your hypothyroidism and length of time in that state.  

If you will please post your thyroid test results and reference ranges shown on the lab report, members will be glad to help interpret your status and advise further.