subclinical hyper on synthroid

[mtkst13]

i've been on 112 synthroid since august for silent thyroiditis / 30yo female / 135lbs.  

i'm on sertraline and get labs done once a year to monitor liver function, etc.  
my results
tsh = .099
ft3 = 3.0   (2.3 - 4.2)
ft4 = 1.42   (.61 - 1.76)

should i call the endo to get meds adjusted?  i don't have another endo lab check until july.  can i wait?

i'm having mixed symptoms...shortness of breath, very groggy at work with pulse < 60 (i could be bored).  other than that, i feel pretty good.  could these symptoms be from the subclinical hyperthyroid?  i'm afraid to get meds adjusted because i hate the yo-yo.  i finally feel like my weight has stabilized and feel pretty energetic when i'm not sitting at my work desk ;).

since my tsh is going down, does it mean that my thyroid has healed?  does it mean that i may be able to go off the meds?  do i have hashis?  or something else?  i had high antithyroglobulin but neg antiTPO.

[Mark Lupo, M.D.]

The dose decrease seems appropriate.  The TSH is now normalizing.  Muscle aches may be seen with both hypo and hyper and sometimes take several months to resolve after normalizing the TSH.  Would hold the course at this point and exercise as tolerated but discuss your symptoms with your doctor.

[mtkst13]

i've tried to post a NEW question 2 different days....i wrote out the question both times in detail, and when i hit submit, it said this forum reached its limit for the day!  ahhh.  

please please please just tell me if it's okay/safe to exercise considering the strange pain i'm getting afterwards, as it's not normal pain.  it's really quite scary and debilitating.  why is this happening?

my tsh prior to taper was .099.  my tsh on monday after almost 30 days on 88 syn. was .35.  could this have anything to do with the pain?  what's going on? is the pain thyroid-related?  or something else?

thanks in advance.  sorry if i'm driving you crazy.  i'm already there.

[mtkst13]

pretty please answer...
i really do get bad muscle pain after i workout, and it lasts for several days.  it's really not normal pain.  i never had this before i was hypo and i did more difficult elliptical workouts then.
is it dangerous to exercise since my muscles feel so bad?  because the degree of the pain makes me think it's dangerous.  
is there anything i can do to prevent the pain?  is this normal?  should i refrain from exercise until my levels are "normal", even though i had this issue prior to tapering?
i loathe hypo.  

[mtkst13]

hi, dr. lupo,

it's been 26 days since my doctor decreased my meds from 112 to 88.  my next appointment is july 10th.

since then i've had strange heart palpitations (worst than when i was hyperthyroid), but they seem to be decreasing now.  

i have chest pain around my heart that is worsening; it's worst when i laugh or lie on my left side.  it actually woke me up last night.

on friday night i worked out on my elliptical trainer for 20 minutes; about 2 hours later, the pain in my quads was really bad.  any time i moved the pain was exacerbated.  i felt a little better saturday morning, but the pain increased as the day went on and i felt exhausted.  by sunday the pain was gone.  now i'm just tired walking up a flight of stairs.

i feel like my vision is blurry.  my eyes are puffy.  and i feel very weepy.  

is it too soon to determine if this dose is correct?  is it possible that my thyroid will kick in?  i just don't think i can wait that long because my symptoms keep getting worst.

thanks,
maria

[Mark Lupo, M.D.]

By now, the thyroid may be completely recovered from thyroiditis and you may not need any medication.  Talk to you doctor about lowering the dose of medication and monitoring to see if you can taper off.  There is no reason to get the T3 higher at this point.

[mtkst13]

on the thyroid disorders forum, several have suggested that, based on my symptoms and labs,
my FT3 needs to be a little higher and my FT4 needs to be a little lower.  

what do you think about this?  what is your suggestion?