Doc said NO to dose increase

[katydid2807]

At least for now.

I just got off the phone with him. He is reluctant to increase my dose of Acella by 1/4 grain. My FT4 is at 19% of the lab range and my FT3 is at 45% of the lab range. I still have hypo symptoms. Now what?

He wants me to keep a journal for two weeks of resting heart rate, morning temperature and symptoms, and then he'll reevaluate.

He said he doesn't want to increase because most people need 3 grains or less and I'm already on 3 grains.

[gimel]

I do think you should ask the doctor what difference the dosage makes, if the result is that your FT3 and FT4 levels are still below even the midpoint of the range, and you still have all those hypo symptoms?

Sending PM with some info and further questions.

[katydid2807]

I'm in AL. My doc is one of the "top" docs on the list....but he's seemingly presently crippled by the "3 grains max" rule.

I do plan to do my journaling for him, but gosh......I hop he works w/me.

[katydid2807]

Kl42-
I used to be 199 (postpartum weight gain times four kids), lost to 165, got pregnant with baby 5, gained back to 185, had the baby and am now 155. :)

[gimel]

With those symptoms, I'd say that you truly need to increase your FT3 and FT4 levels.  

I do know the name and have steered a friend to him in the past.  For whatever reason, that did not work out so well.  I am also not sure that he is taking thyroid patients any more.   Where are you located?   Maybe we can come up with other good prospects.

[kl42]

are you heavy. ? weight can affect the dose?

[katydid2807]

Gimel,

I see you're in MI. Do you know a Doctor Walter Woodhouse in Temperance? I hear he's good. I would like to fly in to see him.

[katydid2807]

Okay, symptoms are:
Joint stiffness upon waking or when standing from sitting (I literally feel like I'm elderly and I'm only 37),
Carpal tunnel symptoms coming back
Dry heels, so dry they are cracked and painful to walk on
Heart palpitations
Depression
Lost of interest in things that normally excite me
Dry, scratchy eyes
Muscle aches and tender muscles, almost like fibromyalgia trigger points, but everywhere
Spacey feeling, floaty head, like I'm sleeping in my brain while I'm awake
Occasional bouts of fuzzy vision
Weak legs, weak arms when holding baby
Absolutely void of energy...short bursts here and there and then boom- I could take a nap (but don't)
Inability to multitask or do things that suddenly seem overwhelming but never used to (packing for a trip, for example)
Forgetting words, not following conversations, zoning out and feeling blank inside.

And more.....

[katydid2807]

My TSH, btw, was .01. More in a bit...dinner time!

[gimel]

I'm sure the doctor doesn't realize that the ranges for Free T3 and Free T4 are far too broad.  The reason for this is that they were established just like the TSH range.  A data base from the total population of patients was analyzed statistically and the assumption was made that about 2.5 % of the population was hypo, so the limits were set based on that assumption.  Over 8 years ago, the AACE recognized that there were a lot more than 2.5% that were hypo, so they purged their data base of suspect hypo patient data and recalculated the range limits.  The reference range changed from .5 - 5.0 down to .3 - 3.0, which was huge.  

Unfortunately the ranges for Free T3 and Free T4 have never been corrected like the TSH range.  If that were done and their data bases purged of suspect hypo patient data, I have previously estimated that the new ranges would be essentially the upper half of the current ranges.  That is why I think we hear form so many members with FT3 and FT4 in the lower half of the ranges, yet they still have hypo symptoms.

The ranges would not matter so much, if the doctors used them  only as guidelines within which to treat hypo patients clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms.  Instead they use them as pass/fail decisions and resist med changes to relieve symptoms.

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.  Again, symptom relief should be all important.  You can get some good info about clinical treatment from this link.  The letter was written by a good thyroid doctor for patients that he consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

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

The doctor who wrote the letter once said that dosage is irrelevant.  People absorb and respond differently to the same dosage of meds.  The only thing that is important is symptom relief.

Speaking of symptoms, please tell us which ones you are still having.