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75mcg levothyroxine
I started on my meds 6 weeks ago because I have had a possible thyroid problem all my life. At that time my TSH was just at 3, but i had so many symptoms and mine always fluctuates, so the doctor agreed to put me on 75 mcg of levo to see how it made me feel (I weigh 160lbs). He wanted to try to get me down to .5 TSH.
Just got my 6 weeks test results back and I am clearly on too high of a dose (TSH = .023!) but i have been feeling terrific lately.... I think I might have made a mistake taking my pill right before the test, but otherwise it's still too low. My doctor feels that there is no way 75 mcg could have caused my numbers to go that low and thinks that I am either taking more than 1 a day (which I am not) or he thinks my thyroid started becoming overactive on it's own... I think I should just lower my dose and see how that goes. I also think that he started me on a dose that was too high to start off with. My mom's TSH used to be 5 or higher and she is on 75mcg to get down to a TSH of 1.
What do you guys think? Is it possible my dose is too high and that 75 mcg can really lower your TSH that much? Or is my thyroid really overacting on it's own? At first I really liked my doctor for being willing to give me a chance with the meds, but I kind of think he is wrong in thinking that 75 mcg wouldnt have lowered me that quickly. I'm not sure what he is going to suggest yet. He may take me off the meds completely, but my symptoms really have gotten better and I am not experiencing any Hyper symptoms....
Just got my 6 weeks test results back and I am clearly on too high of a dose (TSH = .023!) but i have been feeling terrific lately.... I think I might have made a mistake taking my pill right before the test, but otherwise it's still too low. My doctor feels that there is no way 75 mcg could have caused my numbers to go that low and thinks that I am either taking more than 1 a day (which I am not) or he thinks my thyroid started becoming overactive on it's own... I think I should just lower my dose and see how that goes. I also think that he started me on a dose that was too high to start off with. My mom's TSH used to be 5 or higher and she is on 75mcg to get down to a TSH of 1.
What do you guys think? Is it possible my dose is too high and that 75 mcg can really lower your TSH that much? Or is my thyroid really overacting on it's own? At first I really liked my doctor for being willing to give me a chance with the meds, but I kind of think he is wrong in thinking that 75 mcg wouldnt have lowered me that quickly. I'm not sure what he is going to suggest yet. He may take me off the meds completely, but my symptoms really have gotten better and I am not experiencing any Hyper symptoms....
Best Answer
Oops, I posted my comment before seeing your labs in your second post. I stand by my comments. Your dose is cleary too high at the moment, but you were also cleary hypo before meds. You are feeling better...trust your instincts and symptoms. You need a decrease, but not discontinuation of meds.
I'm really surprised that your doctor would think 75 mcg couldn't make your TSH decrease that quickly. My TSH started out at 57 (way higher than your 3!) and I went down to something like 0.12 in just 6 weeks. I was on 125 mcg (weighing about 150 at the time), and my free T4 was lower than yours. It seems logical that a lower dosage could easily make you go from 3 to 0.023, especially if you were not that severely hypo. I'm surprised that they wouldn't start you out at something lower - 50 mcg or even 25 mcg, since you are of pretty normal weight.
I do want to say that when I went hyper, I actually felt great for awhile. So many of my hypo symptoms went away so quickly. I was even saying to the nurse who called with my results "but I feel totally normal!" It wasn't until I saw an endocrinologist that I really understood things better. He actually lowered my dosage (which at that point was down to 100 mcg) without new bloodwork, based on knee reflexes and hand tremors (nothing I really "felt," but which could be seen.) He also suspected that even 100 mg was too high. Even your 75 mcg is a pretty high starting dosage for even a severely hypothyroid patient. From what I have learned, most doctors start low - it was unusual for my PCP to start me so high.
I'm now actually down to 50 mcg, from 125 mcg, even though I have Hashimoto's so my thyroid will continue to deteriorate. It wasn't until I was on this dramatically lower dosage that I realized I really had been having some hyper symptoms. Now I just truly feel normal.
I'm glad your doctor is agreeing to have you cut your pills in half. I suspect you will end up feeling even better, although you might backslide now and then... your thyroid functioning may be fluctuating.
I do want to say that when I went hyper, I actually felt great for awhile. So many of my hypo symptoms went away so quickly. I was even saying to the nurse who called with my results "but I feel totally normal!" It wasn't until I saw an endocrinologist that I really understood things better. He actually lowered my dosage (which at that point was down to 100 mcg) without new bloodwork, based on knee reflexes and hand tremors (nothing I really "felt," but which could be seen.) He also suspected that even 100 mg was too high. Even your 75 mcg is a pretty high starting dosage for even a severely hypothyroid patient. From what I have learned, most doctors start low - it was unusual for my PCP to start me so high.
I'm now actually down to 50 mcg, from 125 mcg, even though I have Hashimoto's so my thyroid will continue to deteriorate. It wasn't until I was on this dramatically lower dosage that I realized I really had been having some hyper symptoms. Now I just truly feel normal.
I'm glad your doctor is agreeing to have you cut your pills in half. I suspect you will end up feeling even better, although you might backslide now and then... your thyroid functioning may be fluctuating.
thanks for the responses. I got an email from my doctor today. luckily he doesnt want to discontinue my meds!!! he wants me to cut my 75 mcg tablets in half and re-test in a month. thanks again for your help!
In regards to taking meds before blood draws: T3 meds should not be taken until after the blood draw. As far as T4 meds are concerned, some doctors say to wait until after the draw, others say go ahead and take them before. Since T4 builds in your system over time, the impact of a single dose is not huge on your labs. Probably the best thing to do is ask your doctor what he wants you to do. That way, your labs will be consistent with "what he's used to seeing"., and we don't want to confuse him, either! Consistency is what's really important...either always take them or never.
What IS really important is to have labs drawn at approximately the same time of day every time. TSH, especially and for what it's worth, varies considerably intraday and has a bit of a circadian rhythm.
What IS really important is to have labs drawn at approximately the same time of day every time. TSH, especially and for what it's worth, varies considerably intraday and has a bit of a circadian rhythm.
Yes, thanks. That was strange. I started writing a reply and left for a while and then came back and finished the post. In the interim, I guess, all the other replies made mine redundant. By the way, I agree with goolarra about your meds and her assessment of your doctor's expertise.
It is not unusual for a thyroid patient taking medication to have a low/suppressed TSH level. That does not mean that you are hyper. You are hyper only if you have hyper symptoms, due to excessive levels of the biologically active thyroid hormones, free T3 and free T4. For example, I have had a TSH less than .05 for over 25 years, without having hyper symptoms. In fact, I had lingering hypo symptoms until I learned about the importance of FT3 and was able to have my meds adjusted to include a source of T3. Now I feel best ever.
If you doctor isn't testing you for FT3 and FT4, then you should insist that be done. Medicating a thyroid patient by TSH level alone, is frequently unsuccessful and causes a lot of unnecessary changes in meds. TSH is a pituitary hormone that is affected by many variables. It is totally inadequate as a diagnostic by which to medicate a thyroid patient.
In my opinion the best way to treat a thyroid patient is to test and adjust the levels of FT3 and FT4 with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not TSH levels.
If you doctor isn't testing you for FT3 and FT4, then you should insist that be done. Medicating a thyroid patient by TSH level alone, is frequently unsuccessful and causes a lot of unnecessary changes in meds. TSH is a pituitary hormone that is affected by many variables. It is totally inadequate as a diagnostic by which to medicate a thyroid patient.
In my opinion the best way to treat a thyroid patient is to test and adjust the levels of FT3 and FT4 with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not TSH levels.
thank you very much, I will beg him to lower me to 50mcg and if not, i will find another doctor.
what do you think about taking meds before blood tests?
what do you think about taking meds before blood tests?
I totally agree with your assessment of the situation...I think you've hit the nail on the head in everything you say. Your doctor should also be testing free T3 and free T4 and going by those, not TSH alone. 75 mcg is a relatively high starting dose and can change labs drastically. It would probably be worth your while to seek out another doctor who tests FT3 and FT4. It's commendable that your current doctor gave you a trial dose, but it seems that's where his expertise ends.
these were my test results this time:
TSH 0.023 (0.320-5.500 uIU/mL)
Free T4 2.30 (0.70-1.80 ng/dL)
T3 free 6.45 (2.30-4.20 pg/mL)
These were my test results last time:
TSH 2.936 (0.320-5.500 uIU/mL)
Free T4 (0.80 0.70-1.80 ng/dL)
T3 free 2.75 (2.30-4.20 pg/mL)
My TSH has been as high as 13 in the past though
TSH 0.023 (0.320-5.500 uIU/mL)
Free T4 2.30 (0.70-1.80 ng/dL)
T3 free 6.45 (2.30-4.20 pg/mL)
These were my test results last time:
TSH 2.936 (0.320-5.500 uIU/mL)
Free T4 (0.80 0.70-1.80 ng/dL)
T3 free 2.75 (2.30-4.20 pg/mL)
My TSH has been as high as 13 in the past though
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