Confused about increasing NDT dose

[1Kel12]

Hello!

I was on a half grain for 1 month and didn't feel anything positive, in fact I felt really bad the last 2 weeks it seemed like what was described on STTM about getting worse if dose is too low.

I increased to 1 grain about 2 weeks ago and for the first time I noticed a positive change. I have read on STTM you need to increase by 1/2 grain in the beginning but my ND wants to wait 5 weeks between increases so she can measure them. So waiting for labs I am about 6 weeks between increases.

I can see her point but I'm confused by what I have read. fyi I also started supplements D3, B12, iron, progesterone cream and a thyroid support pill. I feel like I am taking a lot right now, before all of this I took no meds at all.

Thank you for your time, Kel

[1Kel12]

Thank you for clarifying, it really helps, so many odd symptoms its been a long painful journey and I think I'm finally seeing progress.

Gratefully, Kel

[gimel]

The reason for the effect you mention is that serum thyroid levels are a sum of both natural thyroid hormone and thyroid med.  As you start on a dosage increase, the TSH will go down and the natural thyroid output will be reduced.  So the total effect is often very little until TSH is very low or suppressed and serum levels are totally a result of the med.  

Doctors don't seem to realize this so they think your levels will automatically increase because of the med and that you don't need to come back for at least 4 weeks in order for serum levels to reflect most of the dosage increase.  I expect that you will have to be somewhat patient and wait at least 4 weeks between dose changes before new tests.  That is not all bad, since symptom changes tend to lag somewhat behind changes in serum levels and as you approach optimal levels you make small dosage changes and allow time for the effect.

I know that taking those supplements seems a lot right now, but they are really necessary for thyroid patients.  D should be about 55-60, B12 in the upper end of its range, and ferritin should be about 70 minimum.