Dosage

[karenms]

Hello.  I was wondering if I could get some advice on my current dose of Synthroid.  I was on 88 mcg with a TSH of 5.8.  I was increased to 100 mcg.  I have been on 100 for 3 weeks.  I went ahead and tested my TSH after only 3 weeks because I wasn't feeling great. I did not test Free's.  The TSH is now 3.44.  My symptoms are anxiety, constipation, interrupted sleep, etc. Do you think it is too early to see if I might need a little more, or would waiting 3 more weeks really make a difference in TSH.  Thank you in advance. I also take iron for low ferritin.

[magpieannie]

To answer your question- I would not increase again as it can take 6 to 8 weeks to see the entire result of the t4 increase. T4 takes awhile to show up completly on labs. Wait until next labs (say 1 more month) as you don't want to become hyper accidentally. Also, push for the freet4 and freet3 level as it tells us so much more than the pituitary signal (TSH).

[karenms]

Thank you again for your wealth of information.  Regarding the D, I am a little low.  25 (35-100).  Whenever I take D, I don't feel well. It is like it makes me feel hypo.  I immediately have symptoms such as anxiety, depression, etc.  I have heard of a few others that this happened to.  I have low ferritin, so I do take iron and Synthroid only.  I thought it would probably be better to fix one thing first, especially since my thyroid is not optimized.  As per my first message, do you think that I should wait a few more weeks on my current dose of Synthroid to see if the TSH comes down some more, or do you think that I am going to need an increase to possibly 100 mcg.  Have a great day.

[magpieannie]

You're welcome. Also, you may want to get your vitamin D level checked as many with hypothyrodism find this to be too low.(Should be atleast 50 ) Do you take any suppliments? My daughter (almost 10) was born without her thyroid gland and she use to have severe constipation with blood in stool while on Synthroid, plus MANY other hypothyroid symptoms. She had issues with converting the t4 into t3. She is now on desiccated thyroid (1 1/2 years now) This has t3 in it plus t4 and t2, and t1 and selinium and calcitonan.( resembles human thyroid hormone more except for the amounts)  Her t3 is kept at the higher side of normal range instead of at the lower side as it was while on Synthroid. Most if not all of her issues of the past are gone and she feels normal and good. You can get t3 in a synthetic form (Cytomel) which can be added to your t4 regiment. This is good to try first before going with desiccated as the desiccated thyroid world can be difficult to manuver. (formula changes, availability, etc...). Also, magnesium has been a good suppliment for my daughter and has helped with aches and constipation and sleep if taken before bed. Psillium with lots of water (we used capsules) can also be of help to some with constipationt too). Hope this helps some, however getting  those thyroid hormones in better balance helps the most with the symptoms you are having plus many others.Having enough available t3 reaching the cells takes care of many hypothyroid symptoms over time. Good luck and God Bless!

[karenms]

Thank you so much for the great information.  The free's were not tested this time, but I will request that you are next time.  Again, thank you.

[magpieannie]

Did you have the actual available thyroid hormone levels taken---Free t3 and Free t4? Free t3 corolates best with hypothyroid symptoms and many people feel better when this is kept higher in the reference range, as t3 is the biologically active hormone. You have to keep in mind that Synthroid is only t4 (storage hormone) that must convert to the biologically active t3. If your body is not able to do this well enough (conversion process), then an addition of a t3 medication may be beneficial in helping to relieve some of your symptoms. If your free t4 is high in normal range, yet your t3 is very low, then you probably have problems with converting.The problem is, many Synthroid prescribing doctors (endos.) usually never check it and just assume you're converting the t4 into enough t3 on your own. Also, your TSH is still a little elivated, even though it is in range. Many people feel better when this is slightly lower-say arond 2.0 or even lower. These ranges are very broad, so it matters where you fall within them. We all need to find our optimal range and not just a normal range. Shoot for a lower TSH and a higher free t3 (will probably have to have t3 added in to get there) with a mid range freet4 and see how you feel? If your doctor will not check the freet3 level, then find one who will.