Dosage

[ando35]

I was at 12 tsh when I was taking 100 mcg pill but biting off a little piece to make it "88"

Then my doc took me to 125, and then 112 because I felt too jazzy. I went down to 100 and was at .25 tsh.

Now I am at 88 and at 4.1 TSH,  free t4 of 1.2 with a range of .8-1.8

and a free t3 of 2.9 with a range of 2.3 - 4.2

Tsh is 4.1

So I went to a 100 again on my own. Will I go to .25 again?

I think part of the reason is that I have hashi's and it goes up and down on its own.

[ando35]

So I think I can go to 100 without getting hyper?

That small a dosage increase shouldn't move the needle that far, I think. Before when I went down to .25 tsh, I may not have waited long enough while at the dose to test.

My B is ok my D was low so I will take D.

Thank you.

[gimel]

TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, Free T4 and Free T3.  When already taking thyroid meds, TSH is basically a useless test because it frequently becomes suppressed when taking adequate doses of thyroid med.  That does not indicate hyperthyroidism, unless having hyper symptoms, due to excessive levels of Free T4 and Free T3.  

A good thyroid doctor will treat a hypo patient clinically, by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not just TSH levels.  

From your test results your Free T4 was a bit lower than we normally suggest, which is middle of the range, at minimum.  Your Free T3 is even lower in its range, which shows that your body is not converting T4 to T3 very well.  Free T3 is the thyroid hormone that correlates best with symptoms.  Many members say that symptom relief required Free T4 at the middle of its range, and Free T3 in the upper third of its range, or as necessary to relieve symptoms.  

So, short term you need to get your Free T4 level up a bit and also get your doctor to prescribe some T3 med to gradually raise your Free T3 level as necessary to relieve symptoms.  Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin I also suggest that you get those tested and then supplement as necessary to optimize.  D needs to be 55-60. B12 in the upper end of its range, and ferritin should be 70 minimum.