Aa
General question
I was diagnosed with hypothyroid while I was pregnant over 11 years ago and have been on synthroid since. Fast forward to about a year ago I noticed my hair was thinning and becoming corse but my thyroid was normal. A few months back while on 150 mcgs my thyroid was checked and tsh was at a 32! My doctor upped my dose to 175 mcg and as of 2 weeks ago I'm in normal range (I think I was at a 2) but still having dry skin and hair loss and it being corse. Can you still have symtoms while being in normal range? Also what would make it go from normal to 32 so rapidly?
TIA
TIA
Hypo patients tend to have low stomach acid levels, which results in poor absorption of many vitamins and nutrients, such as iron, and Vitamin D, and B12, among others.
Doctors like to believe that TSH accurately reflects levels of the biologically active thyroid hormones, Free T3 and Free T4. In reality TSH cannot be shown to correlate well with either Free T3 or Free T4, much less correlate well with symptoms, which should be the main concern.
When already taking thyroid medication, TSH is almost useless as an indicator of thyroid status. Free T3 is the most important thyroid test, since scientific studies ahve shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
So you need to always make sure to be tested for both Free T3 and Free T4 (not the same as Total T3 and T4) each time you go in for tests. Since hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin, you should also make sure to get those done.
Most important is that you need to find out if your doctor is willing to treat clinically, as described in the link. If not, then you will need to find a good thyroid doctor that will do so.
When already taking thyroid medication, TSH is almost useless as an indicator of thyroid status. Free T3 is the most important thyroid test, since scientific studies ahve shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
So you need to always make sure to be tested for both Free T3 and Free T4 (not the same as Total T3 and T4) each time you go in for tests. Since hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin, you should also make sure to get those done.
Most important is that you need to find out if your doctor is willing to treat clinically, as described in the link. If not, then you will need to find a good thyroid doctor that will do so.
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