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Low TSH level

I have had hypothyroidism for about 14 years, I had quit taking my medication for about 4 years. I was hospitalized with a TSH level of 197. Since then (about 2 years now) my TSH level has varied. I was on 350 mcg of Levoxyl and tested at .9, I was then put on 300 mcg of Levoxyl and tested at 25, then I was put on 350 mcg of Levoxyl and 25 mcg of Cytomel and tested at .003. I am currently on 325 mcg of Levoxyl and 12.5 mcg of Cytomel. My question is after two years of constant medication should my TSH level be so hard to get under control?
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649848 tn?1534633700
It appears that you/your doctor are basing your dosage strictly on your TSH levels.  This is usually a recipe for disaster and generally, gets you nowhere, as you can see by how your levels are bouncing around.  

You need to have the biologically active thyroid hormones tested.  These would be Free T3 and Free T4 - not total T3 or T4.  TSH is a pituitary hormone and fluctuates greatly, even throughout a day's time.  It should never be used, alone, to determine hypothyroidism or adjusting medication dosage.  

If you've had Free T3 (FT3) and Free T4 (FT4) tested, please post those results, along with the reference ranges, since these vary from lab to lab, so must come from your own report.  

You need to be working with the FT3 and FT4, as those are the levels that determine how you feel.  TSH, itself, causes no symptoms.  

If your doctor refuses to test for FT3 and FT4, you need to find one who will, because without those, you will never get stabilized.  I'm also shocked that your doctor even gave you a script for cytomel, without testing FT3 and FT4; that alone would be enough to make me find another doctor.

By the way - just curious: if your med is being adjusted on the basis of TSH, why was there an adjustment at 0.9?  That's in range for almost lab, even the ones not using the "new" standards.  

My TSH typically stays at < 0.01 and it's not even considered a factor, so long as my FT3 and FT4 are where I need them to be.
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393685 tn?1425812522
It would be best to get the free levels checked.

It sounds - based off when you started the Cytomel .25 - You immediately responded but no one is looking at the Free T3 level to know exactly where you are at.

Taking any T3 med would = getting a Free T3 lab.

Free T3 is your direct hormone going into the cells. The FT4 is your "converter" mostly that turns into T3 for your free cell.
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