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I have been on synthroid for 32 years.  At first I was on 0,150mg for 18 years and did not have problems with weight or fatigue.  In 1996, my doctor said that the tests were more refined and I was taking too much synthroid.  It was lowered to 0,112mg.  I started gaining weight immediately, losing hair and could not focus at all.  It was raised to 0.125mg and has remained at that dose even though my tsh is a little suppressed.  I still can not lose weight even though I diet and exercise, feel mostly kind of run down all of the time, dry eyes, just never feel great.  I want to ask my doctor to add a T3 to see if that helps.  How should it be dosed with my synthroid?  Would it be better to switch to something like Nature-throid?  Thanks.
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Avatar universal
You are yet another victim of the "Immaculate TSH Belief".  Many doctors still have this belief, even though there is lots of evidence that TSH is totally inadequate as a sole diagnostic for thyroid.  TSH is a pituitary hormone that is affected by so many variables that at best it is an indicator, to be considered along with more important indicators such as symptoms, and also the levels of the biologically active thyroid hormones, free T3 and free T4.

FT3 is actually the most important thyroid hormone test, because FT3 largely regulates metabolism and many other body functions.  Studies have also shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not correlate.  

Another incorrect assumption by doctors is that a suppressed TSH means that you are hyper and that meds must be reduced.  In reality you are hyper only when having hyper symptoms due to excessive levels of FT3 and FT4.  It is very common for TSH to be suppressed when taking significant doses of T4 meds.  For example my TSH has been about .05 for over 25 years with no hyper symptoms.  In fact, I had lingering hypo symptoms until I learned about the importance of FT3, found out my FT3 was low in the range, and got my meds revised to include a source of T3.   Now I feel best ever.  

A good thyroid doctor will test and adjust FT3 and FT4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not test results.  Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.  

You can read about the clinical approach in this letter written by a good thyroid doctor for patients that he is consulting with from a distance.  The letter is sent to the PCP of the patient, to help guide treatment.  If your doctor is not willing to treat you clinically, rather than by TSH, then you will need to find a good thyroid doctor that will do so.

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Avatar universal
The possibility of osteoporosis is frequently brought up by doctors to justify their decision to reduce meds when TSH is below range.  For that reason I hope you noted the comment in the link I provided.  

"Thyroid hormone does not cause bone loss, it simply increases metabolic rate and
therefore the rate of the current bone formation or loss. Most older people are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies. The solution is not life-long hypothyroidism or bisphosphonates; one should correct the hormone deficiencies."
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Avatar universal
Thank you for your comment.  I talked with my pcp doctor about my symptoms and he was great about it.  He has other patients having the same problems.  He is reluctant to raise my doseage significantly because I am in the Osteoporosis age, but he is letting me try the nature throid instead of synthroid.  Nature throid has t3 and t4.  He also told if this doesn't help, then maybe we need to look at trying synthroid and cytomel. I started the nature throid today.  I am anxious to see if it helps me feel better.
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