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Please help with tests & levoxyl/cytomel dosage
I was wondering if you could help me interpret my results from my last blood test in May 2011. My medication continues to be adjusted going on two years in December. I can post the original results from December 2009 if it will help. I've been going back and forth with 100mcg then 125 mcg then 112 mcg then back down to 100mcg then 112mcg alternating with 100mcg etc. etc. I have felt bad (symptoms) though all of this with very brief periods of relief.
Lately, I've been especially tiered and sad (depressed). I've had recent weight gain and have now gained a total of fifteen pounds since starting medication. I have also been diagnosed with ADD, but have had poor concentration and memory (forgetting words for things), achy etc. etc.
It seems they did the TSH 3RD GENERATION twice - figures since I'm afraid of needles.
What should my numbers look like? How much Levoxyl/cytomel does my body need at 137 lbs?
Thank you for any help
May 7, 2011
Test Flag Result Normal
TSH 3RD GENERATION (TSH3) Low .24 0.40-4.00
THYROID PEROX (TPO) AB High 41.1 0.0 -9.0
FT4 1.3 0.6-1.6
TSH 3RD GENERATION Low 0.21 0.40-4.00
FREE T3 2.6 2.4-4.2
Lately, I've been especially tiered and sad (depressed). I've had recent weight gain and have now gained a total of fifteen pounds since starting medication. I have also been diagnosed with ADD, but have had poor concentration and memory (forgetting words for things), achy etc. etc.
It seems they did the TSH 3RD GENERATION twice - figures since I'm afraid of needles.
What should my numbers look like? How much Levoxyl/cytomel does my body need at 137 lbs?
Thank you for any help
May 7, 2011
Test Flag Result Normal
TSH 3RD GENERATION (TSH3) Low .24 0.40-4.00
THYROID PEROX (TPO) AB High 41.1 0.0 -9.0
FT4 1.3 0.6-1.6
TSH 3RD GENERATION Low 0.21 0.40-4.00
FREE T3 2.6 2.4-4.2
I meant to finish that reply off with a thank you (again). I really appreciate the help.
Hi Barb135,
Thank you for your reply.
I think you're right about lab tests BEFORE dose/med changes.
I'm afraid lack of labs is partially my fault. I'm terrified of needles and have been avoiding going AND there were two doctors involved before each telling me something different. The good thing about my current doctor (only one now as the other has retired) is that he cares about my symptoms. The other doctor only considered labs and there was an overseas move in between treatment.
I haven't started the Tirosint yet as I'm waiting for my pharmacy to get it in. Was going to start tomorrow. Instead I'll take my lab slip that I was going to go in with six weeks from start of Tirosint and get my labs done tomorrow. I will hold of on the change until all the results are in. Thank you for your common sense.
I also need to be more organized as I have not idea what dose goes with what labs at this point - it's been almost two years of changes without relief.
I am now on Levoxyl 100 mcg and Cytomel 2.5 mcg taken once a day at 7am.
I will start Cytomel 5mcg (split into two separate doses of 2.5 each) once/if I start the Tirosint 88 mcg. I'm looking forward to taking Tirosint because of it's lack of fillers and because of all my symptoms. I hope to find relief soon.
Thank you for your reply.
I think you're right about lab tests BEFORE dose/med changes.
I'm afraid lack of labs is partially my fault. I'm terrified of needles and have been avoiding going AND there were two doctors involved before each telling me something different. The good thing about my current doctor (only one now as the other has retired) is that he cares about my symptoms. The other doctor only considered labs and there was an overseas move in between treatment.
I haven't started the Tirosint yet as I'm waiting for my pharmacy to get it in. Was going to start tomorrow. Instead I'll take my lab slip that I was going to go in with six weeks from start of Tirosint and get my labs done tomorrow. I will hold of on the change until all the results are in. Thank you for your common sense.
I also need to be more organized as I have not idea what dose goes with what labs at this point - it's been almost two years of changes without relief.
I am now on Levoxyl 100 mcg and Cytomel 2.5 mcg taken once a day at 7am.
I will start Cytomel 5mcg (split into two separate doses of 2.5 each) once/if I start the Tirosint 88 mcg. I'm looking forward to taking Tirosint because of it's lack of fillers and because of all my symptoms. I hope to find relief soon.
COMMUNITY LEADER
You can't base your dosage on your weight; you have to go by symptoms, first, labs second.
Being a gelcap, Tirosint is absorbed much easier than a pill, and supposedly, more of the medication is absorbed, as well. I'm on it and love it.
I am VERY disappointed, and have little faith, in your doctor at this point. I find it somewhat negligent to be changing your dosages and/or meds without testing in between to even see what your levels are...... Lab tests should always be performed prior to dosage/med changes, so you know where you're at.
The best thing you can do at this point, is insist on regular labs until your levels stabilize; get copies of ALL your labs and on each report, note the medication you're on when the test is done, along with what, if any, symptoms you were having at the time, whether you felt good, etc. This will help you keep track of what med/dosage works best for YOU and what lab numbers to "target" in order for you to feel your best.
While it's true that cytomel is immediately available to the body, and a difference can be felt quickly, it can take a while for your FT3 level to rise, so it's a good idea to wait a few weeks after starting it before testing. It took several months after I started taking T3 med, for my levels to come up appreciably.
Because the Tirosint is better absorbed and you're on the T3 med, you will need to watch for hyper symptoms.
Are you splitting your cytomel into 2 doses or taking it all at once? If you split it into 2 doses, and take one in the morning and one around noon, it will stay with you longer, so you'll be less likely to "slump" later in the day. If you're taking the whole 5 mcg at once, you might try taking it later, but of course, that depends on your schedule, too.
I take my T3 med in one dose, but have, recently, began hitting a time of day where I'm really dragging/drowsy; I'm going to try taking my T3 around 11:00 or so and see if that will help get me through the slump.
Being a gelcap, Tirosint is absorbed much easier than a pill, and supposedly, more of the medication is absorbed, as well. I'm on it and love it.
I am VERY disappointed, and have little faith, in your doctor at this point. I find it somewhat negligent to be changing your dosages and/or meds without testing in between to even see what your levels are...... Lab tests should always be performed prior to dosage/med changes, so you know where you're at.
The best thing you can do at this point, is insist on regular labs until your levels stabilize; get copies of ALL your labs and on each report, note the medication you're on when the test is done, along with what, if any, symptoms you were having at the time, whether you felt good, etc. This will help you keep track of what med/dosage works best for YOU and what lab numbers to "target" in order for you to feel your best.
While it's true that cytomel is immediately available to the body, and a difference can be felt quickly, it can take a while for your FT3 level to rise, so it's a good idea to wait a few weeks after starting it before testing. It took several months after I started taking T3 med, for my levels to come up appreciably.
Because the Tirosint is better absorbed and you're on the T3 med, you will need to watch for hyper symptoms.
Are you splitting your cytomel into 2 doses or taking it all at once? If you split it into 2 doses, and take one in the morning and one around noon, it will stay with you longer, so you'll be less likely to "slump" later in the day. If you're taking the whole 5 mcg at once, you might try taking it later, but of course, that depends on your schedule, too.
I take my T3 med in one dose, but have, recently, began hitting a time of day where I'm really dragging/drowsy; I'm going to try taking my T3 around 11:00 or so and see if that will help get me through the slump.
Hi,
I just wanted to update.
My doctor agreed to switched me to Tirosint 88 mcg and Cytomel 5mcg.
Instead of Levoxyl 100 mcg and Cytomel 2.5 (I've been on Cytomel only for a few weeks now.)
I weigh 136.6 lbs. If I was on ONLY taking Tirosint than the dose for that based on my weight would be 105.23 mcg, but I asked for 88mcg instead because of the Cytomel 5mcg addition.
Is this correct?
I hope I did the right thing in asking for Tirosint 88 mcg instead of Tirosint 100 mcg or Cytomel 10mcg.
I've gained 15 lbs in a few months and don't want to keep gaining if the dose is two low. I coulen't open a water bottle my muscles are so weak and stiff, I'm not sleeping, I forgot my home address the other day, I don't have regular bowl movements. I've been miserable.
I think he's going to test my adrenals in six weeks if my symptoms don't improve on the new medications.
Thank you for your advise/opinion, it's appreciated.
I just wanted to update.
My doctor agreed to switched me to Tirosint 88 mcg and Cytomel 5mcg.
Instead of Levoxyl 100 mcg and Cytomel 2.5 (I've been on Cytomel only for a few weeks now.)
I weigh 136.6 lbs. If I was on ONLY taking Tirosint than the dose for that based on my weight would be 105.23 mcg, but I asked for 88mcg instead because of the Cytomel 5mcg addition.
Is this correct?
I hope I did the right thing in asking for Tirosint 88 mcg instead of Tirosint 100 mcg or Cytomel 10mcg.
I've gained 15 lbs in a few months and don't want to keep gaining if the dose is two low. I coulen't open a water bottle my muscles are so weak and stiff, I'm not sleeping, I forgot my home address the other day, I don't have regular bowl movements. I've been miserable.
I think he's going to test my adrenals in six weeks if my symptoms don't improve on the new medications.
Thank you for your advise/opinion, it's appreciated.
you will only go hyper if your FT3 goes high enough to cause Hyper.
Since you appear to be converting slowly any T4 into T3, I'm not sure that you have to worry about going Hyper.
Of course you have to keep your eye out for Hyper symptoms. If you do start to have Hyper symptoms. Then stop or skip your T3 med and call your Dr.
T3 being immediate to be used by your body, by stopping that should most rapidly stop you from continuing to be Hyper should that situation even occur.
If you have been taking the Cytomel with the 100 for a few days already and you are not showing signs of Hyper, Then the chances are not too great that you will suddenly go hyper.
Not saying that it can't happen. I'm just saying that you should be aware of Hyper symptoms, but don't get all stressed out worrying about it. Your FT3 were pretty low in the range.
Since you appear to be converting slowly any T4 into T3, I'm not sure that you have to worry about going Hyper.
Of course you have to keep your eye out for Hyper symptoms. If you do start to have Hyper symptoms. Then stop or skip your T3 med and call your Dr.
T3 being immediate to be used by your body, by stopping that should most rapidly stop you from continuing to be Hyper should that situation even occur.
If you have been taking the Cytomel with the 100 for a few days already and you are not showing signs of Hyper, Then the chances are not too great that you will suddenly go hyper.
Not saying that it can't happen. I'm just saying that you should be aware of Hyper symptoms, but don't get all stressed out worrying about it. Your FT3 were pretty low in the range.
Thank you flyingfool.
I called the doctors office this morning and started crying on the phone (to the receptionist) I feel really stressed and worried about becoming hyperthyroid on 100 Levoxyl (not reduced) when 2.5 Cytomel was added.
I don't know what to tell my doctor when he calls back. They get annoyed if you mention internet, I looked this up or I read and I always take more than 15 minutes in his office.
I called the doctors office this morning and started crying on the phone (to the receptionist) I feel really stressed and worried about becoming hyperthyroid on 100 Levoxyl (not reduced) when 2.5 Cytomel was added.
I don't know what to tell my doctor when he calls back. They get annoyed if you mention internet, I looked this up or I read and I always take more than 15 minutes in his office.
Cytomel is a T3 drug. T3 is almost immediately available to use by your body. You do NOT have to wait 6 weeks to test your blood for a T3 med. That is for a T4 med which takes a long time to build up in your bloodstream. I would think 2 weeks would be plenty to wait to get new blood work.
Hi Barb,
Yes, the results are from May. I think I was taking 112 Levoxyl and he put me on alternating dose of 100 and 112. Then a few weeks in, my other doctor told me to go back to 100 (no testing) so I haven't managed to string six weeks on one dosage since May. So, I haven't been tested again. Now I have to wait another six weeks since Cytomel was added (I asked for it).
I'm only on 2.5 Cytomel total (split from a 5mcg). Today I took it at 7am along with my 100 mcg Levoxyl. I called my doctor yesterday and asked him to reduce Levoxyl and he said no.
I am thinking of calling him again today and asking for an appointment to switch to 88 Tirosint plus the 2.5 Cytomel.
My previous post about the two doctors was too long and confusing.
Thank you again
Yes, the results are from May. I think I was taking 112 Levoxyl and he put me on alternating dose of 100 and 112. Then a few weeks in, my other doctor told me to go back to 100 (no testing) so I haven't managed to string six weeks on one dosage since May. So, I haven't been tested again. Now I have to wait another six weeks since Cytomel was added (I asked for it).
I'm only on 2.5 Cytomel total (split from a 5mcg). Today I took it at 7am along with my 100 mcg Levoxyl. I called my doctor yesterday and asked him to reduce Levoxyl and he said no.
I am thinking of calling him again today and asking for an appointment to switch to 88 Tirosint plus the 2.5 Cytomel.
My previous post about the two doctors was too long and confusing.
Thank you again
COMMUNITY LEADER
Are the results from May, the latest ones you've had done? If so, I think they are too old, to be dosing from them now. You should talk to your doctor about getting current tests, see what your levels are now, and go from there. You need to be tested every 6-8 weeks until your levels are adequate for you and stabilized.
Yes, it is customary to drop T4 medication when adding cytomel, but many doctors don't. It's also customary to have hyper (or worse more severe hypo) symptoms when starting a new medication or changing dosage. I agree with gimel, that you should split your 5 mcg pill and take 1/2 in the morning and 1/2 around noon or so. It's best not to take it after about 3:00 pm, because that will interfere with sleep. Splitting the cytomel into quarters will most likely leave you with not much but powder. I've done it, but it's very difficult and wasn't worth the effort, for me.
Yes, it is customary to drop T4 medication when adding cytomel, but many doctors don't. It's also customary to have hyper (or worse more severe hypo) symptoms when starting a new medication or changing dosage. I agree with gimel, that you should split your 5 mcg pill and take 1/2 in the morning and 1/2 around noon or so. It's best not to take it after about 3:00 pm, because that will interfere with sleep. Splitting the cytomel into quarters will most likely leave you with not much but powder. I've done it, but it's very difficult and wasn't worth the effort, for me.
Hi Barb 135,
Thank you for your reply.
Yes, I think 125 mcg (per the formula) is way too much for me. I found another that said it's weight in Kg X 1.6
I don't take medication for ADD (although I have it) because I think a lot of the more sever symptoms were/are thyroid related. Some of them have improved a bit.
Thank you for your reply.
Yes, I think 125 mcg (per the formula) is way too much for me. I found another that said it's weight in Kg X 1.6
I don't take medication for ADD (although I have it) because I think a lot of the more sever symptoms were/are thyroid related. Some of them have improved a bit.
Hi gimel
Thank you again for your reply. I do like seeing lots of different doctors - rather see just one if I can.
I'm going to read the link today - my brain wasn't working last night. Hopefully I'll read it before talking to my doctor.
I'm splitting a 5mcg tablet in half and taking 2.5 once a day. I'm only taking 2.5 total, but I will talk to him about reducing the Levoxyl to 75 mcg and taking Cytomel 5 mcg (split).
Should I split the 2.5 I'm currently on in half into 1.25 and take it twice a day? I think it might be too small and crumble though.
I have been and might still be deficient in Vitamin D, B12 (had injections) and Copper and high in Selenium.
I'll look at my labs and see what the numbers are for those. do you mind if I post them? I would like to know what to do about iron/ferritin, because I thought it was low, but not advised to do anything about it. Just told to stop eating brazil nuts (my selenium source).
Thank you again for your reply. I do like seeing lots of different doctors - rather see just one if I can.
I'm going to read the link today - my brain wasn't working last night. Hopefully I'll read it before talking to my doctor.
I'm splitting a 5mcg tablet in half and taking 2.5 once a day. I'm only taking 2.5 total, but I will talk to him about reducing the Levoxyl to 75 mcg and taking Cytomel 5 mcg (split).
Should I split the 2.5 I'm currently on in half into 1.25 and take it twice a day? I think it might be too small and crumble though.
I have been and might still be deficient in Vitamin D, B12 (had injections) and Copper and high in Selenium.
I'll look at my labs and see what the numbers are for those. do you mind if I post them? I would like to know what to do about iron/ferritin, because I thought it was low, but not advised to do anything about it. Just told to stop eating brazil nuts (my selenium source).
Hi 78london,
"First, do you still have all or part of your thyroid?"
I haven't had any of my thyroid removed so to my knowledge, I still have my thyroid. I don't know how much of it has been killed by antibodies.
"Are your nails brittle?"
Not especially - they have always been very strong and grow fast. They do however have lots of vertical ridges that I've read are associated with thyroid.
"Losing hair and have really bad dry skin?"
I do loose lots of hair, but I may just notice it more because it's long and dark. I still have lots of hair, but not as much as I had when I was younger. I had Alopecia Areata in my late 20's. The B12 deficiency was found at that time. I also had problems with my platelets then and was under a lot of stress. I think stress brought the Alopecia on then. I also think that recent stress brought the Hashimoto's out. I had thyroid antibodies at that time too and the doctor referred to in my previous post found this, but I was moving to Germany at that time and didn't realize that I really NEEDED to be tested every six months like he'd said. I also never thought to look up the symptoms of Hashimoto's. Naive and ignorant.
My skin gets dryer in the winter and my face gets a little oilier in the summer. I moisturize everyday. I do have a lot of skin problems though - contact dermatitis, hives, rashes.
"Menstral problems?"
My periods are very heavy, I have PMS, cramps and lower back pain, but it usually doesn't last more than five days. They use to be more regular - every 28 days. Now they time between is getting shorter.
Thanks again,
sissaphus
"First, do you still have all or part of your thyroid?"
I haven't had any of my thyroid removed so to my knowledge, I still have my thyroid. I don't know how much of it has been killed by antibodies.
"Are your nails brittle?"
Not especially - they have always been very strong and grow fast. They do however have lots of vertical ridges that I've read are associated with thyroid.
"Losing hair and have really bad dry skin?"
I do loose lots of hair, but I may just notice it more because it's long and dark. I still have lots of hair, but not as much as I had when I was younger. I had Alopecia Areata in my late 20's. The B12 deficiency was found at that time. I also had problems with my platelets then and was under a lot of stress. I think stress brought the Alopecia on then. I also think that recent stress brought the Hashimoto's out. I had thyroid antibodies at that time too and the doctor referred to in my previous post found this, but I was moving to Germany at that time and didn't realize that I really NEEDED to be tested every six months like he'd said. I also never thought to look up the symptoms of Hashimoto's. Naive and ignorant.
My skin gets dryer in the winter and my face gets a little oilier in the summer. I moisturize everyday. I do have a lot of skin problems though - contact dermatitis, hives, rashes.
"Menstral problems?"
My periods are very heavy, I have PMS, cramps and lower back pain, but it usually doesn't last more than five days. They use to be more regular - every 28 days. Now they time between is getting shorter.
Thanks again,
sissaphus
Since your doctor was willing to prescribe Cytomel in order to raise your FT3 level, I think that is a good sign that he is willing to listen and be flexible about your treatment. I'd hang with him and see if you can get what you need to become symptom free. I hope that you took the time to read the link I gave you above. If you did, I think you can understand that clinical treatment, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, is the right way to go.
Accordingly taking Cytomel in order to increase your FT3 level is directionally correct. Your FT3 level was previously too low. Many patients have some initial reactions to starting on T3 meds (sometimes T4 as well). I would recommend splitting the dose and taking half in the morning and half in the early afternoon. Then give it a few days and see if you get acclimated to it. Then you will need to continually increase your T3 meds slowly as necessary to relieve hypo symptoms.
Many hypo patients find that they are low in other areas as well. Some time in the near future, if you haven't already been tested for Vitamin D. B12, zinc, RCB magnesium, iron/ferritin and selenium, that would be a good idea.
Accordingly taking Cytomel in order to increase your FT3 level is directionally correct. Your FT3 level was previously too low. Many patients have some initial reactions to starting on T3 meds (sometimes T4 as well). I would recommend splitting the dose and taking half in the morning and half in the early afternoon. Then give it a few days and see if you get acclimated to it. Then you will need to continually increase your T3 meds slowly as necessary to relieve hypo symptoms.
Many hypo patients find that they are low in other areas as well. Some time in the near future, if you haven't already been tested for Vitamin D. B12, zinc, RCB magnesium, iron/ferritin and selenium, that would be a good idea.
Thank you all for your replies - I appreciate them so much
I had two doctors "involved" with my thyroid. Initially the first (doctor one) a very competent and thorough Hematologist/Oncologist and head of a cancer center, but he is now retired and was a blood man. He only looked at the lab results. I do like that he found a few deficiencies (he was thorough) B12, D and copper.
Doctor two is my (new) primary care which doctor one referred me to. He listens to my symptoms, but doesn't order a lot of tests. He only ordered TSH on my recent labs that I have yet to do, but I have a second lab slip with everything else from my (now) retired doctor (one).
My TSH started out at 60 and my antibodies were over 1000 (they stop count at 1000), but my previous primary care never tested me despite my telling him that I was sitting in the shower, I was so tired. He told me that I was depressed. I knew it was someone else so went to doctor one who had been very through with me ten years prior (discovering the B12 deficiency). This doctor started me out on 25 mcg Levoxyl because I had heart trouble as a child and gradually increased it over several months. I started feeling good at 100 mcg (didn't have any weight gain at this point). He then increased it to 125 mcg two weeks before I was due to relocate overseas (to the UK). I was upset about this, but took it anyway. Once in London I was tested and they found my TSH was too low. So they put me back on 112 or 100? It was at this time that I started gaining weight. We moved back to the States in October and doctor one reduced me to 100 mcg (again,) but I still had lots of symptoms and was especially cold (New England winters).
In the mean time, my primary care (Dr. two) thought my Free T3 was too low and added Cytomel, but I was afraid to take it because the Hematologist/Oncologist thought my moods (anxiety) were too up and down for it and didn't seem to see a value in T3 medication at all. He wanted me to stay on 100 mcg, but I was put on an alternating dose by my primary care (who thought Free T3 was too low) - the values above from May are from this time. I had hyper symptoms on the alternating dose of 100 mcg five times a week and 125 mcg twice a week. So I called both Doctors and the the Oncologist called back and told me to take a week off and then go back down to 100 mcg. He has since retired.
As of Tuesday, my primary care has added 2.5 mcg Cytomel to my 100mcg Levoxyl, but I think this is too much since he didn't reduce Levoxyl as I've read you should when Cytomel is added. I left him a message and will hopefully talk to him today. I slept very badly last night and stayed away for part of the night. This morning I woke up with a massive headache.
I'm sorry this is so long.
I feel so lost want to feel better. I guess I should find an Endocrinologist, but I'm afraid to find a "bad one" and have them try doses that have already been done - several times over.
Thank you again for all your help.
I had two doctors "involved" with my thyroid. Initially the first (doctor one) a very competent and thorough Hematologist/Oncologist and head of a cancer center, but he is now retired and was a blood man. He only looked at the lab results. I do like that he found a few deficiencies (he was thorough) B12, D and copper.
Doctor two is my (new) primary care which doctor one referred me to. He listens to my symptoms, but doesn't order a lot of tests. He only ordered TSH on my recent labs that I have yet to do, but I have a second lab slip with everything else from my (now) retired doctor (one).
My TSH started out at 60 and my antibodies were over 1000 (they stop count at 1000), but my previous primary care never tested me despite my telling him that I was sitting in the shower, I was so tired. He told me that I was depressed. I knew it was someone else so went to doctor one who had been very through with me ten years prior (discovering the B12 deficiency). This doctor started me out on 25 mcg Levoxyl because I had heart trouble as a child and gradually increased it over several months. I started feeling good at 100 mcg (didn't have any weight gain at this point). He then increased it to 125 mcg two weeks before I was due to relocate overseas (to the UK). I was upset about this, but took it anyway. Once in London I was tested and they found my TSH was too low. So they put me back on 112 or 100? It was at this time that I started gaining weight. We moved back to the States in October and doctor one reduced me to 100 mcg (again,) but I still had lots of symptoms and was especially cold (New England winters).
In the mean time, my primary care (Dr. two) thought my Free T3 was too low and added Cytomel, but I was afraid to take it because the Hematologist/Oncologist thought my moods (anxiety) were too up and down for it and didn't seem to see a value in T3 medication at all. He wanted me to stay on 100 mcg, but I was put on an alternating dose by my primary care (who thought Free T3 was too low) - the values above from May are from this time. I had hyper symptoms on the alternating dose of 100 mcg five times a week and 125 mcg twice a week. So I called both Doctors and the the Oncologist called back and told me to take a week off and then go back down to 100 mcg. He has since retired.
As of Tuesday, my primary care has added 2.5 mcg Cytomel to my 100mcg Levoxyl, but I think this is too much since he didn't reduce Levoxyl as I've read you should when Cytomel is added. I left him a message and will hopefully talk to him today. I slept very badly last night and stayed away for part of the night. This morning I woke up with a massive headache.
I'm sorry this is so long.
I feel so lost want to feel better. I guess I should find an Endocrinologist, but I'm afraid to find a "bad one" and have them try doses that have already been done - several times over.
Thank you again for all your help.
COMMUNITY LEADER
I agree with the consensus that treatment should be based on symptoms, as well as test results, and that TSH is not a good diagnostic; Free T3 and Free T4 are much more important. My TSH routinely runs at < 0.01, but my Free T3 and Free T4 levels are good.
The dosage of medication varies from person to person, and is not necessarily related to weight. For instance, if I were to go by the method in the comment above this, I'd be WAY over medicated. I'm 140 pounds, which is 63.6 kg X 2 would be 127.2. I'm on 88 mcg tirosint and doing well. 127 or even 125 mcg would be too much for me.
Your dosage should be whatever it takes to alleviate symptoms. In your case, it appears that you aren't converting the T4 to T3, and the Free T3 is the hormone that's actually used by the body. You might ask your doctor to try you on a small dose of cytomel to see if that will raise your FT3 levels and help alleviate your symptoms. The ADD symptoms could very well be thyroid related and may go away once your levels are stable and at a point that's good for you.
The dosage of medication varies from person to person, and is not necessarily related to weight. For instance, if I were to go by the method in the comment above this, I'd be WAY over medicated. I'm 140 pounds, which is 63.6 kg X 2 would be 127.2. I'm on 88 mcg tirosint and doing well. 127 or even 125 mcg would be too much for me.
Your dosage should be whatever it takes to alleviate symptoms. In your case, it appears that you aren't converting the T4 to T3, and the Free T3 is the hormone that's actually used by the body. You might ask your doctor to try you on a small dose of cytomel to see if that will raise your FT3 levels and help alleviate your symptoms. The ADD symptoms could very well be thyroid related and may go away once your levels are stable and at a point that's good for you.
First, do you still have all or part of your thyroid? I don't have a thyroid . And after my surgeries it took less than 6 months to get my levels and body back to normal.
I have been on thyroid replacement hormones now for 15 years. I was on Synthroid fro years and HATED it. It made me irratated and moody and down right hateful sometimes. I got switched to Levoxyl, but have been on Levothyroxine for about 4 years. I love it! Point is everyone is different with different medications. But they say to stick to one, don't keep switching brands.
I agree with gimel about treatment not being constrained by test results. I did read some where that your dose is calculated by taking your weight in Kg's and multiplying by 2. So 137 is 62.1 kg. That times 2 is 124.2. So more than likley that would be 125 mcg dose. I would try another doctor. An endocrinologist specifically. It wouldn't hurt to get a 2nd opinion. My doctor only uses the TSH, T3 and T4 tests. I've been tested by 5 different doctors and all of them only use those 3 tests.
If your levels are low it explains the tiredness and inability to concentrate &/or remember (I would be leary about the ADD diagnosis) and the weight gain. Are your nails brittle? Losing hair and have really bad dry skin? Menstral problems? A lot of symptoms you wouldn't think of are related to low thyroid levels.
Finally, I learned that with my levothyroxine it can't get too warm or it will lose its potency. I keep mine in the fridge. It doesn't last forever either. Meaning its shelf life isn't that long. That's why I can only get a couple of months worth at a time. And lastly, its important that I take it 1 hour before or 2 hours after eating(so on an empty stomach), and at the same time every morning. Otherwise I may not absorb it all into my system.
Hope this helps.
I have been on thyroid replacement hormones now for 15 years. I was on Synthroid fro years and HATED it. It made me irratated and moody and down right hateful sometimes. I got switched to Levoxyl, but have been on Levothyroxine for about 4 years. I love it! Point is everyone is different with different medications. But they say to stick to one, don't keep switching brands.
I agree with gimel about treatment not being constrained by test results. I did read some where that your dose is calculated by taking your weight in Kg's and multiplying by 2. So 137 is 62.1 kg. That times 2 is 124.2. So more than likley that would be 125 mcg dose. I would try another doctor. An endocrinologist specifically. It wouldn't hurt to get a 2nd opinion. My doctor only uses the TSH, T3 and T4 tests. I've been tested by 5 different doctors and all of them only use those 3 tests.
If your levels are low it explains the tiredness and inability to concentrate &/or remember (I would be leary about the ADD diagnosis) and the weight gain. Are your nails brittle? Losing hair and have really bad dry skin? Menstral problems? A lot of symptoms you wouldn't think of are related to low thyroid levels.
Finally, I learned that with my levothyroxine it can't get too warm or it will lose its potency. I keep mine in the fridge. It doesn't last forever either. Meaning its shelf life isn't that long. That's why I can only get a couple of months worth at a time. And lastly, its important that I take it 1 hour before or 2 hours after eating(so on an empty stomach), and at the same time every morning. Otherwise I may not absorb it all into my system.
Hope this helps.
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Thyroid patients taking large doses of T4 meds frequently do not adequately convert T4 to T3, resulting in to low levels of FT3, such as yours. Just because your FT3 is just within the low end of the range does not mean that it is adequate for YOU. The ranges are far too broad. Many members report that symptom relief for them required that FT3 was adjusted into the upper part of the range and FT4 adjusted to around the midpoint of its range,
A good thyroid doctor will treat a thyroid patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can get some good info from this link to a 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 doctor to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf