Should the Synthyroid be increased from 50mcg to 75mcg?

[Alekatt73]

Thyroid panel shows
Negative antibodies
TPO - 38
T3(total) 94
T4 6.0
TSH 6.05
T7 1.7
History of Hypothyroid w/nodule.
Increased Synthroid from 50mcg to 75mcg....is this heading in the wrong directon?
I appreciate any info and suggestion

Kindly Thyroid Inept

[gimel]

I really don't understand why you were tested for Total T3 and Total T4 and T7, which is sometimes called Free T4 Index, which is an estimate of Free T4.  Note the following quote.

"Free T4 Index. Using the T3 resin uptake test in conjunction with the total T4 measurement, one can make a calculation of a free T4 index. Some labs very ingeniously call this a T7, because they’re taking a T3 and a T4 and it becomes a T7. Actually, this index is a multiplication of the T3RU and the total T4. The free T4 index is a good test, even though it is not completely accurate, due to abnormalities in binding or other situations. However, free T4 is definitely a great advantage over the older total T4 or protein-bound iodide tests."

Why use outdated tests instead of just testing for Free T4 directly and also  Free T3.  Total T4 and Total T3 measures of the total serum levels.  Most of that is bound to protein and thus biologically inactive.  Only the small portions free of protein are active.  That is why it is better to know the Frees rather than the Totals.  

Trying to assess your status, I would say that if your Free T4 and Free T3 are in the same position in their ranges as are Total T4 and Total T3, then that would account for you being hypothyroid still.  I highly recommend that you get tested for Free T4 and Free T3 every time you go in for tests.  Many of us have found that T4 needs to be mid-range and Free T3 high enough in the upper half of its range to relieve hypo symptoms.  Symptom relief should be all important, not just test results.  

Since hypo patients are so frequently low in the ranges for Vitamin D, B12 and ferritin, I also suggest testing those and supplementing as needed to optimize.  D should be about 55, B12 in the upper end of its range, and ferritin should be about 70.

If you have any problem getting your doctor to do these tests and adjusting your Free T4 and Free T3 levels as needed to relieve symptoms, then I suggest that you will need to find another doctor that will do so.  

Also, I am sending you a PM with some further info.  To access, just click on your name and then from your personal page, click on messages.  

[Alekatt73]

Ok Thank you
Reference ranges

TPO - less than 34
T3 (total) - 76-181
T4  4.4-12.5
T7 1.2-4.3
TSH 0.450-4.5

essentially the TSH and TPO are out of range.
S/S can include increased fatigue and minor hair loss
I am a practitioner myself, however I am learning Thyroid/endocrine and find it challenging to say the least. Have no support been reading ALOT, any book or website references you have to offer is appreciated.

Kindly,
Thyroid Inept

[gimel]

In order to make an assessment of your status we need you to post the reference ranges for those test results, as shown on your lab report.   Also please tell us about any symptoms you have.