TSH, T3 & T4 levels tested, what do you recommend?

[Carolynmcc]

I have been on Levoxyl for 3 years every since my Thyroid was removed because of CA. I am 54 and the side effects of this med is scary for me but even scarier without it. My hair is falling out by the handfuls. I only wash my hair a few days a week instead of every day like I used to. You can even see my scalp it's so thin. My MD has adjusted my dosage but there has been little change in the hair loss. My sleep is a disaster even with a sleep aid. I don't take them anymore because there was little to no improvement. I gained 50 lbs with this drug and my metabolism is slow as a  sloth.  My skin is like a lizard - all dry and scaly even tho I use a lotion every day. I am on 125 of Levoxyl and the last drug test for my TSH was 1.070.
So, that comment was written I think in April, now it's the end of November. I argued with my MD to have my TSH, T3 & T4 tested - and the results - Ta Da-   T3 Free is 2.5    My T4 Free is 96 and my  T4 Free Direct was 1.31   My TSH was 5.020
My question is - what dosage of Levoxyl should I be on?
Pretty please answer. Thank you!  Carolyn

[gimel]

Good additional info from toni.  I especially want to emphasize the importance of testing for Vitamin D, B12 and ferritin.  Also, like with Free T3, just being in the low end of the so-called "normal" range is not adequate.  Midrange and above are much better.  It is very important to get ferritin to adequate levels, when you are taking thyroid meds.  

[toni2251]

Hi
I wanted to add Gimel told me about cytomel and it has been a God send. I will tell you though that it is gonna take some time for you body to recover from the loss of hormone but don't worry it will recover. I tell myself that it might take a year just to keep calm. You will recover once you get balanced. Hang in there. I have a doc that will prescribe me meds but doesn't help with my levels. Medhelp has helped me tremendously. Also make sure you are taking your vitamins and minerals. Also b12, vitamin d, calcium, mag, and zinc. These are very important with thyroid issues. Be blessed!

[Carolynmcc]

Thank you for taking the time to explain some of this to me. I have asked my doctor to consider all the tests results but he informs me he will NOT change my medication because according to him - I am in the "sweet spot". I will be on a journey to find another doctor to consider all the test results not just what he deems important.Thank you so much!

[gimel]

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.  Symptom relief should be all important, not just test results, and especially not just TSH results.  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 from a distance, after an evaluation and tests.  The letter is then sent to the patient's participating PCP,  to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

In the letter please note this info,  "the ultimate criterion for dose adjustment must always be the clinical response of the patient. I have prescribed natural dessicated thyroid for your patient (Armour, Nature-Throid) because it contains both T4 and T3 (40mcg and 9mcg respectively per 60mg). This assures sufficient T3 levels and thyroid effects in the body. Since NDT has more T3 than the human thyroid gland produces, the well-
replaced patient’s FT4 will be below the middle of its range, and the FT3 will be high “normal” or slightly high before the next AM dose."


So you need to find out if the doctor is going to be willing to treat clinically and prescribe T3 type meds.  If not, then you are going to have to find a good thyroid doctor that will do so.

[gimel]

I'd suspect that your hair loss is due to low levels of the biologically active thyroid hormones, Free T3 and Free T4, not due to the Levoxyl.  Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  

It is fortunate that you got your doctor to test for both Free T3 and Free T4.  Even without having the reference ranges, I  can see that your Free T3 is way too low in the range.  The range is far too broad to be functional.  It was erroneously established.  The ranges for both Free T3 and T4 should be more like the upper half of the current ranges.  That is why we hear so many members say symptom relief required Free T3 in the upper third of its range and free T4 around the middle of its range.

Again, without the reference ranges, I expect that your Free T4 is in the higher end of the range and, as noted, your Free T3 in the low end of its range.  this occurs when your body does not adequately convert all that T4 med to T3.  The solution to this is to reduce the T4 med and introduce some med with T3.  This can be either a T3 only type med like Cytomel, or an NDT type med like Armour Thyroid or Nature-Throid, both of which contain Free T3 and Free T4.  

        Continued below.

[Brucergoldberg]

Can you post the lab ranges?