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Thyroid Disorders Community
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Thyroid meds not working

Has anybody experienced that when taking thyroid meds for hypothyroidism, the levels do not change in line with the amount of medication you are taking? I am on meds but the TSH and T4 are barely elevating despite taking a high dose or 2 x 88 mcg per day.
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649848 tn?1534637300
COMMUNITY LEADER
What medication are you taking and how long have you been taking this dosage?  You're taking 176 mcg/day?

What are your actual lab numbers?  That would be the TSH and Free T4 results.  Be sure to include reference ranges which vary from lab to lab and have to come from your own report.  

What, if any, symptoms do you  have?
Avatar universal
What was the diagnosed cause for your hypothyroidism?  What was your starting dose of the T4 med.  Please post your thyroid related test results and reference ranges shown on the lab report, from your initial tests when diagnosed, and current results and reference ranges.  What symptoms do you have?
Avatar universal
For 2 months I was taking 50 mcg.

TSH=2.6 (0,35-5.0
FT4=10.0 (10-24)

After increasing to 88 mcg:
TSH = 3.7
FT4=10.4

2 x 88 mcg.
Symptoms similar. No test results yet.

Symptoms mainly absent mindedness, forgetfulness, anxiety, fatigue.


Avatar universal
For thyroid replacement I am on levothyroxine
Avatar universal
Thanks. Reply below
Avatar universal
Thanks. Reply below.
Avatar universal
When you were first diagnosed, was the cause identified?  Was it possibly Hashimoto's Thyroiditis?  Do you know your TSH from that time?

Clearly your Free T4 is still inadequate, even though your dosage is significant.  You really need to also know your Free T3 level.  In fact you should insist on being tested for both Free T4 and free T3 every time you test.  When taking an adequate dose of thyroid med, TSH often becomes suppressed, so keep in mind that a suppressed TSH does not mean you are hyper, unless you have hyper symptoms due to excessive levels of Free T4 and free T3.  I mention this only because doctors frequently will react to a suppressed TSH by reducing meds, even when you are still hypo.  

So, before trying to figure out what is happening with you right now, we really need to get more test information.  Specifically we need to get you tested again for Free T4, Free T3, Vitamin D, B12, and ferritin.  I would even ask for a Reverse T3 test and tests for progesterone and estrogen.  Those should be a good start, then we can go from there.  
Avatar universal
No I did not get to know the root cause of the hypothyroidism. Does it matter?
And what would the FT4/3 vs T4/3 tell me? I know what it is but could it indicate that the cells are not connecting to the thyroid hormones?
Why test all those hormones and vitamins?

And one more question. Why do the reference ranges differ between labs?
Avatar universal
If the root cause is Hashimoto's Thyroiditis, then the thyroid gland is continually under attack from the antibodies produced by the autoimmune system to destroy the gland.  So, if that was the cause, the TSH rises as the ability of the thyroid gland is diminished.  

You have been tested previously for Free T4 each time.  You need to always test for both Free T4 and Free T3 because it gives a more complete picture of what is going on.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.  

Hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  A deficiency in either can cause symptoms that mimic hypothyroidism.  Low D or ferritin can also adversely affect metabolism of thyroid hormone.  So  Vitamin D is best around 55-60. B12 in the upper part of its range, and ferritin should be about 70 minimum.  

In addition a good thyroid doctor will test and adjust Free T4 and free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  Many members say that symptom relief required Free T4 at the middle of its range, and Free T3 in the upper third of its range, or as necessary to relieve symptoms.  

For a variety of reasons, a patient's test results from the same blood draw can vary a bit from one lab to another.   So, since the results vary, the ranges calculated from those results also vary somewhat.  That is why it is always important to compare test results to ranges from that same lab.  
Avatar universal
I overlooked mentioning why I suggested testing for progesterone and estrogen.  If the ratio of P to E is too low that is called Estrogen dominance.   Estrogen dominance causes the liver to produce high levels of a protein called “thyroid binding globulin”, which, as its name suggests, binds the thyroid hormone and decreases the amount of thyroid hormone that can be assimilated into and utilized by the cells.  In other words your Free T4 and Fee T3 levels can be too low, even if your Total T4 and Total T3 are high. Your relatively low Free T4 just made me wonder about that possibility.
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649848 tn?1534637300
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