I wonder if anyone has had a similar problem - I have been hypothyroid for 8 years and gradually increased levothyroxine dose to 100mcg.

[Valt1]

Each time I have needed an increase I have experienced recurrence of symptoms despite being 'in range' . My GP has been very supportive and agreed to keep me at Free T4 around middle of range. This time however my Free T4 has dropped to 10, I have all the usual symptoms but my GP is unwilling to increase the dose as my TSH is low at 0.68. (Previously there was always a corresponding increase in TSH levels when Free T4 dropped). Bloods are being retested but if results are similar, I am wondering where that leaves me...?? Any thoughts appreciated.

[Aurora-auspice]

I'm at same stage so don't know where it will go yet but I take 225mcg levo daily now recently reduced for same reason and feel shattered etc as before! Blood tests for new dose are in two weeks so hope your responses are enlightening. Thanks for asking!!!

[Valt1 in reply to Aurora-auspice]

Thanks, lets hope someone out there can give us both some hope!

[Aurora-auspice]

Exactly xxx

[shaws Administrator]

Ask GP if he will consider adding 10mcg T3 to a reduced T4, as recommended by Dr Toft ex of the British Thyroid Association extract from Pulse online article:-

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

[Jane104]

If your T4 has dropped that low with no significant rise in TSH there may be something else going on which your GP doesn't understand. As he is reluctant to do anything and is not an expert, I would ask to be referred to an endocrinologist.

[Jackie]

Hi I would make sure I had a Free T3 test, you may need some T3 and may be less or more T4 ( levo. ) It is quite common to suddenly need T3. TSH can be low, mine is immeasurable. You do need to have a pituitary gland test, in case , as it is sometimes that.GP`s are reluctant to give T3 if tSH is low. You need an Endo who considers everything not just bloods ie a good one of your choice!

Not sure if you know , we only get replies if you click on "reply to this" under that post.

Best wishes,

Jackie

[Valt1 in reply to Jackie]

Thanks for everyone's ideas and suggestions. Repeating tests again this week so will see what transpires - at least I have more information to back up a request to see an endocrinologist if there is no great change....

[Heloise]

Especially the last paragraph in this link.

thyroid-rt3.com/whatis.htm