Lastest labs. Input welcomed.

[Carrie97]

Hi!

I'm 30 mother of 3. Got dx with hyper 6 years ago after sons birth went hypo 2 months later.. Been on levo since 125mcg got pregnant again in 2010 dose was never increased. Lately I've been feeling anxious, panicky, totally constipated, dry itchy skin, tired, palps, dizzy, you know the drill.. Labs a month ago were tsh 0.69 (0.30-3.30) t4 15 (10-25) asked my dr for a raise she wasn't happy but agreed so I'm taken 100/125. Does this seen like the right thing to do I defo do not want to go hyper!

[shaws Administrator]

You may well need an increase due to your clinical symptoms.

This is what Dr Toft stated in his article in Pulse Online about the treatment of hypo:-

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

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.

[Carrie97]

Sorry I meant I'm taking 125/150! So an increase would help?

[Carrie97]

Any other advice? Sometimes I worry all this isn't thyroid and it's something awful like terminal cancer.

[Carrie97]

After my increase of 150 I was doing good. Now couple months on I'm back to being totally constipated etc.. My recent bloods were same as before my increase!