Am I under medicated

[lexilou]

December 13

serum TSH level (XaELV) 28.00mu/L (0.2 - 4.0)

Free T4 5pmol/L (7.8- 14.4)

prescribed 50mcg levothyroxine

was given 50mcg levo

February 14

Serum TSH level (XaELV) 2.69 mu/L (0.2 - 4.0 )

THYROID PEROXIDASE ANTIBODY 730iu/ml (0.0 - 50.0)

currently taking 50mcg t4 and 10mcg t3 .

Any help would be appreciated not doing well at all.

[Tweetypie28]

Hi Lexi

It's interesting to see you have been given T3. Were you prescribed these by a doctor?

I don't know enough about T3 and how much you should take when combining with T4 but 50mg of Levo is a low starter dose. Did you go back to docs in February after further tests and they then gave you T3 instead of raising your Levo?

How do you feel? Do you still have symptoms?

[lexilou]

Hi Debsy,

Yes I was prescribed the T3 by my doctor, although he had never heard of it I had to ask for it.

My doctor was happy to keep me on the 50mcg levo as my feb results were normal.

As far as my doctor is aware I am taking the T3 only, I have added back the levo myself as I cant get an appointment until next week.

I still have really bad symptoms and think the medication is making me worse.

[shaws Administrator]

I think you may be still undermedicated. 50mcg is only a starting dose but the fact that T3 has been added is good. You can take both together but your dose may still be too low for you i.e. equivalent to 100mcg levo.This is a link and if you go to the answer to question dated November 20, 2002 to read re low dose.

drlowe.com/QandA/askdrlowe/...

Your TSH is still a bit on the high side if you are still feeling unwell and Dr Toft of the BTA says:-

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).

(PS references ranges vary between labs).

[crimple]

You have high TPO antibody levels I have answered on earlier post about paleo diet to exclude gluten and dairy and hopefully reduce your antibody level. The antibodies can go up and down and cause you to feel unwell in spite of medication.

[lexilou]

Thanks for the replies will be speaking to my doctor and will take a look at the paleo diet crimple.