Stay on same dose of levothyroxine?

[lacrandall]

In 2011 my tsh suddenly jumped to 3.11 (had previously been in the 0.75 - 1.50 range), at which time my doc switched me from 75mcg synthroid to 50mcg of levothyroxine. Now in 2015 my tsh has dropped to 0.68 (0.35 is the bottom end of our medical plan's range), and my doc says to stay on same dose of levothyroxine (no t3 or t4 was run in either testing as far as I can tell when I look online). This doesn't seem right to me. In the last 6 months I have noticed more brittle nails and hair loss, as well as sluggishness. However I have been successful in losing 40 lbs in the last 6 mos on purpose. Any thoughts? Thanks!!

[hose1975]

Free T4 is a more useful indicator of what's going on. Do you have those results and the reference ranges?

[lacrandall in reply to hose1975]

Hi hose1975. No I don't have the T4 results. My HMO changed their patient online system, and it appears they got rid of the lab results segment that gives us the breakdown, as well as the comparison graph with previous tests. I'm going to dig around some more to see if it's just hiding somewhere. Thanks for the reply!

[shaws Administrator]

I believe you are on too low a dose. When you had your last blood test for your thyroid hormones, did you take levothyroxine before?

Do you take levo first thing with a glass of water and not eat for around an hour. Some take it at bedtime but you must have eaten last about 2 hours beforehand. Has your doctor checked for thyroid antibodies?

Cursor down to the date November 28, 2003 on this link and read the answer.

web.archive.org/web/2010103...

[lacrandall in reply to shaws]

Thanks shaws for the info. I read the article and will bring itto my doc's attn. I am with an HMO that I am very happy with, but one of the drawbacks is that the docs are limited with regard to what they can prescribe as it has to be within the "formulary."

In answer to your questions: I do take it when I wake up (along with 2 other meds) and don't eat/drink coffee for about an hour afterwards.Yes, I was on the levothyroxine when the test was done. No, she did not test the anti-bodies. I'll have to inquire about doing that.

I do have a question though: you stated I am on too low a dose. If my current dose lowered my tsh from 3.11 to .68, wouldn't an increased dose lower it further? This whole thing confuses me!

[lacrandall]

I finally found the previous results page. I wish I could attach a screen shot. Basically, from 2007 - 2009 I was on 75mcg of synthroid and the tests were coming back at just over 1.0 to just over 2.0. No tests in 2010. Then in 2011 the test revealed the 3.11 (after this test is when my doc switched me to levothyroxine 50mcg), followed by another test in 2012 showing a .26. After that subsequent tests were back in the 1.0 to just over 2.0 range until now (these are generalized results from what I can remember of the test results). I am dealing with brittle nails, hair loss/thinning, constipation, tiredness. These symptoms have occurred over the past 12 to 18 mos, and I recently increased my biotin intake in an effort to combat the hair and nails issue. I had none of these issues when I was on the synthroid.

[Clutter in reply to lacrandall]

lacrandall, Brand changes can be very upsetting and presumably you were switched from Synthroid to generic Levothyroxine due to cost. It may be worth getting private labs to check your FT4 and FT3 levels. If they are low, which would account for hypo symptoms, you might ask your doctor to put you back on Synthroid, presscribe a different generic or to increase your current dose of Levothyroxine. TSH 0.68 to just over 1.0 is generally comfortable for most people but some need it lower, or even suppressed, to feel well.

[lacrandall in reply to Clutter]

In June of 2012, while on the levothyroxine, my free T4 was 1.51 (max on the range was 1.54) and my tsh was 0.26 (below the range of 0.35). This doesn't make sense to me. That was the last time the T4 was checked. Based on my research the synthroid is geared more toward correcting a T4 issue (true/false?). My doc switched me to the levothyroxine in 2011 when my tsh suddenly shot up to 3.11 from just above 1.0. I'm going to ask her to run the full panel instead of just the tsh she did last month. Anything else I should have her run? Thanks!

[Clutter in reply to lacrandall]

lacrandall, TSH fluctuates according to circadian rhythms and is generally lower in Summer than winter. Having a cold or virus at the time of testing can make TSH rise too. It is helpful to have a full panel occasionally and particularly if hypo symtoms have come back. Ask for TSH, FT4 and FT3 for thyoid and ferritin, vitamin D, B12 and folate which are often low in hypothyroid patients. Post the results with the lab ref ranges in a new questions and members will advise.

[lacrandall in reply to Clutter]

Will do. Thanks!