Neep Input

[guysgrams]

Saw my doc yesterday. I've been hypo and treated since 1996. Visited with doc about test results. I usually get my results in print out form since I am with so many others and don't take 'fine/normal' as a given. My results last year showed TSH at 3.10 Triglycerides were 190 and cholestrol had ticked up as well. This year same lab and now my TSH is1.77 and thyroxine serum free is 1.7. Cholestrol is down and Triglycerides are at 143. I have never in the almost 20 years since being medicated has my TSH swung that much in one year. Over the course of this past year I have become more cold sensitive, eye lashes falling out, fatigued and just not felt myself. Tried to visit with my doc (new to me) about this and she said my numbers were good and she didn't feel the need to change anything as if she upped my dosage it would put me in the hyper area as the T4 was at the upper range already. Her suggestion was to take my regular dosage 6 times a week and on the 7th day take a pill and a half. Has anyone ever heard of this type of suggestion? I am trying to wrap my head around that one as I don't know how that could help and it scares me to take 11/2 times my normal at one time. For me my normal or some what normal is TSH of .5-1.5 but closer to .5. At least then I feel as though I have energy and I'm not falling asleep at 7 PM and not cold. HELP.

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Has she considered testing FT3 this would shed light to see if a different approach was required?

This is something that I am just about to pay for myself?

[guysgrams]

Actually I asked that question and she said 'it didn't matter'. I am planning on getting an entire profile done at my own expense just to see.

[guysgrams]

Can anyone tell me what a 1.7 thyroxine serum free results mean in laymen's terms? Thanks

[Jazzw in reply to guysgrams]

That's what we call an FT4 result (free T4). Is there a range for your results on that print out? I suspect that might not be in the top quartile of the range (which is where many people feel best) but can't really tell without a range.

[guysgrams in reply to Jazzw]

yes, the range is .08-1.7 but the problem is I'm cold sensitive now and have been for the past several months, eye lashes thinning, and fatigue. My TSH is 1.77. I have been on Synthroid .125 for almost 19 years now and am having this issue for the first time. Last year I have no idea what my FT4 was but my TSH was 3.10. So it has not been a good year for me. Optimally I feel the best when my TSH is .50-1.5 being closer to the .50 most of the time. Trying to figure out why I am having issues now.

[faith63 in reply to guysgrams]

It looks as tho you are not converting the t4 to t3 properly. This would leave you hypo, but high in range on ft4. It happened to me. I finally got very jittery and toxic, hyper symptoms plus the hypo too, at the same time. Terrible.

[eeng]

TSH varies quite a bit during the day, being highest at about 3-4am. If you had your blood test at different times of day that may account for some of the variation, but I am with faith63 on this one. You need a T3 test. Your TSH reading responds to your T3 level, not your T4 level. Taking a bigger dose once a week shouldn't make a difference to you because Thyroxine takes 6-8 weeks to stabilise in your bloodstream when you change your dose.

[guysgrams]

Thanks. Going to pay for a full panel to be done at my expense then I will know all the numbers. I am still very puzzled as to why a person would take a pill and a half one day a week though. Why wouldn't one just have the dosage increased by that same amount spread over all 7 days and then recheck in 6-8 weeks? I have two people in my office that are doing that now (the pill and a half one time a week) and it seems like it is becoming a trend maybe? Do you all see that happening a lot?

[helvella Administrator Thyroid UK in reply to guysgrams]

In some parts of the world, dosing is done as a weekly amount. For example, at the trivial end, 700 micrograms of levothyroxine a week. Then, if you seem to need a little more, you might get 725 a week.

In the UK, we are usually told to take the same dose every day. So an increase would be by 25 a day.

You can see that the weekly dosing allows doses to be changed by very small amounts, if needed. Whereas the daily dosing changes by a relatively huge amount. That is, 25 a week (weekly dosing), or 175 a week (daily dosing).

Quite how you take your tablets is then up to you. And it might end up with only one day being different to all the rest. We have seen both people taking more one day a week, and others taking less one day a week. It would, obviously, help if 12 microgram tablets were available in the UK!

We see a lot of people here who find one dose too little, but adding in 175 extra is too much.

[Eddie83]

Varying T4 like that usually works, since it is the storage hormone. That is, taking different dosages different days isn't a big deal. But I suspect that, due to your hypoT symptoms, you need a little T3 to be really well.

If your thyroxine serum is in the units I'm used to, 1.7 is high. The normal range is 0.8<FT4<1.8 ng/dl. I know that I can't tolerate FT4 high in range, makes me jittery. My doc has other patients who feel best when FT4 is low in range, and T3 is added in to bring FT3 up.