My 3 months Treatment Summary and Latest Tests

[Ali1101]

Hi Friends ... I started my membership when I started my levothyroxine, It has been a while since I wrote last time, here is my summary and latest test results:

Before medications:

TSH: 0.015L (ref. 0.460 - 4.680).

FT4: 18.10 (ref. 10.00-28.00).

FT3: 7.48 (ref. 4.28-8.1).

Radioactive Iodine Uptake very low 0.1% (N 0.4-4%).

Antibodies:

Anti TPO <10 (ref. up to 34)

Thyreoglobulin abs 233H (ref. up to 115).

After 6 weeks on 50 mcg Levothyroxine:

TSH: 4.690H (ref. 0.460 - 4.680).

FT4: 9.93L (ref. 10.00-28.00).

FT3: 4.17L (ref. 4.28-8.1).

I have taken 75 mcg for a month then 100 mcg for another month, here is the latest results:

TSH: 0.371L (ref. 0.460 - 4.680).

FT4: 15.80 (ref. 10.00-28.00).

FT3: 5.61 (ref. 4.28-8.1).

B12 Vitamin: 264 (ref. 239-931)

My doctor thinks my current dose is high (100mcg) but I don't agree with him as I still have symptoms (I clearly see some improvements). The doctor and I both agree on TSH is not relevant as it goes from high to low and reverse without any relation to T4/T3.

I strongly believe I need to increase to at least 150 mcg to feel well (my weight is 83 KG). I think I need to have T4 in the high normal range like 22-24, Any thoughts?

Thanks

Ali

[Ali1101]

hope someone can advice!

[Sddixy]

Hey. I'm pretty new here. So please don't take what I say as gospel.

I believe that your symptoms can lag behind and also it takes 6weeks for you meds to be in your system. So if these tests were taken after 1 month (4weeks) after increasing your dose you may not have a clear ide of your results. I also think the symptoms lag behind about six weeks.

I'm not very helpful. I'm sure someone more experienced wi comment soon x

[shaws Administrator]

Before the blood tests were introduced the average dose of thyroid hormone replacements was between 200 and 400mcg. Dr Skinner (RIP) and others who were trained in his era stated this but now, due to the blood tests alone, we might be undermedicated with remaining symptoms. Excerpt:

There is a further problem that when a patient is diagnosed as hypothyroid many patients receive too low level of thyroid replacement through servile reliance on thyroid chemistry with (often) cavalier disregard of how the patient feels accompanied by an implicit and bizarre belief that a level of thyroid hormone is a better index of wellbeing than the patient’s own view of his/her wellbeing.

This situation has arisen from the mindless deification of ‘evidence-based medicine’ which usually means laboratory-based-medicine where one chooses the evidence which suits and ignores evidence which doesn’t suit. There is no evidence that the efficacy of thyroid replacement is better correlated with levels of thyroid chemistry than with the initial clinical picture nor clinical outcome and in a small pilot study the author has provided preliminary evidence of this assertion.

worldthyroidregister.com/Go...

[Hidden]

I totally agree that you need a dose increase. Your active hormone T3 should be above half way and yours certainly isn't. That's why you're still not feeling well.

It is the FT3 level that matters the most.

[Ali1101]

For my own records, I have started this morning 150 mcg ( I was 50, 75, 100 mcg for more than a month on each). This is based mostly on my symptoms (shortness of breath, slow heart rate, constipation ... ) my T3/T4/TSH go up and down without clear directions or correlation but T3/T4 never went over normal, after starting levothyroxine, they became lower! they both less than mid range now! Anyway, I'm increasing the dose to see the effect in my symptoms in one month and do lab work too.

[Ali1101]

13 days ago I voluntarily increased my dose to 150 mcg (against my doctor recommendation), I felt obvious improvement for almost two weeks, I'm confident I did the right thing. Today however, I feel very hypothyroid! I feel shortness of breath and exhausted! I woke up 4 AM and couldn't go back to sleep, the symptoms I had 4 months ago before stating my treatment.

My plan is to wait to complete a month on this dose and test to see my T3/T4 levels.

Any comments are welcome.