Dose increase and no effects yet - how long until I notice improvement?

[Ellissa]

Hi all,

I have been posting here beginning of Jan, after I had been underdosed (TSH level end of december was at 5,61). I have been steadily increasing since End of December, first by 25 LT, to 125 LT.

I found a new very capable doctor, a thyroid expert who knows all the facets and doesn't just use TSH levels, but listens to how I am feeling. She told me my symptoms were due to being underdosed and I have increased my doses for another 25 LT 18 days ago. I am taking 150 LT now and I so hope that this dose will finally rid me of first of all my strong symptoms now (moodwise etc) and also of those persistent symptoms I have had for years.

But what can I say, I stil do not notice much improvement. Sometimes I thought my hands are warmer, or there were days when I am not as tearful, but all in all, not an "aha effect" or a clear feeling that I am really getting better.

I know patience and all...My doctor also said not to worry, it can still get better. But I have been feeling bad now for so long and I am getting scared that maybe Hashi has nothing to do with it, or maybe I will never find a good dose that makes me feel good on a physical and mental level.

Could it be that my body has been mildly underdose for so long that it takes long now to notice the increase?

I am still loading up on VitB12, Vit D, Vit K, Vit B Complex, Iron, Selen, Magnesium...

Any feedback or encouragement is appreciated

Thanks!

[Ruthi]

No, on the contrary, a body that has been starved of hormone tends to jump with joy when some arrives!

I think it more likely that either you are still woefully under on other nutrients, or you are not converting your levo to T3 very well (or both).

Free T3 is the real hormone to measure - TSH is such a blunt instrument, especially once you are having your homone replaced. Has that been tested?

[Ellissa in reply to Ruthi]

Thanks for the reply, Ruth.

Yes, has been tested.

My levels, dated 31 Jan were:

TSH 0,23 (0,3 - 3,0)

FT3 3,0 (2,2 - 5,0)

FT4 1,34 (0,89 - 1,76)

The TSH dropped like that within 5 weeks, from 5,61.

I have had levels like that before and haven't felt this bad though.

[Ruthi in reply to Ellissa]

See what I mean about TSH? At that level, if all was balanced you would have both FT3 and FT4 towards the top of the range, where you would hopefully feel much better. Your TSH has plummeted, but there isn't enough hormone in your system to make you feel right. FT3 should be in the top quarter of the range - in your case over 4.

What about B12, D3 vitamins, folate and ferritin?

[Ellissa in reply to Ruthi]

Thanks Ruthi,

my new doctor (who is a Hashi expert, and I have high hopes that she will really treat me according to my symptoms...I have to call her in another two weeks with new blood work and tell her how i feel) took

Vit B 12: 386 (211-911)

Vit D 29,8 (30-100)

Ferritin 51 ng/ml (10-191)

I am already taking all supplements.

I know that my TSH doesn't "fit" my levels of FT3 and FT4. But since my previous doctors rarely cared about FT3 and 4, they have been that low most of the time, yet I feel especially bad now.

[Ruthi in reply to Ellissa]

Life is so unfair! Sometimes there seems no logic to things.

Something entirely different could be going on, of course. Being hypo most definitely does not let us off all the other things that go can go wrong!

How about your stomach acid? The single most important thing is to absorb our nutrients properly, and so many hypos have low stomach acid which throws everything out.

[Ellissa in reply to Ruthi]

I am pretty sure I have low stomach acid, since I have been having digesitve issues for a few years, and getting worse. I have a heartburn some days now, mostly during PMS time, which I never had up until a couple of years. Also, bloating etc.

I have HCL and Pepsin. I don't take it now because I am eating a salad with lots of vinegar almost every night and it does seem to make it a bit better.

I still do think that most of my issues must be hormonal, and in the end down to the thyroid.

Saliva levels of estrogen and progesteron were normal a while ago (but my new doc told me blood levels are a lot more important, so maybe she ll test them soon).

What bothers me most now are the psychological symptoms like crying, feeling down or super irritable.

[shaws Administrator in reply to Ellissa]

From this link you can read why we need to know FT3 and FT4. TSH should be ignored, I believe (am not medically qualified) as it is the hormones we need and the TSH is only a thyroid stimulating hormone.

thyroiduk.org.uk/tuk/testin...

One doctor wrote an article about the Tyranny of the TSH which can keep people undermedicated/unmedicated.

healthunlocked.com/thyroidu...

[Ellissa in reply to shaws]

Thanks Shawn.

Yes, I know FT3 and FT4 are definitely needed, and TSH alone is not useful in determining the situation.

My TSH has had weird changes as well, with free levels around the same, so I know for a fact my TSH doesn't really say much...