Thyroid UK

Frustrated Hypo

Getting frustrated with not being able to get things regulated. In 2014 my TSH went up to 15.42! Doctor and I were both surprised, as I had been rather stable for several years and felt fine. She had it ran a second time and it came out the same. That's when the Synthroid dosage was changed to 112mcg. TSH in November 2016 was at 0.11. Dosage not changed. My TSH in December, 2017, went up to 3.19. Doctor didn't want to change the dosage because the T4, 1.51, is at the upper end of the range. I've never been tested for T3. I'm feeling very sluggish, have heart palpitations, dry and cloudy eyes, and just feel unwell overall. Am wondering if it should be time for a small dosage increase?

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Were all these tests done at the same time of day, and fasting?

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Yes. I've also noticed that I have difficulty concentrating. Shouldn't the TSH be at the lower end of the range?

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It most certainly should. When you are on thyroid hormone replacement, levo, the TSH should be one or under. But, I asked that question because, if the tests are not done under the same circumstances, you cannot compare them. And the way your TSH is jumping around is rather strange.

Is TSH all that your doctor tests? If so, ask him to test the FT4 and FT3, as well. The TSH is a very unreliable test. You should also get your antibodies tested, because having Hashi's could be the reason your TSH is so unstable.

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Thank you for the reply. I go back in 60 days for recheck. Doctor has never checked FT3, just T4. That was at 1.51. I will have T3 added. Is it common to not increase Synthroid if the T4 is at the higher end of the range?

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Can you give ranges, please. The results are meaningless with out the ranges. I don't know what 1.51 signifies for the lab that did your test.

Difficult to generalise like that. Each case should be treated individually. But, if the FT3 is never tested, they don't know if you need an increase or not. Because it's low T3 that causes symptoms, not T4.

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TSH 3.19 (0.50-3.00). T4 1.51 (0.89-1.76)

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A TSH over-range certainly indicated a need for an increase in dose. BUT, with an FT4 so close to the top of the range, what that high TSH probably indicates is that you're not converting your levo very well, and that your FT3 is low. So, you really do need that tested.

But, it's also imperative to test your antibodies. And also the nutrient tests that SlowDragon suggests.

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Do you have autoimmune thyroid disease (Hashimoto's)

Ask GP to test vitamin D, folate, ferritin and B12

Often too low and can affect thyroid function

Do you have any gut symptoms?

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No to both questions. Will request additional test. Thank you. I'll also read up on Hashi.

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