Thyroid UK
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Help! I need somebody!

So, I've posted before but don't know my way around too well so starting another post now. I am an almost 11 year Thyroid cancer survivor. For the past 10.5 years I have been on various dosages of Synthroid. In August of 2017 I switched to NDT ERFA. My Synthroid dosage prior to the switch was 175mcg daily. I was given 90mg of NDT ERFA daily.

Five weeks after switching from Synthroid to NDT ERFA my labs were as follows:

TSH less than 0.03 (0.20-4.00)

Ft3 5.8 (3.5-6.5)

Ft4 10.1 (9.0-23)

My doctor felt my TSH was too suppressed so they decreased my dose of NDT to 75mg daily from 90 which I had been taking.

My labs three months later were as follows:

TSH: 0.79

Ft3 5.8

Ft4 8.1

I was told my TSH was too high and that I needed to go back up to 90mg daily which I did two months ago.

My latest labs which were drawn two days ago a full 16 hours after my last dose are as follows:

TSH: 0.53

Ft3 4.2

ft4 9.1

I am convinced I'm underused and need to increase my NDT or add a bit of T4 in the form of Synthroid each day. I was thinking of increasing my NDT by 15mg daily to see if I feel better in 6 weeks time and if my TSH has hopefully gone lower.

Please, can someone give me some advice? Some of my symptoms are as follows:

Extreme fatigue and lack of motivation; facial puffiness, especially the upper eyelids; weight gain, depression, lack of stamina, blurry vision, forgetfulness and brain fog, trouble with word retreival.

Thank you all so much.

3 Replies
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You're the first person that I have heard talk about 'word retrieval'. I am currently taking 100mcg of levothyroxine and feel very peculiar and struggle with the same, also get my words back to front. (rather embarrassing during an important meeting at work!). I'm a firm believer in experimenting cautiously and with the help of your doctor. What is somebody else's 'normal' may not be yours. I'm no good at interpreting test results, so hopefully somebody can help.

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When on NDT or T3, the TSH is basically useless as it tends to be suppressed. You need to go by your free Ts along with symptom relief.

Both your free Ts look lowish. Did you leave 24 hours between meds and labs? If not, your FT3 levels are really low. But even if you did, they are still suboptimal.

Have you ever considered raising your current dosage of Erfa until you rid yourself of typical hypo symptoms? My own experience (I'm not a Thyca survivor, I have Hashimoto's but take NDT) is that you need to go by symptom relief more than anything when on NDT.

Since both your FTs are too low for complete symptom relief, I would not add T4 just yet, but instead try to increase your current dosage of Erfa and see how you react.

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Chigl53,

If you are supposed to be suppressing TSH <0.1 you are undermedicated and should raise dose. I'd increase by 30mg and retest in 6-8 weeks.

FT3 4.2 is low in range. Most people taking NDT are optimally dosed when FT3 is 5.48 - 6.5.

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