On Dec,21st,2017 I had a complete thyroid removal,at first my endo stated me on 100 mcg of levo.then on my 6 weeks checkup she cut it back to 88 mcg.My last tests I had on last week showed my free t-4 at 1.21, tsh at .20 and my t-3 at .83,she says that she thinks my levels are normalizing,I feel awfully tired.cold all the time and the day got light headed.What is your opinion on this?
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shortydjs
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I think she's probably trying to have all your numbers in range. I'll bet TSH is her most important consideration and she's happy even though your T3 is at rock bottom and T4 is in the middle. Assuming common ranges. Those ranges would help us to be sure, but your symptoms speak for themselves. Hypothyroid symptoms. After TT I started on 112mcg and ended up on 150mcg. You are on a very low amount.
For many of us, especially after a thyroidectomy, TSH is suppressed if we are on a dose high enough to make us feel decent. If your endo cannot get her head around dosing until symptoms resolve, find a different one.
This 'professional' will not help you to recover your health. Switch to another who, hopefully, knows how to make patients well.
When we are on an optimum dose, be it levothyroxine, T4/T3, or T3 only we should have no symptoms and feel well. In these 'modern times' doctors don't know any clinical symptoms which we used to be diagnosed upon when no blood tests were available so were dosed until symptom-free.
200 - 400 mcg used to be the norm after thyroidectomy, the trouble is the TSH test. It's your FT4 and particularly your FT3 results that matter. As Jazzw says, what are the ranges for these?
For some one who has never had thyroid function and has had to rely on medication all their lives, I am alarmed at your results.
If you are in the UK, you should be on around 150 - 250 mcg of T4 thyroxine and in most cases need a combination of T4/T3 T3, usually around 20 mcg Lithyronine - although this is a very sore subject with cost.
My current dose is 200 mcg of thyroxine T4 and 20 mcg of Lithyronine T3. My last tests showed that I am likely to be under medicated as my TSH levels = 4.87 range 0.27-4.2 T4 = 14.8 range which is low in range of 12-22.
No T3 results but the last one was mid range but I am not worried about that so much as it keeps me on the T3 medication. Your haemoglobin levels can be out of sorts too if your thyroid levels are not right. I am to be retested in a few weeks for everything.
I would say that you need them to check the ferritin and folate levels too for B12 deficiency, anaemia and vitamin D deficiency. These have the similar symptoms regarding tiredness and aches etc and can walk (not all) hand in hand with thyroid conditions.
Can I ask why they removed your thyroid? We can live without the gland but NOT the hormones it creates. I would seek a second opinion straight away. The TSH levels are not what she/he should be going by.
I do hope you get help, I get more and more alarmed at the lack of knowledge these so called Professionals don't have. They treat our medication like sweeties
I am no expert, other than my own condition, but the fact you have no longer have a thyroid gland, should mean that you are now underactive and the symptoms you are showing, confirm that.
Sorry to hear you’re still not well after all you have been through.
Jollydolly is spot on. It used to be 300 t4 and done t3 now protocol is circa 200 t4. They’ve done it so the tsh comes into play. A suppressed one means diddly squat. Patients who were given meds years ago on how they felt are still alive. Err I think that’s says it all. Low doses( adrenals and vitamins too affect our organs)
Yes change if you are able to.
If you can post your ranges it would help. I suspect the tsh is below range and the t3 too low. In which case you’ll need some or at least consider ndt etc.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3
Get a new endo. After my thyroidectomy they played with my thyroxine dosage to try get my TSH just down below the upper reference range. I was a zombie. Couldn’t function. Resting pulse was 44. Had to have fire on all the time. Sleep with an electric blanket on. Put weight on. Blood pressure went up. Been on blood pressure medication ever since. Idiots!! Take control of your own health. The majority of these so called specialists don’t know what they’re doing. Insist they look at your signs and symptoms. Wishing you all the best.
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