Hi. Just wanted to start off by saying that I've been going through many older posts on this forum. It has been a great learning experience. While I joined two years ago I was on and off here but with the slowly lifting fog I'd like to move forward with the proper guidance. This community has been so helpful for me.
I am afraid I'm wasting unnecessary time in between dose increases. I will begin on what I've noticed about absorption of Synthroid.
1) Lets go back to around a year ago. I finally noticed something that makes a lot of sense now, including the increased frustration with optimization which has taken unnecessary time.
May 18 2017
TSH 2.19 (0.32-5.04) FT4 14.1 (10.6-19.7) FT3 4.06 (3.00-5.90)
July 6 2017
TSH 0.57 (0.32-5.04) FT4 17.8 (10.6-19.7) FT3 3.89 (3.00-5.90)
The drop in TSH with subsequent increase in FT4 to slightly over top quarter of range came with the change from 75mcg to 100mcg Synthroid, 6 weeks in between. Feeling some hyper symptoms, such as bowel movements and hand tremors, I asked the doctor to decrease to 88mcg. Made perfect sense.
A few days later, now having begun 88mcg Synthroid, I also began Adderall for ADHD. Previously keeping an hour between Synthroid and breakfast, I would take Adderall 20-30 minutes after Synthroid. It is from here that my thyroid treatment went downhill due to:
- increased metabolism from Adderall decreasing absorption of Synthroid, therefore decreasing thyroid hormones
- dopamine interference suppressing TSH, thyroid adapting and hence change in my "set point" to the bottom part of the range, thanks to diogenes for helping me understand this
Hence while the sharp decrease in TSH was initially from a dose increase of 75mcg to 100mcg, subsequent TSH results would linger around ~.50 as I was now on 88mcg, then reduced to 75mcg, back up to 88mcg, 100mcg, and now 112mcg.
Fast forward to now.
2) For over two months I was on 100mcg Synthroid.
TSH 0.43 (0.32-5.04) FT4 13.8 (10.6-19.7) FT3 3.91 (3.00-5.90)
I have been on 112mcg Synthroid for two and a half months. Most recent labs performed 3 weeks ago, hence on 7 weeks of 112mcg.
TSH 0.26 (0.32-5.04) FT4 14.0 (10.6-19.7) FT3 4.05 (3.00-5.90)
As I had been trialing different ADHD medications, two weeks ago I settled back to Adderall (was on Concerta and before that Vyvanse) and am titrating that. In around a week, having decided on my Adderall dose, the doctor will add 25mg Zoloft for OCD. The plan was to rerun labs, TSH, FT4, FT3, 6 weeks after.
3) Here's my main question. I have already been on 112mcg for 2.5 months now. Furthermore I've read that Zoloft can interfere with Synthroid requiring dose increases. I would take Zoloft and Adderall together 30 minutes after Synthroid. I am wondering if it's not best to run the labs in a week or two, I mean how much more could the current dose possibly be absorbed. Then see how my levels are and increase to 125mcg Synthroid, add in Zoloft, and retest 4-6 weeks after (that seems to be the recommended time here?). What do you think?
4) Not important right now but thought I'd ask anyways.
Is there often much of a difference between dose increases by 25mcg compared to 12.5mcg for the body to properly adjust?
I will need to wage a strong battle with this doctor, who has been cooperative so far, to focus entirely on my actual thyroid hormone levels along with accompanying symptoms.
Thanks in advance.