Confused, advise please

[Jlml]

Until last year I have been on 150mg of levothyroxine and all appeared fine. Last year following my normal annual blood test my doctor advised me to drop initially to 125 mg and then again to 100mg. At this point I felt very unwell. I had another blood test and I was then increased back upto 150mg. 8 weeks ago I had another blood test and the doctor advised that I should take 150mg one day and 125 Mg the next to obtain optimum results.

I was retested this week and my results were

Serum free T3 level-cf-Normal 4.7 pmol/L 3.50-6.50 pmol/L

Serum TSH level-cf 0.07 mu/L 0.55-4.78 mu/L

I have a telephone consultation with the doctor on Weds who will want to drop my medication again.

Could all this be due to hasimotos flare ups as I really don't want to keep dropping and increasing my medication as it is playing havoc with my feeling of well being and weight.

Should I stay as I am and re-test again in 8 weeks?

Advise please, thank you in advance.

[shaws Administrator]

It's about time they stopped messing about with the patient's dose due only to the whereabouts of the TSH. The TSH is from the pituitary gland and it rises if thyroid gland is struggling. However, once on levo or whatever other thyroid hormones one takes the aim is a TSH of 1 or lower with FT4 and FT3 in the upper part of the ranges.

The fact that you were fine on 150mcg of levo until they started chopping/changing has caused your problems.

If they tested us ten times in one day, the TSH will be different each time. It is highest early a.m. and drops throughout the day.

Are you aware that all blood tests should be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take afterwards?

The worst thing they can do is adjust doses to try to 'fit' TSH into a 'normal' level.

This is from TUK:

thyroiduk.org.uk/tuk/thyroi...

You'd probably feel better if FT3 was nearer 6 but also all of your vitamins minerals should be optimum, i.e. B12, Vit D, iron, ferritin and folate.

[Jlml in reply to shaws]

Thank you so much for your help.

[Jlml in reply to shaws]

Sorry just so I understand more how do I raise FT3?

These were my complete results from 4 months ago when my T3 was a bit better?

Serum ferritin 77ug/L (10-291)

Serum TSH level 4.09mu/L (0.55-4.78)

Serum total25-OH vit D level 62nmol/L (50-374)

Serum vitamin B12 556 ng/L (211-911)

Serum folate 9.46ug/L (3.38-23.9)

Serumfree T3 level 3.6 pmol/L (3.5-6.5)

SE thyroid peroxidase Ab conc >1300u/ml (0-60)

In your opinion should I keep on the same dosage or agree to drop?

Thank you for all your help, I really appreciate it.

[Treepie in reply to Jlml]

Vit D looks low as does folate.B12 is just about OK but might be getter higher.What matters is what is optimal for you not just being in range.

See Seaside Susies contributions on vitamins.

[Jlml in reply to Treepie]

Thank you so much for your help

[greygoose]

No, nothing to do with Hashi's, all to do with your stupid doctor dosing by the TSH. This is typical of what happens when doctors dose by the TSH, and they just shouldn't be doing it. He even tested your FT3, so why didn't he look at it? Is it over-range? No. So, you are not over-medicated. You are even under-medicated, because your FT3 isn't quite mid-range. And most people need it up the top of the range to feel well.

The TSH is irrelevant once you are on thyroid hormone replacement, unless it goes high. The most important number is the FT3. Did he also do an FT4, so we can see how well you convert?

I would advise you not to agree to any more changes in dose, unless your FT3 is over-range.

[Jlml in reply to greygoose]

Thank you so much, I thought I was going mad .

[greygoose in reply to Jlml]

No, not at all!