Hey!
I‘m 20 years old and I‘ve been taking l-thyroxin 50mg for 3 years now. Recently I got my new results and I‘m interested whether I should increase or decrease the dosage.
My results:
fT3: 3,34 pg/ml
fT4: 13,56 pmol/l
TSH: 2,16 mU/l
Normal range:
fT3: 2,02-4,43 pg/ml
fT4: 12,0-22,0 pmol/l
TSH: 0,27-4,2 mU/l
Looking forward to your reply!
Have a great day 
Moritz
Oh dear 3 years! You are definitely in need of a raise. Tsh, t3 and t4 much too low. You need tsh below 1, t4 around 18-19 and your t3 above 5. How do you feel on such low levels. You need to test your antibodies to check for hashimotos and ferritin, b12, folate and vit d all need to be optimal for you to feel well
I didn‘t want to say how I feel because I thought it would influence your answers.
But I feel like shit 
always tired and no motivation. How much do I have to increase it?
Do you speak about t3, t4 or fT3 fT4
It would be safe to increase by 25mcg. That would help but im going to tell you what i wish someone told me. Dont expect to feel good for a while when raising from 50mcg to 75 i had good days and bad days. As the feed back loop comes into play and your thyroid function shuts down and the pills have to take over it can feel bad. Take 75mcg for 6 to 7 weeks and get your bloods re tested. Its a long slow frustrating process but in the end when your tablets are at the correct level for you, you will feel better. Dont forget those other tests. They are important for the thyroxine to work properly and feel well. You are converting not too badly but hour ft3 is very low probably shy you feel like "shit"
The thing is that at the moment I feel like I have to sleep 24 hours a day and there is no motivation to do anything but I have to learn very much because in 7 weeks I write my „Abitur“ a very important thing in Germany.
I‘m at a dead end because I can‘t learn because of my situation at the moment but I know that when I increase my dosage I‘ll also feel like shit for a while which also prevents me from learning. Oh damn
Oh your in Germany? Im married to a German! We live in Scotland. Your ft3 is low. Once that starts to climb you will feel better mine raised quite a bit when i went up to 75mcg. Are you taking selenium that will help your conversion. I use 200 mcg but i dont take it every day taking so many suppliments is just too much some days and i "forget". Aches and pains were worst for me but its getting better
I‘m only taking a vitamin B complex, a good one.
The thing is that I feel every change. When I started using the vitamin B complex my heart was raaaaaising. Same thing when I started using l-thyroxin. I probably had my 4 worst weeks in my entire life feeling so bad, mood swings, fast heart rate and not be able to sleep.
So it‘s not possible to increase my dosage before my Abiture although I probably had to
Redhuhn, if you've had a bad reaction starting on thyroid replacement or increasing dose you can instead start super slow. Get a razor blade and cut the tablets up as small as you can get, then instead of increasing the usual increment of 25mcg, increase by the tiny piece instead. Hold for a few weeks then add another piece, and continue on like that, adding more pieces, until you have added in the full 25mcg. If to feel the speeded up symptoms again, drop back to where you where comfortable and go even slower next time.
Redhuhn, increasing your dose is not all bad. You may feel strange, and there may be days you feel worse, but overall you should expect to feel an improvement.
Sorry, but what do you mean by "your thyroid gland shuts down"? After all, the reason we are put on hormone replacement in the first place is because our thyroid glands are dysfunctional.
Depending on what your problem is? If you have a very high tsh like my sister had (140) her thyroid had already shut down and the tsh hormone was screaming at it to work. This is how most drs diagnose thyroid problems. When you start taking any form of thyroid replacement the tsh gets lower and shuts off the normal function of the thyroid gland via the feed back loop to your brain. This is why drs keep us sick they are satisfied when t4 and t3 fall into normal range which means the medication you are taking is fighting against your thyroid and the feedback loop is very confused. You have to replace enough to keep that feedback loop quiet. Your thyroid will go to sleep and allow the thyroxine to take over thats why tsh must be kept about 0.5.
What does your doctor say?
Important to test vitamin D, folate, ferritin and B12. These are often too low when under medicated
Dose of Levothyroxine should be increased slowly in 25mcg steps until TSH is around one and FT4 in top of third of range
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to Doctor )
I supplemented vitamin D and got IV iron, have very good levels. I‘m also taking a good vitamin B complex.
I always wait more than 24 hours for the blood test and I‘m always fasting before.
My doctor said that I have to stay at this dosage ??
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
UK guidelines are also very poor.
But endocrinologists who specialise in Thyroid recommend TSH between 0.4-1.5
Getting dose increased is first step
Important to test both TPO and TG thyroid antibodies
Most common reason for being hypothyroid is autoimmune thyroid disease (Hashimoto's) diagnosed by high antibodies
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ideally ask GP for coeliac blood test first
chriskresser.com/the-gluten...
amymyersmd.com/2017/02/3-im...
thyroidpharmacist.com/artic...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
If you read posts on here regularly you will see many UK patients eventually get T3 (Liothyronine) by private prescription from Germany- Thybon Henning
But first step is to get Levothyroxine increased & try strictly gluten free diet
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
rcpe.ac.uk/sites/default/fi...
New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be between 0.4-1.5 when treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking Levothyroxine
sps.nhs.uk/wp-content/uploa...
Very interesting article, although not very easy to read so I doubt anyone who's not a doctor would understand much...however, one of his conclusions is seriously flawed, IMHO:
"3. We can prescribe a combination of LT4 and liothyronine, ensuring that serum TSH is normal."
No dose of T3 enables me to maintain a so called normal TSH. Even as little as 2.25 mcg of T3 (1/4 grain of NDT) will suppress it.
Advice like that won't help patients who need both T3 and T4 (or T3 only) and who cannot maintain a normal TSH on any combination of those drugs.
Yes several of us questioned this at recent lecture by Prof Toft
It's unusual NOT to have suppressed TSH as soon as taking any T3
According to US natural doctor Westin Childs, an advocate of NDT/T3, these are optimal levels when adequately treated:
TSH 0.5-1.0 uIU/mL (ref 0.4-4.5)
free T3 3.8-4.4 pg/mL (ref 2.0-4.4)
free T4 1.4-1.7 (0.8-1.7)
He stresses that optimal levels have nothing to do with reference ranges. But I am a bit curious about the FT4 levels he recommends; when on NDT, and getting direct T3, why would you need FT4 levels in the upper third of range....wouldn't that increase the risk of rT3 dominance?
Also, I am not sure many who are on adequate doses of NDT or T3 can maintain a TSH between 0.5 and 1...
Im like you i feel every change my body is sensitive to everything even food. I think i was hypo so long my body craved the thyroxine. If the doctor is telling you to stay at this dosage hes very wrong and you will never get well. Which brand of thyroxine are you taking? Euthyrox? Its very popular in Europe im taking it as its far better quality than what we get here. Is Germany prescription only? In Spain its easily bought over the counter
I agree with you about Euthyrox...I tried several different brands of T4 but kept coming back to Euthyrox .
It‘s prescription only , yes.
I use l-thyroxin Henning maybe you know this brand.
I‘m currently thinking about whether I should increase my dosage now before the big exam or in 2 months
I would do it now, i doubt if you will feel any worse than you do now. If your t3 rises you will start to feel better as you don't have enough t4 to convert right now
What do you recommend? Slowly increasing by 6,25/12,5 or instantly by 25 ?
At your age a 25mcg increase is no problem. If your heart responds cut the rise back to 12.5 for a few weeks then try 25 again. Thats what i have to do but im 60 lol! If like me you eespond to everything then you need to check your cortisol or progesterone levels both these can cause problems
I really hope I‘ll be able to sleep otherwise I have a huge problem
Maybe your night time cortisol is too high or your progesterone is too low. I suppliment with progesterone which supports my adrenals and i sleep much better. Being young are you using hormonal contraception? If so that is upsetting the thyroid balance. Chemical progesterone interferes and shuts down real progesterone. Real progesterone is required for normal thyroid function and to sooth your adrenals and help you sleep at night
Well I‘m a man.
I would say that I‘m the best sleeper in the world, I can sleep where I want and I fall asleep as soon as I close my eyes.
But as I stated above, back than when I started using l-thyroxin and increased the dosage from 25 to 50 my heart was beating much faster and it was much more difficult to fall asleep. This took 4 weeks to get better.
Maybe it‘ll be better this time because it‘s 3 years later an der maybe things have changed .. I hope so
Oh i am sorry thats the thing with these profile names. Mind you if you are under stress your progesterone could still be low as under stress it is stolen to make cortisol. And men need progesterone too. Try the 25 but if you continue to have heart racing problems check your cortisol
Already checked my cortisol and it‘s very very very low. The doc said it‘s the lowest value he has ever seen.
Is it right to say that my convertion from fT4 to fT3 is good enough which means that vitamins and minerals needed to convert fT4 are not difficient? Or is this a wrong conclusion?
Its low but hes done nothing to help you? You need your DHEA checking too. If your cortisol is that low your adrenals will not like thyroid hormone. You need to find a doc who can help you fix your adrenal problems and check your dhea and progesterone. They must all be optimal or you will never function properly. Have you had a stressful life?
Hey guys!
So I decided to get some liquid thyroxine.
1 drop = 5mcg
I wanna increase my dose (to 75mcg) slowly so it‘s not too hard on my body. Should I increase 5mcg per week or every 2nd week (maybe too slow)?
Thanks
Looking forward to your replies!
Request for dosage for optimal level on Levo and B12, D3, Ferritin and magnesium 
Is fatigue normal with optimal levels?
Optimal TSH and T4 levels?
Optimal serum levels for thyroid antibodies?
Once you find your optimal level, does it remain the same?
