Question for the specialist

[Adam1805]

Hi

I wrote here before and all of you helped me a lot.

I have hashimoto for 2 years my antibodies test more them 5 times and always anti tpo and anti tg above 1000.

My ft3 always on the middle around 5.5 (range 3-7)

My ft4 is around 12 ( range 7-16)

And the tsh around 4 ( range 0.2-4)

My endo finally agreed to give me lemy one year ago and im taking 600 mcg in week and my tsh dropped to 1 .

Now i start to feel coldness and tiredness and neorology pain( like burning feeling in my legs)

I asked for blood test again and today i get the result that tsh is 2.75 ( range 0.2 -4)

Ft4 and ft3 not tested

My b9 and b12 is not the problem ( i take supplements )

My questions is if its possible to feel this symptoms again with tsh 2.7?

I need ro increasing my levo? I want to increase myself but iam afraid to be hyper

I dont want to wait two month to endo

Its be safe to increse to 800 mcg levo in week? Thx for your help

[shaws Administrator]

The fact that your TSH is not 1 or below you need an increase in dose. The more informative blood tests - not taken by doctors - are Free T4 and Free T3, if these are low we need a higher dose.

If you wish you can get a private blood test and blood draw has to be at the earliest, fasting (you can drink water and allow 24 hour gap between last dose of hormones and the test and take afterwards.

A Full Thyroid Function Test which is TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/testin...

GP should test B12, Vit D, iron, ferritin and folate. Everything has to be optimal.

[Adam1805 in reply to shaws]

Thanks for your reply

But my symptoms can be with tsh 2.75?

[greygoose]

The TSH itself doesn't cause symptoms. It's low T3 that causes symptoms. The TSH just indicates that your pituitary considers the thyroid hormone levels in your blood to be too low for you. So, some people will have symptoms with a TSH of 2.7, and some won't. So, you really need that FT3 tested - it is the most important number.

But, whilst the cold and fatigue could be due to low T3, the burning/numbness in your legs is far more likely to be due to low B12. And just because you're taking supplements, doesn't mean you can't have low B12 symptoms. How much are you taking? What sort of B12 are you taking? It could even be that you aren't absorbing the supplements you're taking. Also, it's not good enough to just take B12 and B9, you need the whole spectrum. If you're taking B12 you need to take a B complex with all the Bs, because they all work together, and need to be kept balanced. Also, if the damage already done is too great, taking B vits is not going to repair it, just stop it getting worse, I'm afraid.

[Adam1805 in reply to greygoose]

Hi

I take b complex

My folate acid is 10 ( range 5.5-18)

B12 is 600 (range 200-800)

I already take levo , and now tsh is increasing from 1 to 2.75

Its enough to determine that i need increase the dose of levo?

[greygoose in reply to Adam1805]

Well, your B12 is good - in the blood. But, how much of that is getting into the cells? We can't tell. Do you just take the B complex? Or sublingual methylcobalamin as well?

I know you already take levo, but it's not clear how much? You say 600 mcg a week. So, do you take it all in one go? Or do you take a daily dose?

I would say that with a TSH of over 2 - nearly 3, which is hypo - you do need an increase in dose. But, it's best taken every day, not once a week. Even so, it would be a good idea if, next time, you could get your FT4 and FT3 tested, so that we have a clearer idea of what is going on.

[Adam1805 in reply to greygoose]

I take 100 every day 6 days in week

I ask next time ft3 and ft4 .

But i want to increase my dose right now

Its safe to take 800 insread 600?

[greygoose in reply to Adam1805]

Why 800? That's too much of an increase. If I were you, I would increase by taking 25 mcg on the 7th day, and work up slowly like that, by increasing on that day only.

[Adam1805 in reply to greygoose]

I have only 100mcg pills so the minimum increase can 700 mcg instead 600

I worry thst i not feel the change

[greygoose in reply to Adam1805]

If you increase too quickly, you'll feel worse, not better. Given that changes in levo should be 25 mcg every six weeks, 200 mcg is way, way too much in one go. You'll stress your body and cause all sorts of complications. So, no, it is not safe.

You can cut your 100 mcg pill into quarters with a pill cutter.

[Adam1805 in reply to greygoose]

Thx

I thought that go 7 days 100mcg instead 6/7 days 100mcg its not too much diffrent

[greygoose in reply to Adam1805]

It's four times the normal increase rate. I would not recommend it. I don't think you understand how powerful hormones are and what they do in the body. You can't treat them like aspirin.

[Adam1805 in reply to greygoose]

Ok thanks

[greygoose in reply to Adam1805]

You're welcome.