Dosage advise, current labs and miserable.

[ms_anon]

Any advise ya'll?

currently 5'5 and just under 200lbs and been hypo since 2014. My endo is really booked majority of the time.

right now I'm on 175mcg of tirosint and i know in our last visit roughly 60days ago he stated that dose was too high.

My labs this morning were TSH: 0.07 Ft4: 1.16 Ft3: 2.87

Everything hurts, feel short of breath a little, and tired af

[greygoose]

Can you put the ranges, please? They vary from lab to lab, so we cannot interpret your results without your ranges.

[ms_anon in reply to greygoose]

Ah yes sorry,

FT3 range: 2.30-4.20

FT4:: 0.93-1.70

TSH:: 0.27-4.20

And still miserable, by the end of the day my head is pounding and im just ok symptoms wise usually 5-6hrs at best. my endo visit wasn't great, elevated b/p no one bothered to address. At least when I mentioned concerns about diabetes they tested a1c and blood sugar, which this was close to 5pm my a1c was 5.3 (which is considered "pre-diabetic") and my blood suagr was 113, last thing to eat was appox 2 hrs prior to appt. Not intentional just have gastroparesis so virtually no appetitie anyhow.

He changed my dose to 137mcgs 7days a week (vs 175mcgs 6 days a week) and gave me a script for synthroid, tirosint solution, and tirosint gelcap, so that I'd have an option since I have insurance issues that doesn't cover the tirosint but I've enjoyed that my symptoms tended to be milder initially. Usually by 5-6weeks into a dose and so far the medication type hasn't mattered this timeframe is about all i can last on any single dose it seems.

[greygoose in reply to ms_anon]

FT3: 2.87 (2.30-4.20) 30%

FT4: 1.16 (0.93-1.70) 29.87%

TSH: 0.07 (0.27-4.20)

OK, so as you can see, you are under-medicated. Your results should be more like 75% through the range, at least. So, not surprising you're miserable. Good news is, you convert well.

However, doctors that only look at the TSH would think you were over-medicated because they don't know about Free levels. You are only over-medicated if your FT3 is well over-range. Doctors should not be dosing by the TSH, because it doesn't tell anywhere near the full story. And, it doesn't matter if it's suppressed.

And the stupid man reduced your dose even further? Next test, your FT3 will probably be under-range! I suppose he's trying to raise your TSH. They are so ignorant!

elevated b/p no one bothered to address

Elevated BP is a hypo symptom, not a disease. If you raise your FT3 your BP will more than likely come down.

[ms_anon in reply to greygoose]

Also my endocrinologist is against NDT's which my sister appears to have success with. Aside from her anxiety, her weight and headaches are fewer than mine. and she can stay far more active for longer. I have a desk job, work from home, and aside from chasing/playing w my toddler I'm pretty sedentary. I don't wish to be but the widespread pain and the hypo symptoms have me miserable.

[greygoose in reply to ms_anon]

Why not self-treat with NDT, then, and cut out the ignorant endo?

[ms_anon in reply to greygoose]

ive tried armour thyroid and dont recall being much better, to my knowledge i have to go through a dr since i cant get the medication on my own.

[ms_anon in reply to greygoose]

Also I was wrong about my weight, doc's office weighed me in at 218lbs

[greygoose in reply to ms_anon]

Because you're under-medicated.

[ms_anon in reply to greygoose]

i do have some 5mcg T3 (cytomel) in my arsenal of dosages I'm considering on top of my t4 only med

[greygoose in reply to ms_anon]

Well, you don't actually need T3 because you convert well. You just need an increase in levo. And, if your endo is panicking about a suppressed TSH now, T3 is going to make it worse! So, is that really a good idea?

[ms_anon in reply to greygoose]

Thank you so much, yeah i plan to fire him since ive been w them aince april 2018, even my old endo could get me level/on a dose for longer than the time im on his recommendations. only my old endo left to new york, he managed to keep me pregnant and carry to term this time so he has a lot of my respects. im considering taking my endo issues to my pcp (gp seems to be called elsewhere) ive got an appt w the old office but its not until july

[ms_anon in reply to ms_anon]

heck i even googled my "ideal" dose just based on weight and it stated 1.6mcg per kg of weight. at that calculation i should be at 158mcgs. smh

[greygoose in reply to ms_anon]

You don't dose by weight, that's for people that have just has a TT and need a starting dose. The dose is then adjusted later. For everyone else, you start low and increase slowly until you feel well. You need what you need, not some arbitary number per kilo. That could never be accurate. But, nor do you dose by the TSH, as your endo appears to be doing.