Endos recommendations

[Dolphin40]

Hi,

Following on from my previous thread, we have spoken to the Endocrinologist.

Again here are my 6 year old daughters results on Eltroxin

May 2020

TSH - 31.89 (0.67-4.16)

T4 - 19.4 (10-20)

T3 - 6 (5.1-7.4)

(25 mcg Levo)

July 2020

TSH - 0.7 (0.67-4.16)

T4 - 25.8 (10-20)

T3 - 7 (5.1-7.4)

(50 mcg Levo)

Aug 2020

TSH - 4.77 (0.67-4.16)

T4 - 21.9 (10-20)

T3 - 5.5 (5.1-7.4)

(37.5 mcg Levo)

She first suggested she stay on 37.5 for a while longer but after discussions suggested 37.5 for 4 alternate days and 50 mcg for 3. She doesn’t agree that her meds/thyroid is whats causing the hair loss or tummy aches. Obviously her T4 will increase further out of range with the increase but hopefully her T3 will increase and TSH reduce.

My main concerns are;

What is the impact of too much Levo/too high a T4?

Is too high a T4 better than too low a T3? (I know its not better as both should be optimal but the Endo is not discussing alternatives like T3 being added)

Would too high a T4 be more likely to cause hair loss or too low a T3?

Many thanks as always

[jimh111]

Elevating fT4 doesn't help much, as well as increasing circulating T3 it increases reverse T3 which has no benefit. It will also lower TSH which will tend to reduce T4 to T3 conversion within tissues such as the brain and skeletal muscles ('type-2 deiodinase'). I would stay on the lower dose and see how it goes. Perhaps when they next do a blood test they will also try a different assay just in case the wildly fluctuating TSH is due to assay interference.

[Dolphin40 in reply to jimh111]

Thanks very much for your reply x

[Caper12]

HOW ARE YOU DOING WITH TAKING BOTH MEDICINES AT THE SAME TIME. HOW ARE YOUR NUMBERS?

[Dolphin40 in reply to Caper12]

My daughter is only on Levo at present. I wanted some advice on my post/question as her levels are not right still.

[Lora7again]

It is hard to say whether it will cause more hair loss because as I said before when your thyroid levels are moving either up or down your hair can fall out. Once your daughter is on a dose that is right for her I think her hair loss will stop. Having suffered 2 lots of hair loss that went on both times for a couple of years mine only stopped when my levels were right for me. Everyone is different so it is trial and error with thyroid disease. Also low ferritin can cause hair loss and needs to be over 80 for hair growth. I do know how distressing it must be for both you and your daughter. Have you thought of ways to disguise her hair loss until it stops?