Tirosint

[Bobbobby]

Hello everyone. I just got my T4 tests and tsh results. My tsh is 3.08 last time it was 7.7. My doctor is keeping me at the same dose of Tirosint. I’m pretty sure he said originally that he wanted me down to 1 or point something. Will the medicine continue to lower my tsh at the same dose? Or is he just keeping me here because it’s under the 4.5 cut off. I called and spoke to a nurse who didn’t really know

[helvella Administrator]

You don't give us any idea of the time between tests.

If at least six weeks, then it does look like the doctor is just keeping you in their reference interval.

[Bobbobby in reply to helvella]

It’s been about three months in between and it’ll be three months until the next test.

[helvella Administrator in reply to Bobbobby]

In which case, it is ridiculous.

[Bobbobby in reply to helvella]

Can you elaborate more please? Are you saying that he’s taking to long? Am I correct i’m thinking even though my levels are now in the healthy range it’s still not where it should be?

[helvella Administrator in reply to Bobbobby]

Most people on any form of levothyroxine would expect to see a TSH near 1 or lower when optimally dosed.

Waiting longer than the time required for blood levels to stabilise just leaves you under-dosed for longer.

Also, it is inappropriate to dose by TSH alone.

The TSH reference interval (range) is absolutely not "the healthy range"!

[Bobbobby in reply to helvella]

Thank you that’s what I thought. I’ve been on the same dose for well over three months. I don’t understand why I’m waiting three more months. I don’t think the levels will get any lower right?

[helvella Administrator in reply to Bobbobby]

Unlikely to!

[Maramonro]

I am on Tirosint and can notice the difference in one day if I change the dose. I was at some point tsh 36 and within two days after dose increase I was down to 14 and few days later again down to 3. So I wouldn’t wait anything, and go back to the doctor unless you feel good, which is the most important indicator. Not everyone is the same and I never understood this 6 weeks wait, which doesn’t work for everyone. Good luck!!!

[tattybogle in reply to Maramonro]

The 6 weeks is to allow TSH to stabilise at the new dose , Your TSH may well have dropped quite fast after a dose increase , but the question is , would it have stayed at the low level and settled there, or would the lower TSH have then meant less T4/3 was produced by your own thyroid , which would in turn have caused TSH to rise a little again ....

[Maramonro in reply to tattybogle]

Well, I don’t have thyroid so it’s very simple for me as no other factors can affect my results. For me usually things don’t change dramatically over 6 weeks, so for example once I stayed on 137 every day my results were consistent regardless whether I tested 2 days after change or 6 weeks after adjustment. This also goes for T3 and T4. I think most important are the symptoms as I said I always noticed difference within a day on the days my dose was lower and inadequate but the doctors keep saying you can’t see it. Everyone is different, but I would always follow your body and how you feel. Good luck!!

[tattybogle in reply to Maramonro]

Ah .. well yes that does simplify things As for Doctors who say 'you can't possibly see that on the same day '... i suspect they either haven't tried living on Levo for 20 yrs , or they aren't very good at listening...

I can definitely tell at around 2pm if i forget to take my morning dose of Levo. which theoretically shouldn't be possible ... but all the same i start to feel dreadfully 'vague' at 2pm ish and then realise why.

I've only made very small 12.5 mcg adjustments in levo for the last year or so , so can't say for sure i can tell on the day of a small dose change , but i'd know about it within about 3 days .

However , if i took say 100mcg instead of 50 i would know the same day.

I have to wait several weeks to know if a new dose is OK though.. things seem to change every week for a while, but then i do still (presumably ) have some working thyroid left... well i must do cos my fT4 goes all over the place on same dose.

Can't decide which is worse .. still having some thyroid to complicate proceedings , or having none left and so none of your own hormones at all.... They both suck !

[Maramonro in reply to tattybogle]

Yeah, I feel your pain and hope you get better. All I know is that I don’t trust doctors anymore—most of them have no common sense whatsoever. It’s all about what’s better and easier for them, and couldn’t care less about patients. Take care!

[Bobbobby in reply to Maramonro]

I’m agree with that. I have numerous issues and nothing is getting better. The doctors were generally dismissive and don’t really listen