Starting dose of Synthroid For Hashi

[Clark77]

I’ve been on 25 mcg of Synthroid for about 6 months and feel it should now be higher dose. Please advise.

Just had blood work done. I’m in Canada

TSH 2.41 (down from 2.86)

25 hydroxy vit D - 95.5

Ferritin - 175.2

Antithyroid peroxidase Antibodies - 449 (down from 538)

T4 -12 (has gone down from last blood test - was 19)

B12 - 1351 (high??)

They didn’t test T3

I’m not eating gluten, soy, dairy, sugar.

Would it be beneficial to be on a higher dose to get my thyroid numbers in a better place?

Thank you.

[SeasideSusie Remembering]

Clark77

I’ve been on 25 mcg of Synthroid for about 6 months

I'm afraid that doesn't make sense as when you posted here on 8th June, just over 2 weeks ago, you said in this post

healthunlocked.com/thyroidu...

Do I need to be on thyroid medication as my doctor just says wait and watch and if so should I start on 25mg Synthroid with these numbers from my bloodwork?

My TSH is 2.89 mIU/L

Free T4 is 12 pmol/L

Free T3 is 3.9 pmol/L

Anti- TPO 532 kIU/L

Anti- TG 223 kIU/L

You have now posted this:

T4 -12 (has gone down from last blood test - was 19)

but you previous post said your FT4 was 12????

If you have been prescribed levothyroxine then the guidelines in Canada are quite different from those in the UK.

25mcg levothyroxine is a starter dose for children, the elderly and those with a heart condition, otherwise normal starter dose is 50mcg with retesting 6 weeks after initiation of Levo and increases of 25mcg every 6-8 weeks after retesting until your levels are where they need to be for you to feel well.

You haven't given any reference ranges so it's not possible to interpret your presults properly. Ranges vary from lab to lab so we need your lab's ranges as mentioned in reply to your previous post.

The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges. Your TSH is obviously too high but we can't say anything about your T4 without the range.

Is it Total T4 or Free T4 that has been tested? Total T4 isn't any help, it's the Free T4 and Free T3 that tells us what we need to know.

[Clark77 in reply to SeasideSusie]

Thanks for replying.I’m know I am in a confused and very stressed state and wrote a couple of weeks ago.

I just need to understand if 25 mg is a good starting dose or should it be higher for hashi.

I can’t seem to get a clear answer from anyone here in Canada.

My Free T4 reading of 19 was the blood test before this one of 12.

Sorry for misleading not what I wanted to do

Just needing clarity and it’s so hard to get the thyroid panel blood work done here.

[SeasideSusie Remembering in reply to Clark77]

Clarke77

So how long have you actually been on Synthroid?

My Free T4 reading of 19 was the blood test before this one of 12.

What is the reference range?

If you did your tests exactly the same way, as we advise -

* blood draw no later than 9am

* nothing to eat or drink except water before the blood draw

* last dose of levothyroxine 24 hours before the test

then your FT4 dropping from 19 to 12 doesn't make sense as there is very little difference in your TSH. As your FT4 falls your TSH rises and you say your TSH has reduced. Perhaps you took your levothyroxine before the test when the FT4 came back at 19 and you didn't when it came back at 12. That needs clarifying to make any sense of your results.

I just need to understand if 25 mg is a good starting dose or should it be higher for hashi.

I've mentioned above how it works in the UK when starting on Levo, it doesn't matter if there is Hashi's or not, it's the hypothyroidism that's treated not the Hashi's.

[Clark77 in reply to SeasideSusie]

* blood draw no later than 9am

* nothing to eat or drink except water before the blood draw

* last dose of levothyroxine 24 hours before the test

Almost yes to these above, except blood test was 9.30am, and no biotin for 5 days before.

I have been on and off of synthroid for the last six months as doc says come off and then says go on it? So that's why I said I have not been on it before as it is baffling what the medical world is telling me.

So now on synthroid properly for the last two weeks since my last message on here at 25mcg.

I have asked to see an endo but am waiting for the referral as I don't know what I should or should be doing and not convinced by my doctor's knowledge at all and it is making me very stressed.

I am grateful for any help or recommendations, truly.

[SeasideSusie Remembering in reply to Clark77]

Clark77

I think it's quite clear that your doctor hasn't got a clue. You don't take Levo, come off it, go back on it, come off it. What is he basing this on? Does he tell you why he's asking you to come off it?

You have Hashi's and test results (and symptoms) can fluctuate with Hashi's, and sometimes it helps to adjust medication but often only a reduction if hormone levels go over range or an increase if you go through a hypo episode.

Testing 2 weeks after restarting Levo isn't that helpful. It can take up to 6 weeks for the full benefit of starting (or a dose change) and levels to settle so it's too early at the moment. Best to wait 6-8 weeks from when you restarted and test then. Come back with new results then but please include the reference ranges otherwise we wont be able to interpret your results.

[Clark77 in reply to SeasideSusie]

Thanks Susie I really appreciate your understanding and support.I haven't got a real clue with the doc as they said I have thyroid issues and put me on it, took me off it etc

So I am going to stay on the synthroid now and look after myself with the help of those that know what is going on and what to do.

It feels like I am in the dark and very alone so

I will do what you suggest and test again in 6/8 weeks and come back to you with reference ranges.

Grateful to you.