Synthroid dosage

[Sdfoxy]

I have a question about synthroid. I had my thyroid removed last September due to large nodules. It was discovered that I had micro papillary carcinoma. Very small cancers. This is my question. I am at my current and supposedly proper dose of 150 mcg. After getting on this dose I tested tsh 1.04. And then 2 months again tsh 1.45. The doctor wants me under 2.00 for

Thyroid cancer suppression. I have felt fine on this dose. Sometimes a little hard to tell because I have fibromyalgia. For the last two days I have felt shaky after my dose, which I take in the morning on an empty stomach. My hands were even trembling. This has not happened before. I’ve been at this dose for about 5 months. Has anyone experienced this before. Is it a problem. Thanks.

[radd]

Sdfoxy,

Welcome to our forum and sorry to hear about the cancer.

Our bodies can become intolerant of thyroid hormone replacement meds when iron levels aren't optimal. Also look to improving adrenals health as stress hormones will have taken a battering after what you have been through.

Do you have any blood results including ranges (numbers in brackets) to share?

[fuchsia-pink]

It's important to test more than just TSH to know how you are doing. Yes, you need TSH less than 2 - and many of us need it less than 1 - but you also need to see what your actual thyroid hormones are doing. That means testing free T4 and free T3. People can feel "trembly" if they are over-medicated - ie if free T3 is over-range, but you can also feel rough if under-medicated. Many of us need both free T4 and free T3 in the top third or higher of the relevant lab range to feel properly well.

And it's worth testing key nutrients as well - ferritin, folate, vit D and B12 and seeing what - if any - you need to supplement. Good luck x

[Sdfoxy in reply to fuchsia-pink]

Hi. I am in the U.S. I had the free t4 it was .98. Range .60-1.30. I also had tumor markers which were good. Vitamin D. Low. .26 range 30-100. I am on 10000 units a day now. They won’t test T3 here unless you are having a problem and I wasn’t at last visit. I only use synthroid brand always the same. B12. 1507. Range. 180-914. Iron. 57 range 50-212. These were all done in may. Thanks

[fuchsia-pink in reply to Sdfoxy]

With free T4 only 54% through range you're highly unlikely to have over-range free T3 and I'd say you are under your optimal level of medication. Obv vit D is poor, but you are taking steps to improve this and iron is towards the bottom of the range ...

Is it worth trying your levo in two doses - half in the morning and half at night and seeing if you feel better like this? x

[SlowDragon Administrator]

Just testing TSH is completely inadequate

TSH of 1.45 may be too high

Do you always get same brand synthroid at each prescription

For full Thyroid evaluation you need TSH, FT4 and FT3 tested.

Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common on levothyroxine

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

When were vitamin D, folate, ferritin and B12 last tested

Please add any results and ranges

[pennyannie]

Hello Sdfoxy and welcome to the forum :

A fully functioning working thyroid would be supporting you daily with trace elements of T1.T2 and calcitonin plus a measure of T3 at around 10mcg plus a measure of T4 at around 100 mcg.

T4 is a storage hormone that needs to be converted by your body into T3 the active hormone that the body runs on, and T3 is said to be about 4 times more powerful than T4 with the average person needing to find/ convert and utilise around 50 T3 daily, just to function.

Since you do not have a thyroid your HPT ( hypothalamus/pituitary/thyroid ) feedback loop is broken, and just testing your TSH when on monotherapy with T4 treatment is totally misleading, as with no gland, the TSH-T3 disjoint it lost.

You must be dosed and monitored on your T3 and T4 thyroid hormone levels with the intention of keeping these 2 vital hormones balance within the ranges at around a 1/4 conversion ratio T3 / T4.

Your conversion of the T4 can be compromised by low vitamins and minerals and it's advisable to also measure your ferritin, folate, B12 and vitamin D with the intention to keep these at optimal levels and not just somewhere in the NHS range.

In the first instance we need to see your full thyroid blood test results, to include a T3, T4, inflammation, and the vitamins and minerals as already detailed. Just post back on here, in a new post, the results and ranges and then we can talk you through hat it all means and your next best back to better health.

If your doctor can't help you with these tests there are details of companies who can, on the Thyroid uk website, who are the charity who supprt this amazing forum, and where you can find everything you need to know regarding hyroid health conditions.

I'm with Graves Disease and had RAI thyroid ablation back in 2005 becoming very unwell around 8 years later, and thanks to this forum, i'm now so much better, it simply defies me why the medical establishment don't run the correct, full blood tests, and restore and maintain health and well being.