I’ve come up against the old argument about effects of long term suppression of TSH. Been on T4/T3 combo for almost 4 months. My old Levo dose for 20 odd yrs was 200mcg a day. Endo insisted I slowly reduce levo when starting T3. I’m now on 125mcg levo and 27.5mcg T3 split over 3 doses daily. NB I’m prescribed 20mcg (the extra 7.5 is self sourced) My most recent tests results are attached from this dose. Usual protocols about skipping doses pre test.
Endo wanted me to drop levo further to 100mcg to increase the TSH and, although not convinced, have done it for the last week. In just a week the pain, muscle cramps, itching and insomnia have returned. I had felt so much better on the combo- sleeping better, less muscle pain, hair loss improving. Resting heart rate is still low at 50bpm and temp is marginally better than it was. Ferritin and Vit D are in a good place although still room for improvement and I do take supplements to aid this. By chance I had an ecg 4 weeks ago- all good. My query is- Following those most recent results with T4 so low I was thinking I needed to increase back up a little but endo only wants me to reduce it further to get TSH up a bit. Since lowering my levo to 100mcg is causing a returning of symptoms, would I be better off reinstating my 125mcg levo and then later reducing the T3 dose in an attempt to up the TSH a bit? I’m aware and pointed it out to my endo that any thyroid meds will suppress TSH but it’s how low it has suppressed that is the endo’s concern. Advice please.
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Daisywhoopsa
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First of all, it's probable that on 200 ug T4 for 20 years, your pituitary has been virtually silenced (TSH either undetectable or <0.01). I would say that nothing you can do now will restore it to anything like normal. The pituitary has had all this time to adjust, as has your body in general, to treatment and will not willingly be reactivated. It isn't like a sleeping tiger, ready to leap up in a moment, more like a dead battery that nothing can reactivate.
Thanks SlowDragon. You have summarised what I was thinking, just needed to know I was on the right track. Yes same brand and yes I dosed as you described before testing.
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