TSH is going back up , again….
This is ridiculous. One doctor tells me to up my T4 and the other tells me to up T3. I really don’t know what to do anymore. But I can’t live like this any more!!!!!!!!!!!! Why are there never two doctors who say the same thing?! WHAT DO I DO?! my tsh is now back up to 2… and probably getting worse as the days go by..
The curse of relying on TSH to medicate hypothyroidism strikes again!!Bottom line...medics are poorly educated in this field!
TSH is a pituitary hormone not a thyroid hormone, the test was originally developed as a test for hypothyroidism, it was never intended as a guide for dosing. After initial diagnosis it has limited use....yet many medics insist that it has and their patients remain unwell.
Reducing your dose will raise your TSH, conversely raising your dose will lower TSH...roughly speaking.
These papers - may help
thyroidpatients.ca/2021/07/...
bmcendocrdisord.biomedcentr...
The important lab is FT3 but persuading medics of this can be a struggle.
8 days ago you posted what I assume are your current labs ( no dates!)
112 Synthroid.
FT4: 1.4 (0.8-1.8)
FT3: 2.8 (2.3-4.2)
TT3: 82 (76-181)
TSH: 0.23 (0.27-4.6)
Your T4 to T3 conversion is poor ( high FT4 with low FT3)
Your high FT4 is keeping your TSH on the low side.
When medicated TSH should be close to 1 but it does not indicate which hormone is high or low e.g. your high(ish) FT4 is reducing your TSH which is (just) in range so medics conclude all is well, when in fact the problem is your miserably low FT3 level, which is the cause of you feeling unwell
In other words your TSH does not reflect your importantly low FT3!
In the first instance I suggest you raise your levo dose which, by conversion, may help raise FT3. Some people need a high dose of levo to generate a decent level of FT3
Also....it is vitally important that vit D, vit B12, folate and ferritin are optimal these nutrients support thyroid function and conversion
However if this does not help then the addition of T3 may help
Currently your FT3 is shockingly poor so I'd guess you may eventually need to do this....but not before trialling more levo and optimising those nutrients.
We are all in this mess together battling against the limited knowledge of medics...it is a travesty!
You can feel better again!
Good luck
DD
So increase the levo first?..
TSH is now close to 2.
That's what I would do, along with ensuring nutrients (listed above) are optimal.
It may or may not be the answer but I'd want to be confident that an increase didn't work before adding T3.....which can start another challenge with medics
Give an increase of 25mcgs about 6 weeks to settle in the system, then test again.
If there is improvement add another 25mcg.....as before. Some people need a high dose of levo in order to achieve a beneficial level of T3 and to feel well. Your body will tell you when the dose is correct....listen to it!
If there is no improvement then either ask to be referred to an endo or start to self medicate by adding a little T3.
It's a personal thing and unfortunately trial and error is the way forward.
You are not alone here.
Don't worry about TSH. FT3 is the important result.
I have a form of thyroid hormone resistance/cellular hypothyroidism and need a huge dose of T3 only so have travelled the bumpy thyroid road to recovery!
But,...I'm not a medic so can only comment based on my own learning and experience.
Hope it helps.
Take care
DD
I was only prescribed 12 more. Not 25
I noticed that, but adding 12mcg is unlikely to make a difference to your FT3.You could ask for a referral to an endo and ask for a trial of T3
Or....self medicate
TSH can fluctuate slightly
Have you had antibodies tested to check for thyroid autoimmune disease/ Hashimotos?
He is an endo!!!!
I have no thyroid due to thyroidectomy!!
How much hormone are you currently taking?
You appear to have stopped taking T3.
What on earth are your medics thinking!!
You need a decent level of exogenous T3
Following a thyroidectomy and given your poor T4 to T3 conversion, he should be considering T4/T3 combo!! Simply tweaking your T4 dose isn't going to work....did this endo not take cognisance of your low T3 and understand it's importance to the body
clinicaltrials.gov/ct2/show...
pubmed.ncbi.nlm.nih.gov/206...
In order to convince your endo that your conversion is poor and therefore that you need exogenous T3 it might be an idea to have a Dio2 genetic test. Your labs already make this clear, though I doubt this endo understands that!! When / if the test proves you have the Dio2 polymorphism then there is a better chance that you will be prescribed T3....the evidence will be in black and white!
thyroiduk.org/deiodinase-2-...
Like many members here I know what it feels like to continually hit your head against brick walls when dealing with medics....particularly those who are TSH obsessed!
As I've said....remember, I can only comment based on my own experience, I'm not qualified to diagnose. You need to push your endo to do that! Build your case using the above links and hope s/he is open minded....if not find another endo!! You need to take control.
Well I have 88-125 T4, and 5mcg T3.
I’m unsure as to whether to go to 125 T4 or add more T3.
What do you mean by 88-125 T4?
I have doses of Synthroid 88mcg-125mcg. I also have 112mcg tirosint. And I have 5mcg cytomel,
Mine fluctuates a lot lol
When we're having problems similar to yours, I would begin treating myself (with advice from members) - many who've recovered their health - despite the guidelines laid down by the BTA etc.
I am trying to treat myself but idk how
Reason for TSH to go up, 
2.5mg carbimazole but tsh going up
Why is my thyroid level going up but tsh staying high? 
Getting My FT3 back up again and what about RT3?
Why is why TSH going up?
