Results Advice Needed.

[Pink-mist]

I am confused about my test results.

My previous results were: TSH. 0.02. (0.27 -4.2) T3 4.29 (3.1 - 6.8). T4 10.2 (12 - 22) T4 50 mcg daily. T3 15mc daily.

I was advised to increase the dosage as the results were too low. Medication was increased to T4 50 mcg daily plus 25 mcg every other day. T3 25mcg daily.

I soon started to feel over medication, feeling like I had overdosed on caffeine, very shaky. I persevered for 7 weeks and was tested again. My results had improved to TSH 0.02 T3 6.0 T4 15.6.

I was then advised to lower the dosage to 50 mcg plus 12.5 every other day and T3 15 mcg daily.

I now feel less over stimulated and shaky but not yet as well as I can be. I don’t understand why my bloods look good but I felt so unwell and what would you suggest the best way forward with medication.

Thank you for your help.

[SeasideSusie Remembering]

Pink-mist

Whoever is telling you to adjust dose of both Levo and T3 at the same time is incorrect. We should only change one thing at a time, give it 6-8 weeks for levels to settle then test before deciding on next step.

Also, T3 should only be adjusted in 5mcg increments, 10mcg increase was too much so couple that with an increase in your Levo which would also raise FT3, plus the rise in FT3 from your increase in T3, then no wonder your FT3 level shot up and you felt overmedicated. And now you've been advised to decrease your dose of both Levo and T3 again, with a 10mcg drop in your T3.

I was then advised to lower the dosage to 50 mcg plus 12.5 every other day and T3 15 mcg daily.

When did you make this dose adjustment?

Test TSH, FT4 and FT3 6-8 weeks after the change in dose. Post levels here and members will make suggestions to help you achieve a better balance of dose at a more sensible rate.

[Pink-mist in reply to SeasideSusie]

Thank you for your reply. I made the adjustments on 3rd March.

[Pink-mist in reply to SeasideSusie]

I am now concerned as I have been prescribed HRT which I have been taking for a week. Should I be taking this if my thyroid is not settled?

[SeasideSusie Remembering in reply to Pink-mist]

Pink-mist

As you adjusted dose on 3rd March leave things as they are for now and I would retest somewhere around 14th-28th April. Come back with your new results and we can see what's happening.

As for HRT, it's not really my thing, I'm way past menopause, never had sex hormones tested or even suggested I take HRT but then again the only problem I had was occasional hot flushes so I probably wouldn't have taken it anyway.

If you feel you need the HRT then if you use HRT patches I think there's no problem but if you use an HRT pill then take it at the opposite end of the day to your thyroid hormone tablets. Taking HRT can reduce the absorption of thyroid medication, in which case dose adjustment can be made, another reason to keep a close eye on your levels.

[Pink-mist in reply to SeasideSusie]

Thank you, much appreciated.

[greygoose]

That was too much of an increase in too short a time. It stressed your body. T3 should only be increase by 5 mcg every two weeks maximum - and never increase levo and T3 at the same time. Leave a few weeks gap in between. It will probably take a while longer for symptoms - or lack of them - to catch up with blood test levels.

Now, you're lowering your dose again, too soon, and it's going to completely confuse your body. It won't know if it's coming or going. And reducing T3 by 10 mcg in one go is too much. You probably only needed to reduce it by 5 mcg. Your doctor is practicing yoyo dosing, and that's never a good idea. Slow and steady is the rule. Your body now has to catch up again, when it hadn't caught up from the last set of dose changes. Tell your doctor to curb his enthusiasm! lol

[Pink-mist in reply to greygoose]

Thank you for your reply. I have been on this dose since 3rd March, should I continue or make changes?

[greygoose in reply to Pink-mist]

No, give it a rest. You're changing too much too often. Wait at least another six to eight weeks for things to settle down.