I am finally feeling better after decades of fatigue. A nurse practitioner prescribed cytomel er and though I am not perfect it beats the past years of couch sitting. Synthroid alone never helped me feel well.
She now suggests lowering the levo to raise my tsh a bit so it won't be suppressed. I am afraid I will get tired again. Can anyone explain what lowering levo will do? Won’t it lower the T3 and T4 thus making me tired again? Would it be better to stay as I am or lower the levo, then take extra lio if i get fatigued again?
Now taking morning levo and split doses of lio:
8.79 ex release lio and .100mcg levo at around 8 a. m.
8.79 lio again 3 1/2-4 hr later
3 mg lio around 3 p.m.
test results:
tsh .002 range: .4-4.5
t4 free 1.5 range .8-1.8 (middle of top quarter of range)
t3 free 3.5 range2.3-4.2 (top of the third quarter of range)
antibodies 1 range < or =1
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marlyn123
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She now suggests lowering the levo to raise my tsh a bit
Well, that just goes to show how much she understands about thyroid! lol Your TSH is suppressed because you're taking T3. That is what T3 does and there's no way around it. And it doesn't matter one little bit because if you're taking T3, you don't need TSH.
TSH - Thyroid Stimulating Hormone - as far as we know has just two jobs:
a) it stimulates the thyroid to make more hormone - well, you don't need it for that because you're hypo, on thyroid hormone replacement, and your thyroid isn't making hormone any more.
b) stimulate conversion of T4 to T3, and you don't need it for that because you're taking T3.
If you reduce your levo, it won't raise your TSH at all, because it's the T3 suppressing it, not the T4. But, it will reduce your FT4, that's for sure, which might or might not have any effect on the way you feel. Probably won't have any effect on the FT3 - or not much, anyway.
So, yes, if you feel good, stay as you are and to hell with the TSH. You don't need it.
Oh, and if she tries to tell you that suppressed TSH causes osteoporosis and heart attacks, ask her to prove it. Because there are plenty of research papers on here proving that it doesn't.
Greygoose has beat me to it—what your nurse practioner is suggesting won’t raise your TSH but it will almost certainly leave you feeling more unwell.
If your FT3 and FT4 are not overrange, you aren’t overmedicated. The TSH level becomes totally unreliable when you take T3 (it’s not always a whole lot of use when you take levothyroxine only either).
From my observations the information is out there as is evidenced in this forum and in the work of diogenes et al.But, a willingness to accept this and to change current diagnoses and treatments that science proves are wrong, is lacking!
If it were then patients would not be struggling in huge numbers as they are.
The powers that be/ the decision makers have a lot to lose if they concede that they have been wrong!
Political power, the clout of Big Pharma and the reputations of those decision makers are strong adversaries against a shift in the status quo.
Medics inevitably practice what they are taught and are constrained by guidelines they are expected to follow.
Clearly guidelines are there to protect patients but they must be based on solid evidence.
We cannot always blame the doctors!!
As far as thyroid disease is concerned questions are being raised....and have been in both Westminster and Holyrood with little effect so far.
Nothing will change anytime soon but change in the long term seems/ is inevitable as science undermines long established misconceptions in medical circles... the focus on TSH referred to in this post, for example.
Fresh understanding must be adopted by a new generation of more open minded medical decision makers and taken up by lecturers and subsequently their students and future medics.
Too many thyroid patients have suffered for too long in the care of those charged to " first do no harm"
To quote a rather trite saying...."it's not rocket science"!!
Absolutely agree DippyDame... except it is the medical fraternity holding this back now. ...politics! Personally I think its partly pride....they hounded doctors who dared to treat patients not by the TSH but thyroid hormone levels and other factors & who were prepared to prescribe more than Levothyroxine if needed and ensured their patients were optimally treated. Put these poor doctors under incredibly stress threatening them with malpractise that they left. Now its shown to be the wrong approach theyre too ebtrenched in their thinking to turntail I guess because they fear retribution for the terrible way they treated these doctors. And frankly those doctors deserve justice. Even now I still hear the myth about a suppressed TSH will destroy my bones & I will get heart disease!
At the end of the day it should be about works best for patients not perpetuating a practise thats long been proven to be erroneous & causes patients to remain poorly. I guess its like a tanker takes a long time to turn!! Be good to see sone sign of it happening beyond the amazing research that has validated the need for change.....lol.
I would like to add to this that doctors are trained similar to Special Boat Service. They are broken down and "rebuilt" during their medical training. All criteria of brainwashing apply...sleep deprivation, humiliation, restriction of information, obedience and adherence to a strongly hierarchical system etc. By the time they are released to the public they are perfect clones no matter how idealistic they were when they decided to be doctors. Of course there is a range of behaviours depending on personality and there are a few doctors who rebel but overall there is a strong adherence to "the system" and that makes change difficult and slow. And, like members of Special Boat Service, doctors see themselves as an elite (gods in white). Following developments I think this is starting to change but it's not likely to happen in my lifetime.
You may find this interesting. From the ThyroidUK website, articles about the 'Myths of Hypothyroidism' . Things that too many doctors think are true.....
The reason why your T3 is having a suppressive effect on the pituitary is that, normally in health both T4 and T3 are controlling the pituitary approximately equally. Since FT4 is about 3 x the concentration of FT3, this means that weight for weight, the T3 is having 3 x + the effect of the T4. So if your dosing leans more towards T3 levels, then it will be much more suppressive of the gland than if T4 was in its normal dominance.
Wow! Thank you for all the helpful info! It didn't feel right to me that after finally feeling well, I would want to lower my levo dosage. But I would not have been able to discuss it effectively with my practitioner. Now I think I will be able to respond more knowledgeably and confidently at my appointment. I am so grateful for all your input!
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