When do I increase my meds?

[Juliet_22]

Hi All, I wonder when can I increase my meds?

Currently, I alternate between 75/88 mcg of thyroxine.

But my recent TSH tested at 10!

T3 is 28% of the range

T4 is 50% of the range

Anti-TG is normal range

Anti-TPO is raised a bit at 150 (but my diet has been gluten and dairy free for eons and I lowered TPO from 600 to 150, and TG from 600 to normal). Trying LDN.

All my other nutrients - D, B12, folate, ferritin, iron, etc. are in the ideal ranges - what's recommended here. CRP is healthy too, I track everything regularly. I eat lots of carbs, calories, nutrition is healthy.

I have to be very careful with increasing thyroxine as previously when I went up to 100 from 75, I had problems with high pulse rate, heart palpitations and blood pressure. It stabilized after I decreased the meds.

My TSH in mid Feb was 4.9, which is still high for me as usually it sits at around 1. Due to stress it jumped up further.

I've been doing 75/88 for 3 weeks now and I feel very hypo in terms of symptoms and mental energy.

I really, really need more thyroxine and ideally don't want to wait for 6-8 weeks to re-test and live with all the low symptoms.

Shall I jump to 88 mcg now, considering my results, or do I have to wait for longer for the body to adjust? Or try something like 88-88-75 now having been on 75/88 for 3 weeks?

As such, 75 to 88 is not that much of a jump. But I know ideally you should wait 6 weeks, re-test, etc. But 6 weeks is a long time when you're struggling ...

I tried adding T3 and it didn't work for me at all. Considering switching to NDT in a hope that it will help me feel better. Already have a private prescription for it, but still holding fire to see if T4 can help, though it's been months already trying to get to the right dose and I haven't yet seen results, yet don't want to trigger pulse and BP with jumping up the dose too much.

Would appreciate your help!

[Jaydee1507 Administrator]

So your latest increase has been by 12.5mcgs every other day?

What dose were you on for the latest test?

I know you've really strugled to increase at all and as you are going in very small increases I see no harm in going up a very small step before waiting 6 weeks to retest. How much is really up to you and your symptoms.

[Juliet_22 in reply to Jaydee1507]

Thank you for the reply! Well, that's the thing, I have not been stable with the increase up until the last 3 weeks. I tried 88 every day before, then backed off, then did 75 mcg for a few days, etc. So the stable 75/88 dose is something I've been doing for 3 weeks. When you said you see no harm in increasing, did you mean going up to 88 mcg daily (or even 88-88-75) now, after 3 weeks of stable 75/88, looking at the symptoms of how the body responds, and then maintaining for 6 weeks and retesting?

[Jaydee1507 Administrator in reply to Juliet_22]

Before you retest at 6-8 weeks of a stable dose it would be good to achieve a 12.5mcgs increase from where you were originally. I doesn't matter how long it takes you to get there depending on your symptoms.

You could now try 88mcgs daily and see how it feels. You could always then drop back to 88-88-75 if needs be.

[Juliet_22 in reply to Jaydee1507]

That makes a lot of sense, I will do that, yes! Otherwise a tiny increase doesn't seem to make any difference, I have to say. Thank you so much!