question you can not ask a doctor =)

[tresa56]

If I take a little extra thyroid medicine for a few days will I get extra energy without hurting anything..my numbers were so bad last time and I am exhausted...Don't want to mess anything up..Just wondering if it would help get over this hump and get some extra medicine in my system to kick start things.

[tattybogle]

Taking 'a little extra for a few days' is not a good idea , no .

if your dose does need increasing then it will need increasing consistently , not just up for few days / then down again ...doing this will just confuse your HPT axis . and will mean you have to wait even longer before you can get an idea of where you are from blood tests ( every time you fiddle with the dose you need to wait another 6 wks before a blood test is reliable)

and even if you are not going by blood tests .. you still need consistency of dose for several weeks to know how a particular dose feels.

[tresa56 in reply to tattybogle]

Ok Thankyou.. My dose was just upped and I'm so tired and have brain fog.. So it was a thought that occurred to me

[tattybogle in reply to tresa56]

have you got any blood results from previous doses of NDT yet ?

[tresa56 in reply to tattybogle]

yes.. I was upped to 120 This was a few days ago on 90 armourTSH 7.72 H mIU/L

Reference Range > or = 20 Years 0.40-4.50 ...

T4, FREE 0.7 L Reference Range: 0.8-1.8 ng/dL

T3, TOTAL 85 Reference Range: 76-181 ng/dL

On 60 armour 6 weeks ago

TSH 5.80 HmIU/L

Reference Range > or = 20 Years 0.40-4.50 .

T4, FREE 0.8 Reference Range: 0.8-1.8 ng/dL

[tattybogle in reply to tresa56]

ok so assuming you did 6 wks on 90mcg , then that dose was plainly not enough.

TSH far too high / fT4 far too low .

in theory ,

1 grain NDT contains 38mcg T4 + 9 mcg T3.

so 2 grains is now giving you 76mcg T4 + 18mcg T3.

if you assume T3 is 3 times as 'potent' as T4 ,that means 2 grains is roughly 'equivalent' to (76 + [3 x 18 = 54]) = 130 levo.

did you have any results from when you were taking 100mcg levo for comparison ?

[tresa56 in reply to tattybogle]

when I was on 100 mcg on levo at one point I had good numbers. My TSH got down to 1.75 but I felt awful..It might have made the tsh better but my symptoms are still there. Like I was freezing and tired ect,,,,So my doc said we can try armour

[tattybogle in reply to tresa56]

your results on 1 and a half grains are so rubbish that i suspect 2 grains still won't be enough for you ,.... but on balance i think it makes sense to wait and see how you feel on 2 grains before fiddling with it.. i know that is extremely frustrating , but it can be just as frustrating to go up too quickly, still find you feel rubbish and then have no way of knowing if the problem is now caused by slightly overmedication if you missed the sweet spot by going up too fast.

tricky to know what to do for the best i know . but if you decide to increase to more than 2 grains before you get to 6 weeks for blood test , then you should stick to that dose for 6 weeks before testing .. bloods are not very reliable / not much use if you haven't been on same dose for at least 6 weeks before testing .

[tresa56 in reply to tattybogle]

I will probably just stick to the 2 grains for the 6 weeks..I was just wondering if taking a little extra would hurry me along...sounds like a bad plan though...Cause under a docs care for testing and stuff the results are probably more useful if you just do what they like i guess. I am just sick of feeling good for a month and then going back to this...

[tresa56 in reply to tattybogle]

Do you know anything that would possibly make a person functional while waiting

[tattybogle in reply to tresa56]

hopefully you will feel a bit better once you have been in the new dose a week / 10 days,

and if /when you go downhill again , it won't be so far down the hill as it was this time .

Sorry .. still sucks i know .... but you are right to wait i think ..... when dealing with getting a prescription sorted out , which you will need for life , there is a lot to be said for getting there with a good solid evidence base that can't be questioned later by the next GP who comes along ...., rushing things now can mean a lot more hassle in the long run.

[Maisal11 in reply to tresa56]

you could ask to have your b12, folate, ferritin, vitamin d levels tested as there is very often a link with thyroiditis and vitamin deficiencies..

[nouvelleespoir in reply to tresa56]

How are your iron and mineral levels? If too low, they too can leave you feeling this way.

[Singwell in reply to tattybogle]

Really useful to read this. I've been having to titrate up so incrementally that I think I've messed with that's timeline a bit. For the last few weeks (I'll have to check exactly how many) I've been taking around 30mcg instead of 25. I tried going up to 37.5 right away and my heart kicked off so I'm having to bite that half pill in half again. My goal is get up yo 37.5 and then test. I suppose I should.be keeping a more accurate record! So - you're saying wait till I've been taking g 37.5 for 6 weeks before testing? In which case I'll reschedule Wednesdays blood test. Today I've tried the 37.5 and feel OK...

[tattybogle in reply to Singwell]

yes, preferably you want 6 weeks minimum after a dose change , if you test before that time , you'll be wondering if TSH was still going to move some more if you'd waited longer.

in an ideal world you 'd leave more like 8-12 weeks from any dose change , but if you did that every time when you know you really do need to get on with increasing dose as quickly as poss, then you'd have died of boredom before you got up to the right dose. so it's always a bit of a compromise between how long you should wait , and how long you can bear to wait.

[Singwell in reply to tattybogle]

Oh I could get very bored 😞 it's taken over 6 months to get this far. Last tests in May were SERUM TSH 5.19 (ref 0.27-4.20)SERUM FREE T4 15.5 (ref 12.00-22.00).

So at least heading in the right direction from TSH 11.7 last October.

I do feel the benefit though so it's worth it.