Help, need your help

[Susandidaho]

My TSH is .37 so I am low. Do I need to take a higher dose of Synthroid or a lower dose of Synthroid. I can’t remember how that works. My T3 and T4 are within normal ranges.

[SovietSong]

TSH is not a reliable guide for dosage.What are your most recent T4/T3 results and ranges?What dosage are you currently on and how are you feeling on it?

[Susandidaho in reply to SovietSong]

T4. .95

T3. 2.9

[greygoose in reply to Susandidaho]

Can you add the ranges, please, they vary from lab to lab so we need the ranges that came with yours. And, unless the FT3 - is it an FT3? - is over-range, I would not change my dose if I were you. Dosing by the TSH is a very bad thing to do because the TSH can be under-range but the Frees still too low. There's no reason to reduce your dose just to get TSH into range. It doesn't matter if it's low, as long as your Frees are good and you feel well.

And, if you're gaining weight, you're probably under-medicated.

[Susandidaho in reply to greygoose]

TSH range is :47 to 4.68 I am .37

T4 Range is .78 to 2.19 I am .95

T3 Free Range is 2.5 to 5.9 I am 2.9

T3 range is 97 to 169. And I am 143.

[greygoose in reply to Susandidaho]

T3 Free Range is 2.5 to 5.9 I am 2.9 - 11.76%

Your FT3 - the most important number - is only 11.76% through the range! It should be more like 60-70%. You are grossly under medicated. Forget the TSH, that low FT3 is why you are having symptoms like weight-gain.

Although, if your dose is 137 mcg levo, it's probably more likely to be a conversion problem. But cannot work that out because the wrong T4 has been tested: it should be a Free T4.

So, if you reduce your dose, even slightly, your FT3 - the active hormone - will reduce even further and make you feel even wors. I really would not do that if I were you. The TSH is not important.

[Susandidaho in reply to greygoose]

How do I get my FT3 up?

[greygoose in reply to Susandidaho]

It depends. First of all, you need that FT4 tested to see how well you convert.

But how are your nutrient levels: vit D, vit B12, folate, ferritin?

[greygoose in reply to Susandidaho]

OK, I've just seen that you're taking Cytomel! You didn't say that before. So, yes, you need to increase it. Cytomel is T3.

And, if you're taking T3, your TSH is going to be low, and reducing Synthroid is not going to affect it in the least.

But it doesn't matter. Your pituitary isn't making much TSH anymore because it senses that you don't need it.

[Susandidaho in reply to SovietSong]

dosage now is 137

[Susandidaho in reply to Susandidaho]

I am having a lot of hot flashes and gaining weight

[Susandidaho in reply to Susandidaho]

So if I skip my Synthroid every 3rd day, that should help until I can get into my Dr which is two more weeks?

[pennyannie]

Hello Susandidaho :

It's not quite as simple as that - though if you are being monitored and dosed on just a TSH reading ones dose is just adjusted down as the TSH goes down the range - and up when the TSH rises -

When on T4 only - we generally feel best with a T4 in the top quadrant o the range with the T3 tracking jut behind at around 60/70% through its range.

Quite where in the range your T3 needs to be to give you back your wellness is the question and that is unique to you and your body's set point of homeostasis :

Once the T4 is up in the top quadrant the accepted conversion ratio is said to be -

1 / 3.50 - 4.50 T3/T4 and so if you divide your T4 reading by your T3 reading this checks how well you are converting the T4 - Levothyroxine into T3 - the active hormone that runs the body.

No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal - do you have any readings for ferritin, folate, B12 and vitamin D ?

Some people find that their TSH drops very low in the range when optimally medicated - though unfortunately some doctors read this to be a sign of over medication and why we should not be dosed and monitored on just a TSH reading once on any form of thyroid hormone replacement - though fully appreciate in primary care a TSH is all most doctors see.

[Susandidaho in reply to pennyannie]

Thank you!

[pennyannie in reply to Susandidaho]

Sorry - forgot to add - re the little conversion ratio of 1/ 3.50 - 4.50 T3/T4 -

we generally feel best when we come in this ratio at 4 or under.

[Susandidaho in reply to pennyannie]

Thank you! I am thinking of skipping my thyroid every third day until I can get into my Dr. she can’t see me for a few more weeks

[pennyannie in reply to Susandidaho]

Are you feeling over medicated then ?

If you care to share your results - forum members can help explain the results to you :

[Susandidaho in reply to pennyannie]

Yes, I guess. I just wasn’t sure with a TSH being .37, I would need to go up or down in Synthroid. I have got bad hot flashes and should be losing weight rather than gaining

[Susandidaho in reply to Susandidaho]

Should I up my Cytomel ?

[Susandidaho in reply to Susandidaho]

TSH range is :47 to 4.68 I am .37

T4 Range is .78 to 2.19 I am .95

T3 Free Range is 2.5 to 5.9 I am 2.9

T3 range is 97 to 169. And I am 143.

[irishacres in reply to Susandidaho]

I wouldn’t worry about TSH mine has been <0.01 for years. I go by FT4 and FT3. If you were over medicated you would lose weight thus you are under medicated.

[NanaV54 in reply to Susandidaho]

Synthroid is bioidentical T4 formulation... T4 is the storage hormone. Cytomel is a bioidentical T3 formulation... T3 is the active hormone that, if made by your body, is converted from T4 into T3. Which is probably why you are taking T3... Your body isn't converting T4 into T3. T3 helps regulate body temp, metabolism and affects every system in your body. Thyroid Stimulating Hormone (TSH) is secreted from your pituitary, signalling your thyroid to release more T4 and T3 hormone, when your body isn't making enough. You are replacing that hormone through supplementing with Synthroid and Cytomel. Because of that, your pituitary won't make as much TSH, because you are getting it elsewhere. The main guide for dosing is Free T4 and Free T3, meaning, the portion of total T3 and total T4 that isn't bound to proteins and is "free" to work in your body. Your Dr should be monitoring both, on a regular basis. So, in short, your TSH is not below normal, because it is always suppressed on combination therapy. T4 takes 7 days or so to be fully absorbed into your body and used. T3, on the other hand, is felt within 1 to 3 hours after taking it. Some people are more sensitive to T3 and may get a small "hot" flash after taking. Because it directly affects body temp, it's pretty common. Until your hormones get to an optimal range, your systems are adjusting constantly, trying to figure out how to function efficiently. It takes awhile, plus some tweaking to get to where you want to be. Don't adjust your dose while your body is still adjusting. It takes about 6 weeks with every dose adjustments for you to balance out. I've been taking Armour thyroid for 20+ years, and still get the "warm flash" occasionally, but it doesn't last long and I don't really notice it any more. Good luck on your journey!

[Susandidaho]

I sent them to you

[Skylane2]

Susan. That is my daughter’s name too. I have an higher number tsh than you and my endocrinologist has me on 75 mg. Armour thyroid. Each week. Levothyroxine does not work for me. I’m extremely low in thyroid, and I would say you are too, even though I’m no expert . I take 30 mg on Tuesday and 30 mg on Friday and cut one tiny pill in half on Sunday so I’m getting (approximately 15 mg) all together it’s 75 mg.a week. The doctor tests me every 4 months then he will adjust the dose. You need selenium. Selenium is what helps your thyroid gland to heal. Folic acid is very good too. B complex is vital. It will help you heal. Do not drink water with fluoride or use fluoridated toothpaste. Fluoride is for children to prevent tooth decay. Not for adults especially adults with Hasimotos thyroiditis, which is an autoimmune disease lmikemost immune diseases, your diet is the most important thing; eat vegetables. The ones you like. ( corn is not a vegetable) if something gives you hives or a rash, discard it from your diet. Try to have oatmeal every day maybe in the morning. Something easy to digest. Try eliminating dairy products. There are lots of alternatives. If one milk bothers you, try something else. So many people are on vegetarian diets today you’ll find all kinds of appealing and healthy foods. If you can build up your strength, you will have more energy and your hair will grow back and your nails will get stronger and you’ll be able to get out of bed rather than fall out. If you like meat, try chicken breast or lamb or turkey or lean lamb or beef .potatoes are a great carb yams and sweet potatoes too. May God bless you and heal you .

[Coulby]

I am THS 0.15 I'm on carbimizole and feel aweful..al so waiting for appt with specialist for multi Nodular Goitre ??