Optimum dose

[deb25426]

I know it maybe a silly question but all the aching muscles etc that is common with hypothyroid, should they go now I'm on my optimum dose and have been for several years?? I.e weight gain, muscle spasms/cramps...I am quite lucky to a lot of people I read about on here but it does puzzle me why I still get these symptoms.

[helvella Administrator Thyroid UK]

It rather depends on a number of things. The first and most obvious of which is to ask on what basis you think you are your optimum dose?

Second is to ask if you have considered the standard "other issues":

vitamin B12

folates

iron/ferritin

vitamin D

All of which are all too often low in people who have been or are hypothyroid.

Ideally, real optimum dosing and addressing all the other issues that you find, should make you feel somewhat better. Unfortunately, though, some people do continue to have issues which are difficult or impossible to resolve. But definitely worth trying.

Rod

[shaws Administrator]

When you say you are on an optimum dose - is that what the GP said is a 'normal' TSH blood test?

An optimum dose is that which resolves symptoms. Unfortunately, many doctors keep us undertreated due to the TSH. Also, some of us have to try alternative thyroid hormones if levothyroxine doesn't work for us.

The tests which Helvella has suggested are very worthwhile as you can then eliminate them when they are at optimum and, in themselves, may make a huge difference.

web.archive.org/web/2010122...

The above is a link and there are other topics at the top of the page

[deb25426 in reply to shaws]

The dose I've been on for a few years now is 10mcg t3 and 125mcg t4, I have just been discharged from the Endo last month. I can honestly say that he listened to me years ago to be at the upper end of the ranges and it worked for me. The same results at doctors would look like Was hyperthyroid!!!! But Endo said he is happy with me on this dose and to be tested in a year at doctors. My results I had were

FT4 16

FT3 4.2

TSH 0.06

Calcium 2.36

LFTs normal

Urea 6.6

Sodium 141

Potassium 4.1

Creatinine 70

eGFR 76

Cholesterol 3.5

Triglycerides 1 they are the latest results. Also my Vit d was 48!!

[shaws Administrator]

Ideally, we need the ranges of the blood tests (the figures are in brackets) as labs differ and it makes it easier to comment.

I will just say your Vit D is not very high and this is an excerpt. Someone who is more knowledgeable than me will comment about your other tests.

Here are some guidelines

If your blood level is above 45ng/ml and for maintenance, I recommend 2,000-4,000 IU daily depending on age, weight, season, how much time is spent outdoors, where one lives, skin color and obviously blood levels

In other words if you are older, larger, living in the northern latitudes during the winter, are not getting sun and have dark skin, I recommend the higher maintenance dose.

If your blood level is 30-45 ng/ml, I recommend you correct it with 5,000 IU of vitamin D3 a day for 3 months under a doctor's supervision and then recheck your blood levels.

huffingtonpost.com/dr-frank...

[deb25426 in reply to shaws]

Doctor said he was happy with my vitD but advised me to have some fortified cereal.!!! I have got myself some Vit D tablets from holland and barratt gonna try taking them, it can't hurt can it?

[Clarebear]

The range in the Ft3 would be particularly useful. The range a my lab is 3.1-6.8 and I am still working out what my optimum is. I suspect somewhere between 5-6 as I still ha symptoms at 4.6. 4.2 may be a bit low for you too as 10mcg of T3 sounds quite a low dosage. Xxx

[deb25426 in reply to Clarebear]

I must be honest on the readings above I felt really good when I got there a few years ago. I used to take 20mcg T3 and altered my t4 accordingly but I think it sent me over too much.. Been settled on this dosage for a few years now. Some days I'm ok.. I think it's the time of year too. I shouldn't moan there are a lot of people worse than me unfortunately.

[Glynisrose]

Obviously you are not on an optimum dose if you are still getting symptoms! Do not compare yourself to others, you have a right to feel well no matter who else 'is worse off' than you. Blood tests are not relevant, its more about how YOU feel!

[evewood1]

If your symptoms have got worse since the onset of winter then you may be like me, a person who needs more meds during the winter months. If your symptoms have never gone away I would suggest as above that you were never on enough. I found that over the years my thyroid function dropped so that although I felt well on the dose I had at first my symptoms returned as it put out less thyroxine of its own..

I have found that finding the right dose is a very individual thing and you may have to experiment a bit to get it right. Best of luck.