Increased medication but feel dreadful

[Nekomimi]

I was diagnosed with Hypothyroidism 2 years ago. And managed to get my TSH to 4.98 with 125 mcg levothyroxine. At my last blood test 7 weeks ago, my TSH was 15.4 and the doctor increased my medication to 150mcg. Everyday since I feel gradually worse and this week, I am struggling to get out of bed, have freezing hands, my legs and arms ache, I feel depressed, anti social and want to cry at nothing. I can't keep my eyes open in the evening. I know I should probably just go back to the doctors, but the last time I was on 150 mcg and couldn't walk up the stairs I was in so much pain, they just gave me very strong pain killers. My next blood test 3 months later was 0.15 and they reduced me to 125mcg again.

I feel fine on 125mcg, and apart from a struggle to lose weight, pains in my joints and the 15.4 TSH, I have no symptoms at 125 mcg. Should I just reduce to 125mcg? Does it matter if my TSH is high? I wasn't perfect at 125mcg for the last 6 months but I felt loads better than I do now.
Or is there anything else I can do? I rang to book another blood test, but they just said I wasn't due one until December.

[jjohnson5409]

So after starting t4 therapy, doctors should test t4/t3 and the ft3 should be higher?   or balanced?  

[TamraW]

Synthroid is a T4 drug. It will bring up your T4 levels. It will even bring up your T3 levels, because the body takes the T4 and converts it to T3. Sometimes, the body doesn't do a good job converting all of the T4 to T3 and you need a T3 drug like Cytomel.

This isn't the case for everyone, but some people just need a T3 drug.

:) Tamra

[jjohnson5409]

so it is safe to say that if your ft4 and ft3 are in the low range and the doctor puts you on synthroid, it may not work?  or it may work?  Is this why the doc should test both ft4 and ft3?   and the ft3 should be higher then the ft4?   confusing?????  

[Barb135]

T4 must be converted to T3 by the body - a lot of that conversion is done in the liver and sometimes, for some reason it doesn't work right.  That's why you need to have both Free T4 and Free T3 tested - it's not safe to *assume* the conversion is taking place.  That's what my former pcp did, plus he was treating more by TSH and ended up sending right back to "hypo-land" even though my TSH was in the "basement".  

[TamraW]

Ideally, T4 converts to T3; however, the thyroid is directly responsible for making 20 percent of our T3. If we have  no thyroids, or destroyed thyroids, how are we getting that T3? We are relying on our bodies to convert all of our synthetic T4 to the amount of T3 we need. Sometimes, it just doesn't happen. If our T4 levels are high enough, but our T3 is still low or mid range, and we still feel hypo, then Cytomel can help.

This is one reason why so many people who take the natural thyroid meds won't switch to synthetics. They are getting T3 with their natural meds.

:) Tamra

[jjohnson5409]

I thought that taking t4 like synthroid makes more t3?  isn't that the norm?  Does it ever work?  or should all people who have low t4 and low t3 take both?  

[Barb135]

Ask to get your Free T3 and Free T4 tested.  Those are the actual thyroid hormones and are more important than TSH.  TSH is a pituitary hormone and not really indicative of what the thyroid is doing.  Try to get your FT3 and FT4 (make sure it's frees, not total) tested and if they are in range - preferably the upper 1/2 to 1/3 of the range, then maybe they to take a look at your pituitary gland to make sure it's not malfunctioning.

If your doctor refuses to test FT3 and FT4 and treat according to symptoms, it's time to find another doctor.

[TamraW]

Many endos treat only TSH, ignoring the important free levels. Sometimes, the FT3 levels are low and Levo (synthetic T4 drug) alone will not help it. Adding Cytomel (synthetic T3 drug) to the mix makes all the difference. Sometimes, the FT4 levels are still low, but doctors are afraid to push TSH beyond their 'magic' number.

Sometimes, a natural dessicated medication, like Armour or Nature Thyroid is better for patients (made from pig thyroid). Armour has T3 and T4. Nature Thyroid have FT4, FT3, plus I believe it also has FT1 and 2.

Occasionally people who switch to the natural stuff have reactions. Sometimes, people who take the natural stuff have reactions to synthetics.

The point is that we are all different, but that DOES NOT mean we should suffer. There is a medication and dosage that is right for you. You just need a reliable doctor who will get you feeling better.

If I were you, I'd find a new endo, one who can actually treat your levels until you feel better. One who treats FT3 and FT4.

If you live in the US, here's a list of recommended thyroid docs:

http://www.thyroid-info.com/topdrs/

:) Tamra