Originally Posted by foxtrot
it's been awhile since I've seen you on the boards, I hope you're doing well.
I started on 0.25 synthroid in sept 03. My levels where TSH 3.8 (.5-5.0) FT4 14 (10-20) FT3 4.0(2.6-5.7).
I am now upto 0.125 synthroid and my TSH is .07 and my free numbers haven't changed. Why is this?
Most of my sypmtoms have gone away except my energy level isn't where is should be. I have a great doc., he listens to what I have to say. Do you have any advise as to what step I should take next.
Liz, you are seeing what many people do when they get treated for hypo. Before you were being treated, you rhypothalamus and pituitary had gotten used to a decent level of thyroid hormone. YOur Free T3 nd Free T4 weren't too bad, but your thyroid gland had to work really hard to maintain that. (Thus the elevated TSH)
Every time you raise your dose, your hypothalamus and pituitary see more thyroid hormone, and turn down the production of TSH to keep your Free T3 and Free T4 where they were and where they "think" it should be. Your thyroid gland isn't having to work as hard to keep the levels up, because it doesn't have to, so if you had a goiter before, it is most likely shrinking or completely gone.
At this point, you are getting close to the point where adding more thyroid hormone will start affecting your Free T3 and Free T4 levels, though, as your TSH is closer to being suppressed. Some people have to have TSH near Zero to feel well and get Free T4 and Free T3 to rise to where they need to be. In my case, my TSH was .01 before my T3 and T4 budged.
Just be careful, monitor your Free T3 and Free T4 and make small dose changes until those numbers rise above the middle of the lab range and hold that dose for 6 months. (Shoot for Free T3 above 4.2 or so and Free T4 above 15) Keep a symptom journal to track your healing week by week, and see what happens from there.
After being on that dose for a while, you might still need a tiny increase, but deal with that once you get there.