Tree Frog has given you good advice. I want to add that studies have been done to show that TSH has no correlation with symptoms. Other studies have shown that TSH can vary as much as three-fold over the course of a 24 hour period.
Based on the TSH levels that you are reporting, it indicates to me that you are under-treated and most people feel better when their TSH is closer to 1 or so, but again, there is no correlation with symptoms once you are in the "normal" range.
I would suggest getting Free T3 and Free T4 tests done so that your doctor can evaluate the actual levels of thyroid hormones in your blood rather than the more indirect TSH which can vary so much and be inaccurate. The prescription insert for Synthroid indicates that dosing based on these levels rather thna TSH is the way to go if TSH is not correlating with T4 levels. They suggest keeping the T4 level above the middle of the lab range. I suggest the Free T4, since you are on estrogen, because estrogen causes binding and makes the Total T4 test less accurate in your case. Since your TSH fluctuates, I think dosing by T4 is the way to go.
The Free T3 test will determine if you are converting T4 to T3 adequately. Ideally, you woudl want your Free T3 to be above the middle of the lab range, too. If you are not converting well, then adding some (Cytomel) might be warranted, or at least make sure you are getting plenty of selenium (200mcg a day max)in your diet to help the conversion process.
On the note of Estrogen, since you are taking it, Make sure that you are taking it AT LEAST 4 hours (preferably more) from when you take your thyroid meds. Be consistent on the times that you take each if you can. This can help with absorbtion of your thyroid meds and make life generally better, too.
<p>[This message has been edited by Meep (edited 01-20-2002).]
