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Old 06-02-2012, 02:29 PM   #1
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increase Synthroid or not?

I am 43 and have been on 75 mcg of Synthroid for about 7 years. Back then, my TSH was about 8, and my primary care doc did not want to put me on Synthroid at that level. I self-referred to an endocrinologist, who disagreed, esp. since I was having many symptoms of hypothyroidism. Most recently, I am feeling tired all the time again and having a lot of memory problems. One other weird symptom: I am occasionally leaking breastmilk ("galactorrhea"), even though it has been over 7 years since I stopped breastfeeding my babies. My labs this week were:

T-3 uptake: 33%
T-4 Total 7.3 mcg/dl
Free T4 Index 2.4
TSH 3.32 mIU/L

My doctor (same one) considers that all normal and is on the fence about increasing my dosage, but I recall the endocrinolgoist wanted it to be lower, esp. on Synthroid (< 2? ) I can't recall, and the reference range on the labs is < 4.50, which I think is outdated. She basically left it to me whether I wanted to try 88 mcg. I did try that dosage a few years ago and had headaches and heart palpitations, so I went back to 75. I think I'm going to try increasing to 88 since I still have a month's supply and see how I feel. Any suggestions? My endocrinologist thought I could leave it to my PCP to monitor and control my doseage, but mine doesn't seem that comfortable doing so.

 
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Old 06-02-2012, 05:15 PM   #2
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Re: increase Synthroid or not?

I would definitely say you need a dose increase and it's probably going to end up being a lot more than 88 mcg.

I'm sorry to say but the only test that you've had that has any merit is the TSH and it's not as helpful without corresponding FT3 and FT4. You may as well increase anyway, as it definitely sounds like you are hypothyroid and, if you weren't, your TSH would probably be closer to 1 (the average healthy person has a TSH of 1.2). However, I would get TSH, FT3 and FT4 tested in 6 weeks. That will give you a better picture of your thyroid levels. I would also recommend having your next labs taken in the second or third week of your cycle, when estrogen is at its highest (assuming you are not on birth control) because it will give you the worst labs results (highest TSH and lowest Free T's).

Your prolactin must be very high if you are leaking breast milk. This is pretty common in hypothyroidism- I am guessing that you are having long, irregular cycles as a result.

 
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Old 06-02-2012, 07:26 PM   #3
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Re: increase Synthroid or not?

Thanks, Bee. It's reassuring that someone agrees with me on this. My prolactin did come back as normal (6.0 ng/ml, with the normal listed as between 3 and 30), and my cycles are regular. Will start on 88 mcg tomorrow!

 
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Old 06-03-2012, 01:47 PM   #4
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Re: increase Synthroid or not?

Some doctors prescribe based upon TSH levels, others based upon T4 and T3 levels, and others based upon how you feel.

Both dosages of 75 or 88 should result in acceptable blood levels. Having you select between 75 or 88 based upon how you feel would be reasonable thing to do.

 
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