Maintaining a symptoms journal as they related to labs was suggested to me by my first-ever thyroid forum. It was key towards identifying my optimal levels.
I soon realized that noting "feeling good" or "not feeling good" on my lab reports wasn't enough.
I maintained separate Word documents that covered the period of time in between labs. This way, each document represented what was going on with me in relation to whatever dose(s) I was taking at the time.
I would title each document with a date range that reflected the date of the most recent labs and the date of my upcoming labs.
My daily entries weren't particularly long and they were based upon what symptoms I might have been dealing with at the particular time.
Even though I had easily 30 symptoms during the early months of the meds titration process, many of those dissipated once my FreeT4/T3 levels were above mid-range.
This confirmed for me that I was like many people in the fact that I needed both my FreeT4/T3 levels above mid-range to feel well.
I was then dealing with a cluster of fluctuating symptoms. Watching the patterns that developed after a dose increase helped me to realize that my levels weren't necessarily optimal just yet.
This period of time often showed an improvement of symptoms after a dose increase....and then a worsening of some before the time of my next labs. This is a typical experience that tells us our dose(s) and levels still aren't optimal.
Since each of us has his/her own typical cluster of symptoms, it makes sense to note only what applies to the individual.
Therefore, my journal consisted of daily notes about the quality of my sleep, digestion, energy level, strength, stamina and mental function.
I would also note anything that might have been going on that particular day that could have affected how I felt.
An example of this would be noting the chills I had at night and also noting I attended my son's hockey game and/or it was below-freezing outside. I certainly don't want to blame my thyroid for everything
You can only imagine my excitement when my journal entries only consisted of improvements. This was a sign that the labs I had 6 wks. after starting the particular doses could very well be my optimal.
Sure enough, my FT4 level came back around 90% of range (my optimal FT4 is higher than the 60-80% of range most people need to be symptom-free) and my FT3 level at 75% of range (typical for most people)
Moving forward from there, I continued to make occasional notes only if something questionable was going on. I found that there could be many days when I didn't make entries.
There were times when I found the need to make more entries because my digestion was slowing down or my sleep quality had deteriorated. Sure enough, those upcoming labs showed my FT4/FT3 levels to be lower in the range than the levels I had when I was symptom-free.
I had two times during the meds titration process when my levels optimized and I was symptom-free for about 3 months.
By sharing my journal with my doctor as it related to my labs and the times I felt best, she accepted my determination about my optimal levels.
Since my thyroid has been somewhat erratic, my doctor has me get labs every 6 wks. She has adjusted my doses (I take T3 & T4) to maintain my optimal levels.
This has kept me symptom-free and I feel awesome.
I look forward to celebrating the same with you.