Discussions that mention levothroid

Thyroid Disorders board


Hi All,
First off, love this site. I feel better hearing about others who seem to be in the same spot as I am. (Hashimoto's) Got some questions:

1.) I was first tested in Sept 2006 with a TSH of 5.6 (not bad) and my endo wanted to start treatment. I requested a second test and ended up with
T4 Free: 1.3
TSH: 3.4
TPO AB: 922.0
So I started a dosage at 25 levo, and began a nice yoyo effect of getting better then worse. The rest of my tests (each 2 months after) were TSH 3.2 (@25 levo) and 1.0 (@50 levo). My question is should my doc test for anything other than my TSH levels? Other than the initial test it's only been TSH.

2.) I called my doc a few weeks ago and explained that after going to 50 levothroid (roughly 3 months ago), I felt great but the last 4-6 weeks I've really slid backwards, horrible symptoms (worse than pre-diagnosis). She suggested that I take my meds 6 days a week instead of 7. Is that right? Wouldn't I go up in medication, not down? She suggested that I went up in dosage too soon, but I'd been on that level for at least 6 weeks and seemed great. Wouldn't I have an adverse reaction earlier if the dosage was too high?

3.) What's the difference in T4 Free, T3, TPO AB, are there other tests I should know about?

4.) Any votes on which meds are the best? I'm on levothroid, but I've heard of other types and wonder which ones are recommended.
You've been on one dose long enough to get an increase. The process of titrating up to the optimal dose should go in 6-8 week cycles. If you crash in that time frame, a dose increase is justified. I don't agree you should take a dose decrease; that's frankly asinine. Fifty mcgs is the lowest possible therapeutic dose, and there is plenty of room for you to increase that. (FYI, 25 mcgs is not considered a "real" therapeutic dose, but is sometimes fine as a starting point.)

Even though your beginning TSH was considered definitely hypothyroid, your FT4 appeared to be adequate. (Without the lab range associated with that, I can't say for certain. Whenever you post lab results, you need to include the ranges for comparison.) That would have been the perfect time to run a free T3 test as well. It's just as important - maybe even more so - than free T4. The free T tests are the ones that will tell the most about whether your dose is optimal; TSH only won't tell you anything at all. If you can't get the MD to test either of these, and since she's telling you to decrease your dose when you should be getting an increase, it seems likely you won't regain your thyroid health with that MD. I would be lining someone else up to take care of me, if I were you.

The best med is the one that works for you. If you have an MD who prescribes only one and won't consider any others, that bodes trouble. There are minor but significant differences between all the brand names that make it possible for one to work when none of the others will. Also, many people need the additional T3 that's available in natural dessicated thyroid meds (like Armour) which isn't included in T4-only meds like Levothroid or Synthroid. You may or may not be one of them.