# Increased Synthroid Dose



## Hypoman

Hi All,

I have asked a few questions here before, and the insight I have received has been very helpful for me, and I hope others as well. Here's the latest:

I was feeling pretty good until about a month ago, so I decided to get some labs done. The results were:

*TSH*: 2.09 (0.40 - 4.50)
*FREE T4*: 1.5 (0.8 - 1.8)
*FREE T3*: 3.0 (2.3 - 4.2)

Previously, my TSH was hovering around 1.85, and my FT3's and FT4's were pretty close to the same -- FT3 was like 3.1. I have been taking Synthroid _125mcg_ for the past six or seven months (and I have been on Sythroid at different levels for about three years). The doctor recommended upping my dose to _137mcg_ after these last lab results. I did, and have been taking the new, higher dose for 4 days now. So far so good, but dose changes have been hard on me in the past, and I'm not looking forward to the anxiety and general _weird_ feeling that I remember experiencing. I specifically recall getting very emotional around the 10th day of a dose change.

Anyway, I am a little worried about going Hyper, so my question is, how long will it take to know if I'm going to be feeling Hyper symptoms or not? I know it's probably different for different people, but is there an average? 10 days? Months? Thanks in advance for any insight. Best.


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## Andros

Hypoman said:


> Hi All,
> 
> I have asked a few questions here before, and the insight I have received has been very helpful for me, and I hope others as well. Here's the latest:
> 
> I was feeling pretty good until about a month ago, so I decided to get some labs done. The results were:
> 
> *TSH*: 2.09 (0.40 - 4.50)
> *FREE T4*: 1.5 (0.8 - 1.8)
> *FREE T3*: 3.0 (2.3 - 4.2)
> 
> Previously, my TSH was hovering around 1.85, and my FT3's and FT4's were pretty close to the same -- FT3 was like 3.1. I have been taking Synthroid _125mcg_ for the past six or seven months (and I have been on Sythroid at different levels for about three years). The doctor recommended upping my dose to _137mcg_ after these last lab results. I did, and have been taking the new, higher dose for 4 days now. So far so good, but dose changes have been hard on me in the past, and I'm not looking forward to the anxiety and general _weird_ feeling that I remember experiencing. I specifically recall getting very emotional around the 10th day of a dose change.
> 
> Anyway, I am a little worried about going Hyper, so my question is, how long will it take to know if I'm going to be feeling Hyper symptoms or not? I know it's probably different for different people, but is there an average? 10 days? Months? Thanks in advance for any insight. Best.


Hi, Hypoman!! You have a lot of wiggle room on that FREE T3. Mid-range of the range provided by your lab is about 3.2 and most of us feel best when the FT3 is @ about 75% of the range provided by the lab.

It is hard to say when you might feel anything if at all. That really is not a huge bump up and if you are "active" physically, you may never notice it.

I wish I could do a better job of answering your question but we each react so differently.

You will have to let our inquiring minds know how you fare and "if" you became symptomatic. I hope you don't. TSH probably could benefit being lower as well. Most of us like it @ 1.0 or less.


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## northernlite

It takes me about 2 weeks to feel anything on a dose change.


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## Hypoman

Thank you Andros and northernlite. It has been exactly 10 days since I upped my dose. So far, I feel alright. I do feel a little _off_, but I expected that. One thing I am noticing is that I'm retaining water like crazy right now. Is that common during a dose change? I seem to remember that happening last time as well. I don't feel major anxiety or anything, and I haven't noticed any increase in heart rate, so I'm guessing I'm not going to go Hyper. It could be too early to tell though. Thanks!


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## Andros

Hypoman said:


> Thank you Andros and northernlite. It has been exactly 10 days since I upped my dose. So far, I feel alright. I do feel a little _off_, but I expected that. One thing I am noticing is that I'm retaining water like crazy right now. Is that common during a dose change? I seem to remember that happening last time as well. I don't feel major anxiety or anything, and I haven't noticed any increase in heart rate, so I'm guessing I'm not going to go Hyper. It could be too early to tell though. Thanks!


Have you ever encountered this problem before? How bad is the swelling?

http://doublecheckmd.com/EffectsDetail.do?sid=2205&eid=2410&dname=Synthroid

I would check w/ the doctor on this one. Coffee,Celery, dandelion tea and drinking plenty of water are natural diuretics. Especially drinking plenty of water.

Let us know. Edema is worrisome.


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## Hypoman

The swelling isn't bad -- it's more of just a puffiness, like I've gained some weight, except it couldn't be that because it happens so quickly. No one else would probably notice it but me. Could just be a coincidence. I'm drinking a lot of water now, so we'll see if it goes away. Thanks.


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## Andros

Hypoman said:


> The swelling isn't bad -- it's more of just a puffiness, like I've gained some weight, except it couldn't be that because it happens so quickly. No one else would probably notice it but me. Could just be a coincidence. I'm drinking a lot of water now, so we'll see if it goes away. Thanks.


I call that the "fluffy look" which is typical in many who have the gamut of autoimmune diseases.

We with TD are very sensitive to changes and that includes seasonal changes.

Please keep us in the loop re this and if it gets more pronounced, please do check w/your doctor.


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## Hypoman

Hi All,

I'm back with a quick update. It has been a little over a month since my dose change (125mcg to 137mcg), and I feel pretty good. I don't feel like I'm going hyper, so that's good. The puffy feeling still comes and goes, but seems to have eased. What I _have_ noticed, is an increase in appetite, especially my craving for carbs.

Is this normal? Does it go back to normal? I'm not used to being this hungry. When should I get my levels checked again? Thank you in advance!


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## Andros

Hypoman said:


> Hi All,
> 
> I'm back with a quick update. It has been a little over a month since my dose change (125mcg to 137mcg), and I feel pretty good. I don't feel like I'm going hyper, so that's good. The puffy feeling still comes and goes, but seems to have eased. What I _have_ noticed, is an increase in appetite, especially my craving for carbs.
> 
> Is this normal? Does it go back to normal? I'm not used to being this hungry. When should I get my levels checked again? Thank you in advance!


Hi there!! Every 8 weeks is a good schedule until you are euthyroid (feeling really good) and then quarterly thereafter if you stay stable.

If you are more active because you are feeling better, that may increase the appetite. Put the skids to it if you can. LOL!! Takes some will power for sure.

Eat mini-meals; 1/2 banana, 1/2 apple, some nuts, some raisins. That will keep your glucose stable and prevent weight gain as long as your food choices are good and the meals are indeed mini.


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## Hypoman

So, I think I am going a little hyper. My appetite has really increased, yet my energy is down. I'm puffy and gaining water weight. I feel most of my symptoms coming back. I have also been having mild palpitations. I'm not nervous or anxious, but something is definitely up. I think I may be overmedicated and the extra T4 isn't really being converted, so it has me off balance. I guess there's only one way to find out -- get tested again.

My guess is I'll have to go back down to 125mcgs from 137mcgs -- is decreasing a dose hard? Are the side effects similar? What is the best process -- I've heard you stop taking the Synthroid for a couple days, then start the new lower dose? I want to get feeling better quickly (I know it's a process), but I'm fairly certain I'm overmedicated now.

Any insight is greatly appreciated.

~hypoman


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## Andros

Hypoman said:


> So, I think I am going a little hyper. My appetite has really increased, yet my energy is down. I'm puffy and gaining water weight. I feel most of my symptoms coming back. I have also been having mild palpitations. I'm not nervous or anxious, but something is definitely up. I think I may be overmedicated and the extra T4 isn't really being converted, so it has me off balance. I guess there's only one way to find out -- get tested again.
> 
> My guess is I'll have to go back down to 125mcgs from 137mcgs -- is decreasing a dose hard? Are the side effects similar? What is the best process -- I've heard you stop taking the Synthroid for a couple days, then start the new lower dose? I want to get feeling better quickly (I know it's a process), but I'm fairly certain I'm overmedicated now.
> 
> Any insight is greatly appreciated.
> 
> ~hypoman


Are you keeping your glucose stable and how is your ferritin?

Ferritin http://www.thewayup.com/newsletters/081504.htm

http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/

Just some thoughts.

Let us know.

When will you get labs?


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## Hypoman

I have had issues with Hypoglycemia in the past, but I pretty much have it under control lately. I haven't had my iron levels checked, and I do not take an iron supplement.

I see the doc on Monday, so I should know more after getting the new labs. In the meantime, I am continuing my current 137mcg dose. I'm coming to terms with the fact that the way I feel now may be as good as it gets. With thyroid issues, it seems like there will always be fluctuations in health, mood and well-being -- perhaps more than a person with a normal functioning thyroid. I can accept that as long as it remains manageable. Sometimes I find myself wishing I didn't have to worry about these health issues.


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## Andros

Hypoman said:


> I have had issues with Hypoglycemia in the past, but I pretty much have it under control lately. I haven't had my iron levels checked, and I do not take an iron supplement.
> 
> I see the doc on Monday, so I should know more after getting the new labs. In the meantime, I am continuing my current 137mcg dose. I'm coming to terms with the fact that the way I feel now may be as good as it gets. With thyroid issues, it seems like there will always be fluctuations in health, mood and well-being -- perhaps more than a person with a normal functioning thyroid. I can accept that as long as it remains manageable. Sometimes I find myself wishing I didn't have to worry about these health issues.


If you are seeing the doc on Monday, if you can do it, it would be best to stay on the 137 mcg. so you can get a very accurate assessment under the "now" circumstances. I certainly agree w/that.

And I do hope that you will discuss the hypoglycemia and ferritin issues w/ the doc. I will be anxious to hear from you and so will others on this board.


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## Hypoman

Hi All,

Alright, here's an update. I visited the doc on Monday, and I have my new levels:

*TSH*: 1.42 (0.40 - 4.50)
*FREE T4*: 1.5 (0.8 - 1.8)
*FREE T3*: 3.4 (2.3 - 4.2)

The doc wrote "Thyroid looks excellent" on the labs. To be honest, I think I am feeling better at this dose.

Turns out I have had a nasty sinus infection for the past three weeks. I'm on antibiotics now, which I hate taking unless I have to -- but this bug just won't go away. Hopefully as I get over the infection my body will return to normal functioning. I read that when your body is fighting an infection it can cause you to crave more carbs and retain water like crazy, which is exactly what has happened to me. Might not be thyroid related after all. We'll see. I guess I'll eat more yogurt in the meantime.

Thanks.


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## Andros

Hypoman said:


> Hi All,
> 
> Alright, here's an update. I visited the doc on Monday, and I have my new levels:
> 
> *TSH*: 1.42 (0.40 - 4.50)
> *FREE T4*: 1.5 (0.8 - 1.8)
> *FREE T3*: 3.4 (2.3 - 4.2)
> 
> The doc wrote "Thyroid looks excellent" on the labs. To be honest, I think I am feeling better at this dose.
> 
> Turns out I have had a nasty sinus infection for the past three weeks. I'm on antibiotics now, which I hate taking unless I have to -- but this bug just won't go away. Hopefully as I get over the infection my body will return to normal functioning. I read that when your body is fighting an infection it can cause you to crave more carbs and retain water like crazy, which is exactly what has happened to me. Might not be thyroid related after all. We'll see. I guess I'll eat more yogurt in the meantime.
> 
> Thanks.


Eating yogurt w/live cultures is a very good thing to do while on Ab.

I happen to think your labs also look excellent.

We will know more in 8 weeks at which point I do suggest you lab again. You might benefit from a little tweaking at that time; maybe.

There is a lag time between the FREEs and the TSH. So, your TSH may still come down a bit in the next 8 weeks.

Hope you get over the sinus infection and feel better in that department.


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## Hypoman

Hi All,

So, I'm confused. The doctor liked my lab results, but then wrote me a prescription for 125mcg (instead of 137mcgs, which I have been on). Why, if the doc likes my results, would he lower my dose? Obviously this is a question for him, and I've put a call in, but I thought I'd raise it here. I honestly think 125mcgs might be better for me after all -- I go back and forth, and I can't really tell where I feel better. On 137mcgs my appetite is out of control and my energy is down.

I'm now taking the 125's for the last two days, because my 137 prescription ran out. I'm frustrated to keep bouncing around, but maybe I should try 125 again -- what's the worst that could happen? Thanks.


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## northernlite

If one is too low and the other too high you can alternate them and take 125's one day and 137's the next. Maybe your sweet spot is right in the middle.


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## Andros

Hypoman said:


> Hi All,
> 
> So, I'm confused. The doctor liked my lab results, but then wrote me a prescription for 125mcg (instead of 137mcgs, which I have been on). Why, if the doc likes my results, would he lower my dose? Obviously this is a question for him, and I've put a call in, but I thought I'd raise it here. I honestly think 125mcgs might be better for me after all -- I go back and forth, and I can't really tell where I feel better. On 137mcgs my appetite is out of control and my energy is down.
> 
> I'm now taking the 125's for the last two days, because my 137 prescription ran out. I'm frustrated to keep bouncing around, but maybe I should try 125 again -- what's the worst that could happen? Thanks.


Oh, dear Lord. I cannot tell you how many docs do this. What in the world do they think got you to a good place to begin with? Aaaaaaaaaaaaaaaaaargh.

I certainly would question his thinking on that one. I had hope he would have bumped you up a bit actually as per previous post. Dang.

You do have wiggle room for a small increase to get the TSH down around 1.0 where I personally think that you would feel better.


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## Hypoman

So it's now been a little over two weeks since I went back down to 125mcgs. My appetite has returned to almost normal (it was way high, with cravings for carbs and sugar at 137mcgs). I feel better in some ways, and worse in others. I'm a little more achy and moody now, whereas at 137 I didn't notice as much. I'm having some indigestion issues now - likely because things have slowed down some.

Oddly, I seem to have _more_ energy now. The puffiness and water retention I experienced on 137 has decreased dramatically as well. I might be slightly under-medicated, but overall, I probably feel better now. It's hard to say. It leaves me confused as to where I should be. Obviously chasing the perfect lab number isn't always the right thing to do. I just want to explore the options to get feeling my best again.


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## Andros

Hypoman said:


> So it's now been a little over two weeks since I went back down to 125mcgs. My appetite has returned to almost normal (it was way high, with cravings for carbs and sugar at 137mcgs). I feel better in some ways, and worse in others. I'm a little more achy and moody now, whereas at 137 I didn't notice as much. I'm having some indigestion issues now - likely because things have slowed down some.
> 
> Oddly, I seem to have _more_ energy now. The puffiness and water retention I experienced on 137 has decreased dramatically as well. I might be slightly under-medicated, but overall, I probably feel better now. It's hard to say. It leaves me confused as to where I should be. Obviously chasing the perfect lab number isn't always the right thing to do. I just want to explore the options to get feeling my best again.


Perhaps you can do 137 mcgs. on Sat. and Sunday only? See how that works? Also, have you had testosterone and ferritin checked? It would be a very good idea.

Ferritin http://www.thewayup.com/newsletters/081504.htm

How is your diet; high in fresh veggies, fresh fruit and grains like Kashi cereal, pumpkin and sunflower seeds, walnuts..................etc?? Lots of water? Steel cut oats, home made popcorn in olive oil? Roughage, go after the roughage.


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