# Got better then worse



## AnnaBell (Nov 2, 2016)

When I was first diagnosed with (mild) hypothyroidism, I was put on 25 mcg Synthroid and felt increasingly better for 2-3 months, then it all slid backwards. 4 months later, the addition of 5 mcg Cytomel, and 2 Synthroid increases have not helped. What might cause this to happen and what can I do to start improving again?


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## joplin1975 (Jul 21, 2011)

Could you please post your latest labs with the reference ranges? Thanks!


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## AnnaBell (Nov 2, 2016)

I got my labs checked around 2 weeks ago. FT4: 1.13 (ref 0.71-1.85) FT3: 2.8 (ref 2.3-4.2) TSH: 2.19 (ref 0.3-5.0)

This is after 6 weeks on an increase of Synthroid to 50 mcg. My labs right before the increase were FT4 1.21 FT3 2.9 TSH 2.65 (same reference ranges as above). So even though my TSH has dropped somewhat, my free hormone levels have also decreased (albeit slightly). Why does this happen even with an increase in medication?

For complete reference, my original labs from April without any medication were TSH 5.4 (ref 0.3-4.2) FT4 1.3 (ref 0.8-1.6) FT3 2.5 (ref 2.0-4.4). After being put on 25 mcg Synthroid, I felt pretty good and my labs were TSH 1.7 FT4 1.1 FT3 2.1 (reference ranges same as directly above). Around 2 weeks after these labs, I started feeling worse pretty quickly.


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## jenny v (May 6, 2012)

This can happen a lot in the beginning, you have to keep playing around with the doses until you find your sweet spot. In the beginning, your body can just suck up the medicine and need more each time. It took me about 18 months of dose increases before I found my stable dose. Based on your last labs, you definitely need an increase in your Cytomel. 3.25 is the mid point of the range and you're not even close.


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## Lovlkn (Dec 20, 2009)

My opinion...

If you have lower thyroid level readings, you will experience fatigue more than if you were at optimal levels.

I also believe it can take some time for the body to "catch up" and recalibrate to new doses. Post TT, I struggled for years with fatigue - addressed all I mention below and got my levels optimal and it mostly resolved. Still can have the mid day slump but mostly resolved.

Also, have you ever had your Ferritin, B-12 or Vitamin D levels checked? Being low in any or all will also contribute to fatigue.


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## AnnaBell (Nov 2, 2016)

Thank you for your advice! It's been about a month since my dose increase and my fatigue is finally starting to lift  Exercise still noticeably sets me back but I am getting labs drawn in a couple of weeks and will see if I can request a Cytomel increase after that. I have had my Iron, B12, and Vit D levels checked and they are all normal. I take about 3000 IUs of Vit D every day, just to be on the safe side.


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