# TSH not stablizing, please help =)



## Heathers (Aug 14, 2013)

Hi all 

I was diagnosed with Hashi's 16 months ago. My Dr only gives synthroid and doses by TSH. She will however keep my TSH under or around a 1. We will get my TSH under a 1 but it only stays there shortly. I have been on 5 doses of synthroid in the past 16 months. 8 weeks ago my doctor upped my dose to 125 of synthroid. I just had my labs done on Friday and my TSH didn't go down, it went up. I'm at my wits end and I am sick of having symptoms. I am currently trying to find a doctor who will give me Armour but I will tell you I am feeling hopeless. I live in WV and there just aren't any local doctors except for one but does not take insurance and charges exuberant prices for his services. But I will keep looking.... My current labs are as follows

TSH 3.24 (.45 - 4.5)

T3 Uptake 30 (24-39)

T4 8.5 (4.5 - 12)

T3 95 (71 - 180)

Free T4 1.36 (.82 - 1.77)

Free T3 2.6 (2.0 - 4.4)

I paid for these on my own because my doctor will not run them. I see her on Wednesday. If I don't get the answers I want, I am done. So my questions are:

Is this common that TSH will not stabilize for more than one month?

Will Armour help stabilize my TSH?

What about adding in Cytomel? I think I would have better luck with my doctor trying for Cytomel rather then Armour?

Would I benefit from some Cytomel added to my Synthroid?

Thanks so much!!!!!


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## Lovlkn (Dec 20, 2009)

Once you begin taking replacement meds TSH is useless in my opinion.

You need to dose yourself by FT-4 and FT-3 and since your FT-3 is on the low side you may not be converting properly and Cytomel would be worth asking for. I tale a levothyroxine/Cytomel mix and never felt well until I added the Cytomel pst TT.

If your doctor only doses you by TSH then you need to go find another doctor. It took me 6 doctors before finding one who would dose me properly and not cut my dose with the little to no TSH that I run in order to be properly medicated.

Have they ever run antibodies tests on you such as TPO or TSI? You may have some antibodies skewing your TSH.


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## Heathers (Aug 14, 2013)

Yes I have antibodies. So is that the reason why I can't keep my TSH under a 1? I'm working on finding another doctor but I will admit it's been difficult.

Thanks for responding =)


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## Heathers (Aug 14, 2013)

I am going to try and convince my Dr on Wednesday to let me try a little Cytomel. So based on my labs, would I just add cytomel or do I increase synthoid plus add cytomel?

Thanks!!


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## Heathers (Aug 14, 2013)

Anyone else?

Thanks


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## bigfoot (May 13, 2011)

Yeah, you want to monitor TSH, Free T3, and Free T4 at a minimum. Anything less than that is just chasing your tail. In my humble opinion, the TSH is kinda like looking at the forest, while the Free numbers are like looking at the individual trees.  Okay, bad metaphor, but you get the idea. The TSH can give you an idea of overall trends over a large period of time, but the Frees are far more useful for adjusting dosages. Folks around here will suggest trying to get in somewhere around 50-75% of the range for the Free T3 and Free T4, while striving for a TSH of around 1.0 or less. That can be easier said than done, but it's a starting point. And since we are all our own individual cases, some people respond better with different numbers. It's really about finding what works for you and how you feel, not just lab values. That's why it's so frustrating when docs say "Oh, well your labs show as 'normal' so you're fine."

Personally, I would only make one change at a time if you can help it. Otherwise it's hard to know what did what. So it probably wouldn't hurt to ask to try 5mcg of Cytomel. In fact, you might even want to take that 5mcg and split it into 2.5mcg to get started at first. This T3 stuff is like jet fuel. Best to go low 'n' slow with any increases of it.

Also, I don't know if you are taking brand-name medications, but that's a good way to go. Generics can vary in their efficacy, and the FDA gives them something like a 10% window. So if you are taking a generic T4 drug of say, 100mcg, and the pharmacy switches manufacturers this month, you could be getting 90mcg now and 110mcg next month. Had a long discussion with one of my pharmacists about this, and he confirmed it. Sometimes it takes a little trial and error to find the right brand for you, too. I started on generics, was moved to Synthroid, then they switched me to Levoxyl (which is recalled at the moment). From there I wound up with a naturopath and am taking Nature-Throid. Nothing has been perfect, and I still think there is room for improvement.


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## Heathers (Aug 14, 2013)

Thank you Bigfoot, yes I am taking brand name synthroid. I'm going to ask again for the Cytomel tomorrow, I'm not hopeful though as I've asked before but I'm going to show her my labs and see what I can do.

I saw an endo back in November and because my free T3 was in range they wouldn't consider adding in Cytomel either. I'm sure I will just get a Synthroid increase, but I will try.

Thanks


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## Lovlkn (Dec 20, 2009)

Heathers said:


> I am going to try and convince my Dr on Wednesday to let me try a little Cytomel. So based on my labs, would I just add cytomel or do I increase synthoid plus add cytomel?
> 
> Thanks!!


 Usually when you add Cytomel you need to reduce your Synthroid.

In your case



> Free T4 1.36 (.82 - 1.77)


Your FT-4 is low so the Cytomel might raise you into an acceptable range.

Be sure to have your FT-4 and FT-3 tested in the 6 weeks following your Cytomel addition and then we can advise on what you should ask for next. Alot of this also has to do with how you feel so be sure and tell us.


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## Heathers (Aug 14, 2013)

Thank you Lovlkn

So the addition of Cytomel should also help bring up my free T4, am I understanding that right?

And if I'm reading correct, just add one thing at a time, so I want to ask for 5mcg of Cytomel and keep Synthroid right where its at (which is 125mcg)?

Thanks again, I appreciate it!!

Cross your fingers for me =)


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## bigfoot (May 13, 2011)

Yeah, ideally only make one change at a time. Otherwise it's hard to know what caused it. T3 is about four times as potent as T4. So, for example, 5 mcg of T3 is roughly the equivalent of 20 mcg of T4.

So if you are taking 125 mcg of Synthroid, adding in 5 mcg of T3 would give you an rough equivalent as if you were taking 145 mcg of Synthroid/T4.


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## Heathers (Aug 14, 2013)

Well I walked into my doctors office on Wednesday and I was fully prepared to be done if I didn't get what I wanted. But I was the one that got surprised! My doctor agreed that synthroid was not working for me and was willing to try alternatives. So she gave me Armour and I'm on my 4th day of taking it. I was on 125 of synthroid and she gave me 90 of armour. Does that sound about right?

I've read enough to know not to start at the full dose so right now I am splitting and taking half. In 2 weeks I will up in. I go for labs in 8 weeks. Right now I am loving the energy and feel pretty good. But I'm in the early stages of taking it but I really hope it works for me. Very excited about it!

Thanks all!


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

http://www.stopthethyroidmadness.com/free-t3/
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
rT3
http://thyroid-rt3.com/whatis.htm
(Copy and paste into your browser)

You clearly are not converting your Synthroid to T3. Raising your dose is useless. Your FREE T3 is in the basement and I know you feel horrible.

No doubt your T4 is converting to rT3 and that can make you feel awful.

I am enclosing some information which I do hope you find useful to help you in your search for a better doctor. Consider a naturopathic doc as well. You definitely need exogenous T3

Now I see your other post. YES; cut that dose in 1/2 which would be 45 mgs.. You are a very smart lady!!! 90 mgs. would have been waaaaaaaaaaaaaaaaaaaaaaaay too much to start out on.

I am soooooooooooooooo glad. But, you should still read the above links just in case. Credible information helps us advocate for ourselves in a very big way.


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