# First labs after starting on Levothyroxine



## RandomUserAZ (Nov 21, 2012)

I was diagnosed with probable Hashimoto's back in November (600+ TPO-ABI plus multiple nodules up to 1.7cm in size).

I've been taking 50mcg/day of Levothyroxine for 2 months now and just had new labs done. I am supposed to do additional labs in March and then go back in for a followup ultrasound visit in April.

TSH 1.38 (range 0.45-4.50 mU/L) (was 3.23 in October)
T4 Free 1.4 (range 0.8-1.7 ng/dL)
T3 Free 3.3 (range 2.0-4.8 pg/mL)
T3 Total 121 (80-200 ng/dL)

I've never had the T3 Free done before, so no reference point. My only T4 Free was done 6 years ago when it was 0.8.

In all honesty, I don't feel any different than I did before, but I didn't have any major specific issues. I just had the non-specific (weight gain, memory issues, mental 'fogginess') that I had attributed to getting older.

I thought that I would have felt 'something' after 2 months, or is the dose not high enough to make a significant change? Will my TSH need to drop further before I notice anything?

Anyway, just thought I'd share. Guess I should be happy that my TSH is improving!


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## jenny v (May 6, 2012)

Your TSH and Free T4 look great but your Free T3 is lagging a bit behind. Most of us feel good when it's at least above the midpoint of the range and yours is below it.

Honestly, I would stay on the same dose until March and see if anything has changed, sometimes it can take our bodies a while to catch up to the labs and start feeling good again. If your Free T3 is still dragging in March you might ask your doctor for a T3 drug like Cytomel to help.


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## Andros (Aug 26, 2009)

RandomUserAZ said:


> I was diagnosed with probable Hashimoto's back in November (600+ TPO-ABI plus multiple nodules up to 1.7cm in size).
> 
> I've been taking 50mcg/day of Levothyroxine for 2 months now and just had new labs done. I am supposed to do additional labs in March and then go back in for a followup ultrasound visit in April.
> 
> ...


Your doc should have bumped you up to about 75 mcgs. in my very humble opinion.

Most of us feel best w/ TSH @ 1.0 or less and the FT3 @ about 75% of the range give or take. 3.4 is the middle of the range.


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## CA-Lynn (Apr 29, 2010)

_" .....just had the non-specific (weight gain, memory issues, mental 'fogginess') that I had attributed to getting older."_

And maybe, just maybe, the symptoms are the result of just getting older. It happens, you know.


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## RandomUserAZ (Nov 21, 2012)

Just had some new labs done and thought I'd ask for comments.

Old Labs (January)

TSH 1.38 (range 0.45-4.50 mU/L) (was 3.23 in October)
T4 Free 1.4 (range 0.8-1.7 ng/dL)
T3 Free 3.3 (range 2.0-4.8 pg/mL)
T3 Total 121 (80-200 ng/dL)

New Labs (April)

TSH 0.97 (0.45-4.50 mU/L)
T4 Free 1.4 (0.8-1.7 ng/dL)
T3 Free 3.3 (2.0-4.8 pg/mL)

TSH continues to drop but T4/T3 seem stuck. I've still not noticed any difference in how I feel, so really hard to judge what I should do. I'm constantly tired still, but that is probably due to a very hectic schedule more than anything else.

Going in for a followup visit in two weeks and will have another ultrasound to see if there has been any changes.

Comments/suggestions welcome.


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## jenny v (May 6, 2012)

Did you change your dosage between those labs at all?

Honestly, your numbers look pretty good. Your FT4 is really good and your FT3 is okay, maybe a little low--most of us feel better at about 75% of the range and you are just below the midpoint of your range. Have you asked your doc about supplementing with a T3 medication like Cytomel?


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## CA-Lynn (Apr 29, 2010)

New labs look good to me.


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## RandomUserAZ (Nov 21, 2012)

No change in medication between the two. Hard to tell if there is a 'plateau' with only two readings.

I guess the main thing is the TSH dropping dramatically. Would love to see that some of the growths have started to recede, but guess that is a long shot.


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## Andros (Aug 26, 2009)

RandomUserAZ said:


> I was diagnosed with probable Hashimoto's back in November (600+ TPO-ABI plus multiple nodules up to 1.7cm in size).
> 
> I've been taking 50mcg/day of Levothyroxine for 2 months now and just had new labs done. I am supposed to do additional labs in March and then go back in for a followup ultrasound visit in April.
> 
> ...


We are all different in our needs but I do think that your TSH could stand to be lower and the FREE T3 just a little higher. Mid-range on that is 3.4 and most of us like it to be at about 75% of the range given by the lab.

So, you may benefit from a little tweaking. It "is" a slow process.


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