# Big drop in TSH - what next?



## bluesmom (Aug 11, 2012)

Hi folks,
My endo's nurse just called with my latest test result. My TSH is 0.18 so the doctor wants me to take 1/2 pill less one day each week. She did not test for frees even though I pushed for it last time. I have been taking 75mg Synthroid since late October when she upped it from 50mg.
Here's my past labs:

10/25/2012:
TSH 2.84 (.27-4.2)
FT4 1.38 (.9-1.7)
FT3 3.0 (2.3-4.2)

8/30/2012:
TPOAb 350 (<35)
TgAb >3000 (<20)
Ultrasound findings: (goiter right side)
right side 4.45x1.3x1.71
left side 3.04x1.03x1.2
Isthmus 0.56
(no nodules reported - said my thyroid felt soft)
Cortisol baseline 11.6
Cortisol 30 min post challenge 24.0

8/2/2012:
TSH 3.17 (.5-6.0)
FT4 1.1 (.8-1.5)
Total T3 (92 (76-181)

My symptoms continue (hair loss, some anxiety/irritability, fatigue, dry skin, rashes/large painful pimples, joint and muscle pain and weakness). My digestive issues have changed a bit from daily diarrhea to more solid stools and I've gained a couple pounds. My pain is getting worse and I'm unable to keep up my regular running schedule. After cross-country skiing with the kids, had lots of pain and slept for 12 hours that night.
The rheumatologist wouldn't test for lupus (said negative ANA ruled that out) but said that the range of motion in my low back was more like an 80-year-old than a 45-year-old. The xray found a hemi-transitional lumbar vertebral body for which he said there's nothing he can do.
I'm wondering if any of you have any ideas on what I should try next? Though I still don't have much time to devote to my health issues, it's becoming apparent that I need to find someone good to work with me to sort this all out. And does that big drop in TSH make sense?
Thanks in advance for any advice,
Carolyn


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## CA-Lynn (Apr 29, 2010)

I do very well with my TSH at that level. I know it makes my endo a little antsy, so every once in a while I give in and take, at her prescription, the regular dose 6 days a week and half the dose on Sundays. It makes her happy and doesn't really change my numbers.


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## Lovlkn (Dec 20, 2009)

When you are taking thyroid replacement med's you absolutely cannot dose by TSH.

Free T-4 and Free T-3 are the only tests you should adjust your dose by.

If your doctor won;t order the tests, go to HealthcheckUSA.com and order the tests yourself, they email you the lab request and the results. You can go Monday and have the lab done and likely have the results by Tuesday.

I run 0 TSH and would be completely hypo if my doctor dosed me using TSH only.


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## bluesmom (Aug 11, 2012)

Thanks so much for the replies. Like you said Ca-Lynn, I would think a TSH of 0.18 would be a pretty good place to be so I'm frustrated that I don't feel good at that level - maybe giving it more time will help. And Lovlkn, I'm even more frustrated that my endo won't do the tests that I ask her to do. She wouldn't test for TSI either and is dosing based entirely on TSH without considering symptoms at all. 
My symptoms seem to cross over so much that I would really love to have a doctor helping me figure all this out (as would most of us)! It seems that my current endo might not be the doctor for me.
Anyhow, thanks again and any further advice would be more than welcome.
Carolyn


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## Lovlkn (Dec 20, 2009)

bluesmom said:


> And Lovlkn, I'm even more frustrated that my endo won't do the tests that I ask her to do. She wouldn't test for TSI either and is dosing based entirely on TSH without considering symptoms at all.


Time to go doctor shopping.

If you have a doctor refusing to run the proper tests you need a new doctor.

I had some luck with my 1st and only endo. All endo's post op insisted on dosing on TSH only. Post TT I went to 4 doctors before settling on my current DO, who gives me the replacement I arrived with and ask for - other than that I question his ability to manage my replacement.

I wish you luck in finding your next doctor.


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