# Do low doses of thyroid hormone ever work long-term?



## GardenPearl (Mar 17, 2018)

Hi - I am 63. I am subclinically hypothyroid, with all thyroid levels within the middle of normal lab ranges except for my total T3.

My total T3 was at 62 with a desired minimum of 79.

My TSH with no treatment or thyroid hormones is 2.33.

I also have some thyroid peroxidase antibodies with a measurement of 67. "In range" would have me below 9, according to this lab.

So one doctor said treat it. The other said they would not. Both felt the antibodies were typical for my age and not serious.

Doses as low as .50 mcg. levothyroxine bring me within desired lab ranges, bringing my total T3 up to 88 and my TSH down to 1.15.

However, from everything I read, low dosages don't work forever. Has anyone had success staying on a dose of .50 to .75 mcg. levothyroxine long-term? Thanks for any feedback.


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## joplin1975 (Jul 21, 2011)

Antibodies mean autoimmune disease. Autoimmune thyroid disease is a progressive disease. It always gets worse. So low doses of medication will not work long term because your thyroid will gradually produce less and less homrones making it necessary to gradually increase your meds.

The important piece, however, is that low doses of thyroid meds lower TSH. TSH is a stimulating hormone. The higher the TSH, the more active your antibodies are, and the faster the disease progresses. So low doses of thyroid meds ARE important.


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## thyroidboardsfan (Apr 10, 2018)

joplin1975 said:


> Antibodies mean autoimmune disease.


Does it mean it's Hashi if the antibodies number is bigger than 0, even though it's below the lab threshold? Is it biologically possible to have 0 antibodies?


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## joplin1975 (Jul 21, 2011)

It doesn't need always mean Hashi's but it usually does. I'm not sure if it's possible to get a zero result, but you can get what's considered undetectable antibody results.


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## Hopeful (Apr 10, 2018)

It's critical to get the right thyroid tests. The correct diagnostics for your thyroid are a combination of these three tests always ran all together: TSH, Free T3 and Free T4. Notice that "Total T3" or "Total T4" is not listed. This is because the Total tests measure two forms of thyroid hormones, bound (unavailable for use) and unbound (or free and available for use) levels, combined together. The Free hormones are the ones that are available to use and are the correct ones that are always tested, not the combination test, the Total tests. TSH is not a thyroid hormone, but is communicating hormone coming from your pituitary gland that gives instructions to your thyroid. A good range while not on medication is under 2.0. If above that number, your thyroid is low and working on the slow side.

You have Hashimoto's, which can cause hypothyroidism. There is no cure. Treatment is thyroid hormones for the rest of your life. The starter dosage is 50 mcg. Six weeks later TSH, FT3 and FT4 are tested to see how effective the medication was. At that point, dosage might be increased or you might also need to add T3. Medication is always increased at no less than 6 week intervals, tests are always done every 6 weeks, and this continues until your FT3 and FT4 are in the upper half of the range, which is where you'll have the least symptoms. If symptoms persist, then the medication is not right quite yet. If it takes much more than 4-6 months to reduce symptoms, then the doctor is not managing your Hashimoto's correctly. When on the right medication, you will have minimal symptoms.

People with Hashimoto's are on medication to keep their thyroid hormones where they should be. I'm on T4 and T3.


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## Hopeful (Apr 10, 2018)

thyroidboardsfan said:


> Does it mean it's Hashi if the antibodies number is bigger than 0, even though it's below the lab threshold? Is it biologically possible to have 0 antibodies?


If your antibodies are below the top number of the "normal" lab range (example: 0-60), then you don't have Hashimoto's. If it's above 60, you have Hashimoto's. Like @Joplin1975 says, you can get undetectable results, or Hashimoto's with no antibodies present. Sometimes the antibodies just haven't increased to detectable levels yet.


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