# Upped levo and TSH up?



## GOLGO13 (Jun 13, 2018)

I was on 88 per day and tsh was 3.0. Upped to 91 and now tsh is 4.470.

Free t4 1.44 ng/dl range .82 to 1.77
Free t3 2.6 pg/ml range 2.0 to 4.4
Tpo antibodies down a little 181
Reverse t3 19.6 ng/dl range 9.2 to 24.1
T3 uptake 28 range 24 to 39

I wasn't eating enough calories but over past few weeks I've been tracking it.

Any thoughts? 100 Levothyroxine was too much. I had hyper symptoms.


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## Lovlkn (Dec 20, 2009)

> I was on 88 per day and tsh was 3.0. Upped to 91 and now tsh is 4.470.
> 
> Free t4 1.44 ng/dl range 1.2 to 4.9
> Free t3 2.6 pg/ml range 2.0 to 4.4


Your labs are very hypo - your reverse T3 is fairly high. With those two things you will likely have issues increasing levo.

Has your doctor said anything to you to help lower your RT3? Dosing of T3 only will usually reduce RT3. Moderator JennyV has had success with this protocol.

Have you ever had your Ferritin levels checked? Low ferritin levels also cause issues when trying to increase thyroid med's.


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## GOLGO13 (Jun 13, 2018)

I was on too low a calorie diet after cutting out gluten and dairy and processed sugar for a few months. I believe that is why my rt3 is high. That or stress from the past. Over the past few weeks I'm getting at least 2200 calories each day. Still not eating the above but tracking my food now.

My mch and mcv was out of range on the low side. That's why we did the ferritin test.

Vitamin D is now ok. 44. Was 20 a few months ago. I feel a bit better than I had in the past but still have some hypo symptoms. Dry skin and fatigue...but less than before.

On 91 I feel better than 88. But thinking 94 is the next step. I felt horrible on 100. Anxiety was almost unbearable. Had some other hyper symptoms. But 88 sent me too far the other way.

T3 med is worth a discussion but my doctors do far are not well versed. My endo even said why test for ft3 and rt3... so not sure he will go for it. I'm trying to get a referral to another endo.

Hoping my upping calories will help the conversion. That was my first rt3 test so unsure where it was before. The Ft3 is about the same as last test.


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## GOLGO13 (Jun 13, 2018)

I see what you are saying. Upping the levo could be counterproductive since my ft4 is already pretty high. So it may continue to create more rt3 since I have excess ft4. And thus ft3 continues to be low.

I would have thought I had to up levo but I was probably reading too much into tsh vice my other labs.


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## GOLGO13 (Jun 13, 2018)

Sorry. Ferritin was 129.


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## GOLGO13 (Jun 13, 2018)

These were my numbers on levo 88.

TSH 3.010, T4 free 1.50 ng/dl range .82 to 1.77, T3 free 2.8pg/ml range 2.0-4.4, Total T3 89 ng/dl range 71-180, T3 uptake 27%. TPO antibodies 226 IU/ml


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## Lovlkn (Dec 20, 2009)

GOLGO13 said:


> These were my numbers on levo 88.
> 
> TSH 3.010, T4 free 1.50 ng/dl range .82 to 1.77, T3 free 2.8pg/ml range 2.0-4.4, Total T3 89 ng/dl range 71-180, T3 uptake 27%. TPO antibodies 226 IU/ml


These lab results indicate you need T3 hormone. If you add T3 hormone your TSH will drop.


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## GOLGO13 (Jun 13, 2018)

If I end up doing T3 I'll probably have to ask a local pharmacist who prescribes it...because I doubt my Endos would. Though I do have an appointment with another endo in a few months.

I also want to see if me eating more will help. I understand that can hamper t4 to t3 conversion. Some people I watch/read talk to trying to fix your problem before doing T3. And some say it can make things worse for certain people. Without a doctor who knows what they are doing I am cautious as well.

Lately I've been doing better. Making it further through the day before fatigue. I don't have coldness anymore. The only new symptom is slight warmness on my neck. Almost feels like a slight sunburn (unless it actually is one...been trying to get more sun lately).

That being said I've been working on my gut, food, water, etc. My vitamin D levels are coming up with supplementation and sunlight. Can be hard to know what is working and what is causing issues.

My antibodies have come down a ton, but I see conflicting information on whether that really means anything or not. I figure it's a pretty good sign. I feel like I have less inflammation, but I still have an enlarged looking thyroid. Some people say this isn't a goiter and may just be an inflamed thyroid. I'd still like to get an ultrasound done sometime.

I believe my endo will agree to trying 94 levo. Maybe a more consistent dose will help. I was alternating doses and that seemed to make for alternating good days and bad days. 94 is half my 88 and half my 100.


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## Lovlkn (Dec 20, 2009)

GOLGO13 said:


> I see what you are saying. Upping the levo could be counterproductive since my ft4 is already pretty high. So it may continue to create more rt3 since I have excess ft4. And thus ft3 continues to be low.
> 
> I would have thought I had to up levo but I was probably reading too much into tsh vice my other labs.


Correct. You need a doctor to prescribe some T3 hormone which will then require yo to drop your levothyroxine dose.

It's a real pain trying to get things dialed in but you for sure are a good candidate for some T3 hormone.


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## GOLGO13 (Jun 13, 2018)

I tried 94 for about 10 days and am having hyper symptoms now. Not as strong as on 100 but certainly there. I even had a high pulse for the first time in a long time.

I'm thinking 88 is what I should be on until I see my new endocrinologist. My other endo isn't very helpful.

Maybe I didn't give 88 enough of a try. Plus I was low calorie during that time frame.

Looking for advice.


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## GOLGO13 (Jun 13, 2018)

I should explain the symptoms. Belly bounces strongly when breathing in and out. High pulse over last few days. Little heat on back of neck. Poor stools. Cant gain weight despite increased calories for a month. Anxiety strong but not as bad as on 100. Actually all not as bad on 100 but similar.

Really no hypo symptoms. I make it longer through day usually for fatigue but recently not. Think fatigue happens on both sides.


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## creepingdeath (Apr 6, 2014)

Synthetic's have a long half life, seven days.
Have you ever tried just skipping one day a week for awhile?
That will bring your concentrated hormone levels down slightly without you really feeling it that much.

Synthetic hormone takes a very long time to accumulate and acclimate within your body.

Usually months but because everyone's different some might take years....

"Could be you just haven't waited long enough"

Take it easy and good luck to you......


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## GOLGO13 (Jun 13, 2018)

Turned out to be an anxiety event. What's interesting is if I take 88 I feel sluggish that day. If I take 94 I feel better and have more energy. Personally I think I am on the wrong medication for me. But we will see. I may try the name brand to see if anything gets better. Then I may need to try something with t3 at some point.


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