# Synthroid Dosage after Partial Thyroidectomy and Lymphocytic Thyroiditis Diagnoses



## upstate87 (Sep 24, 2010)

Hi all,

I wanted to get some advice/opinions on proper synthroid dosage. I'm a 23 year old male, and was diagnosed back in Jan 2008 with a multi-nodular goiter. It turned out to be benign, but due to it's size (golf ball+) it was constricting my breathing and needed to be removed.

I had the nodule removed in March 2008 and the surgeon left the remaining thyroid tissue intact. The only part removed was the nodule. After the surgery, the surgeon told me that I had lymphocytic thyroiditis. He said I'd likely need to start on Synthroid eventually, but we waited several months before starting to see if my thyroid would be capable of producing on its own.

After several months, my TSH was still elevated and I wasn't feeling 100%. I began taking 50mcg of Synthroid daily and returned to the endo in Nov 2008. I've included my test results since then below and will have updated results next week.

I'm mainly posting because recently I began feeling "off" again. I've been fatigued, no motivation to exercise, having difficultly falling asleep and waking up, irritable, bad mood, horse voice sometimes, and not pooping well. All these symptoms seem to point to something being up with my Thyroid, but it seems odd since I've been fairly stable for a while.

I'm currently on 75mcg of Synthroid and am guessing that it will be upped next week after my test results come back. I was wondering what you all think of my FT3 and FT4 levels from 8/7/09 and whether it appears that I'm properly converting the Synthroid to T3. I just want to make sure that I shouldn't be considering adding cytomel or switching to armour. I also wanted to know if any of you have had similar experiences with being fairly stable for a year or two and then needing to up your dose. I should mention that I switched doctors in Nov 2008 since my doctor was completely unwilling to order full tests (T3, FT3, etc.).

Thanks in advance and I'll be back with updated results next week!

5/20/2010 (75 mcg)
TSH - 1.43 (.34-5.60)

8/7/2009 (75 mcg)
TSH - 1.57 (.34-5.60)
T3 - 1.19 (.5-1.7)
FT3 - 3.19 (2.39-6.79)
FT4 - 1.07 (.61-1.24)

4/29/2009 (75 mcg)
TSH - 1.77 (.34-5.60)
T3 - 1.26 (.5-1.7)
FT3 - 3.49 (2.39-6.79)
FT4 - 1.19 (.61-1.24)

1/21/2009 (75 mcg)
TSH - 1.72 (.34-5.60)
T3 - 1.01 (.5-1.7)
FT3 - 3.27 (2.39-6.79)
FT4 - 1.10 (.61-1.24)

11/17/2008 (new doctor, switched to 75 mcg daily)
TSH - 3.04 (.34-5.60)
T3 - 1.12 (.5-1.7)
FT3 - 3.05 (2.39-6.79)
FT4 - .85 (.61-1.24)
Thyroperox - 1.2 (<9.0)

8/18/2008 (After 4 weeks of 50 mcg Synthroid)
TSH - 4.645 (.350-5.500)
FT4 - 1.34 (.71-1.81)

7/12/2008 (4 months after surgery, no Synthroid)
TSH - 4.663 (.350-5.500)
FT4 - 1.07 (.71-1.81)

1/08/2008 (Original Diagnosis)
TSH - 0.024 (.350-5.500)
FT4 - 1.84 (.71-1.81)
ANTI-TPO AB, IGG 3.0 (<20= neg, 20-30=equivocal, 30+ = pos)


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## upstate87 (Sep 24, 2010)

Got the test results today:

FREE T4 1.05 (normal: 0.61-1.24) NG/ML
FREE T3 3.22 (normal: 2.39-6.79) PG/ML
TSH 1.54 (normal: 0.34-5.60) MIU/ML

Doctor initially didn't want to up the Synthroid dose but agreed to increase to 88 mcg from 75 mcg.

I find it odd that I'm near the top of the ref range for free T4, but close to the bottom on free T3. Any thoughts on this? Could it be that my thyroid isn't doing a great job converting?

I'll see how the increased T4 helps me, but I'm thinking a T3 supplement may be the answer.

If anyone has had similar experiences, thoughts on the results, or willing to share what T3 level they feel best at, I'd love to hear from you.

Thanks!


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## midgetmaid (Jul 22, 2010)

Perhaps some other things need checked. For example, my husband is hypothyroid, but has low testosterone as well.

My endo added Cytomel when my T3 dropped, but I continued to feel worse, even after T3 was raised. She recently switched me to Armour, and I am feeling much better. Hubby, on the other hand, was given Armour years ago and couldn't tolerate it.


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## Andros (Aug 26, 2009)

upstate87 said:


> Got the test results today:
> 
> FREE T4 1.05 (normal: 0.61-1.24) NG/ML
> FREE T3 3.22 (normal: 2.39-6.79) PG/ML
> ...


Hi there. I did not see your first post so welcome. It does not appear that you are converting. I did look at the 2009 labs also. I think you are a candidate for some T3.

Your FT3 is below the mid-range. Most of us do well when it is about 1/4 above the mid-range or even higher w/ TSH down around 1 or less.

You have to be very very tired. Are you?


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## upstate87 (Sep 24, 2010)

midgetmaid said:


> Perhaps some other things need checked. For example, my husband is hypothyroid, but has low testosterone as well.
> 
> My endo added Cytomel when my T3 dropped, but I continued to feel worse, even after T3 was raised. She recently switched me to Armour, and I am feeling much better. Hubby, on the other hand, was given Armour years ago and couldn't tolerate it.


I'd love to have more tests run -- unfortunately, I usually have to insist on getting the FT3 and FT4. This is my second endo and unfortunately both have been hyperfocused on TSH.


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## upstate87 (Sep 24, 2010)

Andros said:


> Hi there. I did not see your first post so welcome. It does not appear that you are converting. I did look at the 2009 labs also. I think you are a candidate for some T3.
> 
> Your FT3 is below the mid-range. Most of us do well when it is about 1/4 above the mid-range or even higher w/ TSH down around 1 or less.
> 
> You have to be very very tired. Are you?


Thanks! I've read a number of your other responses here on the board. You're doing a great service to those of us who don't have actively involved endos.

And yes, I'm definitely tired a lot of the time. I still function fine, but have a hard time focusing, VERY hard time waking up in the morning, and low energy overall.

My doctor didn't want to even raise my T4 after the most recent labs, but agreed to after I asked. I was thinking a bump to 100, but he was concerned about "totally suppressing my TSH". I could understand if he was concerned about elevating my FT4 too much, since I am getting close to the top of that range, but seem to have plenty of room on T4.

I'm probably not going to ask to switch to armour, since I am doing relatively well on synthroid. I do think that adding some T3 could help though.

What sort of does would you recommend starting on?


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