# no dose increase



## Lily1986 (Sep 14, 2016)

Hi taking Levo 150mcg and T3 5mcg any idea why endo won't increase dose?
She wants the TSH below 2 and at the moment it isn't. I am still not feeling all that well.
Thank you

Serum TSH 3.82 (0.2 - 4.2)
Serum free T4 18.9 (12 - 22)
Serum free T3 4.8 (3.1 - 6.8)


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## Octavia (Aug 1, 2011)

Based on those results, you definitely don't want an increase in your Levo...your T4 is already near the top of the range, and any higher might give you heart palpitations. You might benefit from a small increase in your T3 drug. But what is your history? How long have you been taking these drugs? You may still be very much in an adjustment phase if you are new to T4 and T3 drugs.


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## Lily1986 (Sep 14, 2016)

Thank you Octavia, I was diagnosed hypo in 2012 and I have been taking Levo since then. T3 was added a year ago and it was reduced because my TSH was suppressed and the endo didn't like seeing the TSH suppressed. I tested positive for TPO and TG antibodies as well.


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## Lovlkn (Dec 20, 2009)

When in relation to your labs did you take your medications?


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## Octavia (Aug 1, 2011)

Lovlkn said:


> When in relation to your labs did you take your medications?


Good question, Lovlkn. I did not think of that.


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## Lily1986 (Sep 14, 2016)

Lovlkn said:


> When in relation to your labs did you take your medications?


Thank you Lovlkn, I last took my meds more than 24 hours before the test.


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## Lily1986 (Sep 14, 2016)

New results:

Serum TSH 3.97 (0.2 - 4.2)
Serum free T4 15.3 (12 - 22)
Serum free T3 4.1 (3.1 - 6.8)


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## Octavia (Aug 1, 2011)

Interesting. How long have you been on the Levo? What's your thyroid "history" that prompted you starting on it?


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## Lily1986 (Sep 14, 2016)

I had an elevated TSH back in late 2010 but no treatment was started. The front of my neck swelled up and an ultrasound was done which said the thyroid gland was enlarged. I had difficulty swallowing as well. I had symptoms like hard stools, aches and pains, heavy periods, feeling cold and sweating and I kept going back to the doctor with these symptoms and with them giving me antidepressants, painkillers, laxatives, birth control medications etc. Eventually I was diagnosed hypo in 2012 by a new doctors surgery and it was found at a time I was not expecting the diagnosis. I was thin, losing weight, sweating a lot so the diagnosis was out of the blue. I have been taking Levo since then. T3 was added a year ago and it was reduced because my TSH was suppressed and the endo didn't like seeing the TSH suppressed. I tested positive for TPO and TG antibodies 5 times, only once has my antibody count been negative.


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## Lovlkn (Dec 20, 2009)

> I tested positive for TPO and TG antibodies 5 times, only once has my antibody count been negative.


Antibodies will make it harder to regulate levels in my opinion.

The range within your range is

FT-4 ((17-19.5))

FT-3 (( 4.95-5.875))

Since you've taken your med's a full 24 hours prior to the lab draw one would expect to find you closer to the 1/2 range.

How do you feel?


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## Lily1986 (Sep 14, 2016)

Thank you not great I have to say.

Hard stools
Difficulty swallowing
Feeling cold
Heavy periods
Muscle aches and pains
Shortness of breath
Pale skin
Fatigue
Slow pulse (I had surgery back in April and I woke up from the general anesthetic to be told my heart rate was in the 30s and that I had crashed)
Dry skin


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## BurntMarshmallow (Feb 26, 2016)

Do you know what your Complete Blood Count (CBC) results were? Any levels out of range? What about serum iron? Ferritin? Vitamin D?

Are you on any other medications, like PPI's, acid reducers, allergy meds? Do you take any supplements?

In addition to thyroid issues, there are a lot of nutritional deficiencies that can cause the symptoms you describe. Symptoms you'd never even consider to be caused by a deficiency may in fact be just that. Iron deficiency can cause swallowing problems, for example. Low iron can even affect the esophagus, and causing webbing.

I think most people feel better when they are treated both for controlling their thyroid, and treated for the nutrient deficiencies that develop anytime thyroid levels are not optimal. When the thyroid is either slow or fast, it affects digestion, absorption and the speed of use of nutrients, so the two problems go hand in hand.

I used this page a lot to help me.

http://www.health-science-spirit.com/deficiency.html

Blood work can tell you some things about your nutrient status, but signs can be more reliable sometimes.


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## BurntMarshmallow (Feb 26, 2016)

Your iron and ferritin is actually pretty low, even though they are in range. You can definitely experience symptoms at that level. Last year I had about the same ferritin you have now - 30 - and I also had all of your symptoms - including the difficulties swallowing, fatigue, muscle pain etc. I started taking 25mg of iron (with vitamin C for absorption) and felt improvement almost immediately. So I kept taking it, and sometimes took 50mg a day. I felt better but my ferritin stayed the same, until I did the vitamin A protocol. Studies show taking retinal palmitate improves low iron faster than taking iron alone. And this was true for me - my ferritin went up to 45 in two months after adding vitamin A. I took 25,000IU retinal palmitate a day for four months.

The high MCH is called macrocytic anemia. Here's a good description - http://www.healthtestingcenters.com/what-does-a-high-mch-blood-test-result-mean.aspx

I wonder if I broke my arm and went to the doctor, would they look at my chart and say "Oh, well you have a thyroid problem, so that explains your symptoms. ". It seems like once you get the label "thyroid disorder", then all your symptoms are dismissed as part of that. But if they see your thyroid labs are normal, they do nothing. They don't even bother to think something else could be going on. I wonder if you went to a general practitioner with the high MCH, and the low iron, and all your symptoms, if you'd get more help.


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