Hypothyroidism Support Group
Hypothyroidism is the disease state caused by insufficient production of thyrohormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. Advanced hypothyroidism may cause severe complications, the most serious one of which is...
Hi folks!
I know how difficult it was for me during the meds titration process to have faith that I could FINALLY feel better.
Well, I did......and it can happen to you.
I thought it might be a good idea for you to know just what maintaining optimal levels involves.
You probably remember me saying that I've never lasted longer than 3 months on any given dose and that's why I get labs every 6 wks.
Many people who are optimized don't need such frequent labs.
I tried going 8 wks. between labs but, I'd invariably develop symptoms beforehand.....sure enough, my levels showed the need for a dose adjustment.
Getting labs every 6 wks. has enabled me to "catch" any changes in my levels and have my doctor adjust my dose....before I develop symptoms. I have been able to "escape" most symptoms this way.
As a general rule I established for myself (through time and experience)..... if my most recent labs prove to be optimal for me (no dose adjustment required), I will then go 4 wks. for the next set of labs since my history has shown that I've invariably needed a dose adjustment then.
Bottom line, we each need to figure out what works for us re lab frequency. This is a key aspect of maintaining optimal levels.
Another key aspect of maintaining optimal levels is, of course, knowing how to interpret our labs.....always focusing only on the FreeT4 and FreeT3 levels and asking for appropriate dose adjustments.
Please remember - it doesn't matter what dose(s) we take....we take whatever dose(s) we need to maintain optimal levels.
I thought I'd share a little of my dosing history so you guys can see what maintaining optimal levels looks like.
Just as for most people, I started out with 25mcg T4. My dose was slowly titrated up as labs and symptoms dictated. About 10 months into the meds titration process, my labs showed the need for the addition of T3 (my FreeT4 level was near the high end of the range but, my FreeT3 level was slightly below mid-range). I was started on 5mcg T3 which, thankfully, optimized my FreeT3 level.
When both my FT4/FT3 levels finally optimized in June 2011, I was taking 125mcg T4 and 5mcg T3.
Moving forward from there, my T4 dose needed to be adjusted no more than 6.25mcg at a time..... and I stayed on 5mcg T3 for over 6 months.
So, I'd be taking either alternating doses of 112/125mcg T4....possibly go down to 112mcg T4....back up to alternating 112/125 and possibly up to 125mcg T4. Again, all the while I was taking 5mcg T3.
Most importantly, these small changes in my T4 dose kept me virtually free from thyroid symptoms.
I went off hormonal BC in late November 2011 since "female-related" labs indicated that I was in menopause.
Since I already learned that estrogens cause an increase in SHBG (sex hormone binding globulins) which can bind thyroid hormone, I knew to expect a need for either/both T4 and/or T3 dose reductions.
Sure enough, by January 2012, I needed a T3 dose reduction due to an over-range FreeT3 level so I was down to 2.5mcg T3....and still taking alternating doses of 112/125mcg T4.
In late February, I needed a T4 dose reduction due to an over-range FreeT4 level (I then went down from 112/125 to 112mcg).
Throughout last year, depending on my labs, my T4 dose continued to vary from 112 to 112/125 to 125, etc.......and my T3 dose varied from 2.5 to 3.75 to 5mcg.
By the time of my mother's strokes in late August, I was taking 112/125mcg T4 and 5mcg T3.
I am now up to 125mcg T4 and 7.5mcg T3.
(I wasn't surprised at my need for more T3 since stress greatly interferes with conversion. My next labs might show the need for more T4 as well so there's a chance I will be "fooling around" with 125/137mcg T4.....whatever it takes)
These small dose changes helped me maintain my optimal levels: FreeT4 1.7 - 1.84 (.82-1.76)
FreeT3 3.8 - 4.0 (2.0-4.4)
So, if my FT4 dropped below 1.7, I'd get a small T4 dose increase (6.25mcg) that always brought my FT4 back to my optimal range of levels.
When my FT4 went over-range after going off hormonal BC, that same size dose DEcrease restored my optimal levels.
The same concepts apply to what was done with my T3 dose and how my FT3 level was affected.
As you can see, there have never been radical changes in my dose sizes since being optimized.
This type of thing can only happen if a person is getting labs with the appropriate frequency.
People who wait until symptoms develop before getting labs will find that their levels are much farther from their optimal and it can take several dose adjustments over the course of several months to restore their optimal levels.
This is just a plain, biological fact.
By the time symptoms develop, our levels have already been "off" for several weeks. Obviously, the further "off" our levels are from their optimal, the longer it will take to restore them.
Admittedly, I had some "detours" during the process - mostly because my doctor isn't aware of some of the "finer aspects" of thyroid care.
However, I have enough time in with thyroid hormone replacement that I finally have a good understanding of just what's needed to maintain optimal levels.
I have been able to avoid most symptoms by getting labs/appropriate dose adjustments within the timeframe that works for me.
This is what I've always dreamed of.....it made sense to me that it was possible and I'm thrilled that it is.
Since I am aware of other people's success with maintaining optimal levels, I know my situation isn't unique.
Please keep the faith.
I know how difficult it was for me during the meds titration process to have faith that I could FINALLY feel better.
Well, I did......and it can happen to you.
I thought it might be a good idea for you to know just what maintaining optimal levels involves.
You probably remember me saying that I've never lasted longer than 3 months on any given dose and that's why I get labs every 6 wks.
Many people who are optimized don't need such frequent labs.
I tried going 8 wks. between labs but, I'd invariably develop symptoms beforehand.....sure enough, my levels showed the need for a dose adjustment.
Getting labs every 6 wks. has enabled me to "catch" any changes in my levels and have my doctor adjust my dose....before I develop symptoms. I have been able to "escape" most symptoms this way.
As a general rule I established for myself (through time and experience)..... if my most recent labs prove to be optimal for me (no dose adjustment required), I will then go 4 wks. for the next set of labs since my history has shown that I've invariably needed a dose adjustment then.
Bottom line, we each need to figure out what works for us re lab frequency. This is a key aspect of maintaining optimal levels.
Another key aspect of maintaining optimal levels is, of course, knowing how to interpret our labs.....always focusing only on the FreeT4 and FreeT3 levels and asking for appropriate dose adjustments.
Please remember - it doesn't matter what dose(s) we take....we take whatever dose(s) we need to maintain optimal levels.
I thought I'd share a little of my dosing history so you guys can see what maintaining optimal levels looks like.
Just as for most people, I started out with 25mcg T4. My dose was slowly titrated up as labs and symptoms dictated. About 10 months into the meds titration process, my labs showed the need for the addition of T3 (my FreeT4 level was near the high end of the range but, my FreeT3 level was slightly below mid-range). I was started on 5mcg T3 which, thankfully, optimized my FreeT3 level.
When both my FT4/FT3 levels finally optimized in June 2011, I was taking 125mcg T4 and 5mcg T3.
Moving forward from there, my T4 dose needed to be adjusted no more than 6.25mcg at a time..... and I stayed on 5mcg T3 for over 6 months.
So, I'd be taking either alternating doses of 112/125mcg T4....possibly go down to 112mcg T4....back up to alternating 112/125 and possibly up to 125mcg T4. Again, all the while I was taking 5mcg T3.
Most importantly, these small changes in my T4 dose kept me virtually free from thyroid symptoms.
I went off hormonal BC in late November 2011 since "female-related" labs indicated that I was in menopause.
Since I already learned that estrogens cause an increase in SHBG (sex hormone binding globulins) which can bind thyroid hormone, I knew to expect a need for either/both T4 and/or T3 dose reductions.
Sure enough, by January 2012, I needed a T3 dose reduction due to an over-range FreeT3 level so I was down to 2.5mcg T3....and still taking alternating doses of 112/125mcg T4.
In late February, I needed a T4 dose reduction due to an over-range FreeT4 level (I then went down from 112/125 to 112mcg).
Throughout last year, depending on my labs, my T4 dose continued to vary from 112 to 112/125 to 125, etc.......and my T3 dose varied from 2.5 to 3.75 to 5mcg.
By the time of my mother's strokes in late August, I was taking 112/125mcg T4 and 5mcg T3.
I am now up to 125mcg T4 and 7.5mcg T3.
(I wasn't surprised at my need for more T3 since stress greatly interferes with conversion. My next labs might show the need for more T4 as well so there's a chance I will be "fooling around" with 125/137mcg T4.....whatever it takes)
These small dose changes helped me maintain my optimal levels: FreeT4 1.7 - 1.84 (.82-1.76)
FreeT3 3.8 - 4.0 (2.0-4.4)
So, if my FT4 dropped below 1.7, I'd get a small T4 dose increase (6.25mcg) that always brought my FT4 back to my optimal range of levels.
When my FT4 went over-range after going off hormonal BC, that same size dose DEcrease restored my optimal levels.
The same concepts apply to what was done with my T3 dose and how my FT3 level was affected.
As you can see, there have never been radical changes in my dose sizes since being optimized.
This type of thing can only happen if a person is getting labs with the appropriate frequency.
People who wait until symptoms develop before getting labs will find that their levels are much farther from their optimal and it can take several dose adjustments over the course of several months to restore their optimal levels.
This is just a plain, biological fact.
By the time symptoms develop, our levels have already been "off" for several weeks. Obviously, the further "off" our levels are from their optimal, the longer it will take to restore them.
Admittedly, I had some "detours" during the process - mostly because my doctor isn't aware of some of the "finer aspects" of thyroid care.
However, I have enough time in with thyroid hormone replacement that I finally have a good understanding of just what's needed to maintain optimal levels.
I have been able to avoid most symptoms by getting labs/appropriate dose adjustments within the timeframe that works for me.
This is what I've always dreamed of.....it made sense to me that it was possible and I'm thrilled that it is.
Since I am aware of other people's success with maintaining optimal levels, I know my situation isn't unique.
Please keep the faith.
deleted_user
Thanks CD, I was thinking the same thing. The doc put me on Fortesta and my testosterone just went lower....which led me to believe that without the thyroid working correctly, it wouldn't go up anyway.
utahgal
I have low testosterone too! Glad to hear that may improve with thyroid treatment! My doc had me try DHEA to help with testosterone, but I had to stop because I felt it was causing my hair to shed even more!
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