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Old 11-19-2017, 06:48 PM   #1
PACarolsue
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Question about Levothyroxin

This question is for anyone who might know the answer.

Leo, maybe?

I have a friend who was taking 88 mg of Levo daily. She recently lost 35 lbs. When she went for her bloodwork her doctor said her "number" has gone down and he is changing her to 75mg. Doesn't that mean she is now taking less than she was before? Why would this happen? She said she keeps her thermostat on 72 and is always freezing.
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Old 11-19-2017, 09:07 PM   #2
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It sounds like her TSH went down, which many doctors believe mean a person is over-medicated. It is wrong, but that's what many of them think.
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Old 11-20-2017, 03:12 AM   #3
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No idea what 'number' the doctor is talking about. It could be TSH, or it could be her T4. In either case, there's no way to know whether or not the doctor is overreacting, although, as Gina indicates, doctor often mistake a change in TSH that's entirely normal for someone taking supplemental hormones (Rx thyroid).

It's difficult to find a good thyroid doctor--but it's worth the effort to find one because thyroid problems are for life.

The weight loss may have been a factor that convinced this doctor, too. When I was losing weight, my endo thought he would have to lower my dosage, but that never happened because my thyroid did not 'react' as he'd assumed.

A good thyroid doctor will prescribe based on BOTH labs and symptoms, and in my experience, my symptoms are often more accurate than my labs. Again, this is a reason to have a long-term, trusting relationship with the physician who is managing your thyroid issues. My endo has made dosage adjustments based entirely on my symptoms--and they've proved to be the right choice, even though my labs seemed fine.
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Old 11-20-2017, 08:31 AM   #4
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I think it was the TSH he was talking about. This is her PCP and she recently changed doctors, therefore the updated tests. She has tried to lose weight in the past unsuccessfully, but this time lowered carbs, so it's hard to tell if the thyroid had anything to do with the weight loss, but I was concerned that someone who struggled with weight loss in the past would lose so easily. I don't like to give her advice because she is one who does what her doctor tells her.

Thanks for the responses!
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Old 11-20-2017, 07:53 PM   #5
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People assume that because I am thin I can't be hypo....I tell them it's the food. Annoying, though.
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Old 01-11-2018, 09:59 AM   #6
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Are you talking about your thyroid Rx that you declined to increase?

If so, that's a mistake. Your thyroid issues may not at all improve with weight loss; it's a completely different thing from diabetes.

I lost close to 180lbs and have been maintaining for the past 8 years, and during that time, my thyroid Rx increased because a dysfunctional thyroid does not regenerate and continues to decline.

A 50 mcg dose of T4 (thyroid Rx) is very low, and most doctors start you low because your body has to adjust to incoming hormones. But if the doctor suggests an increase, it's important. Your thyroid runs your body, and it's critical to get to an optimal level of Rx for your overall health.
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Old 01-12-2018, 04:42 PM   #7
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My doctor never made a thyroid med adjustment based on the results of one blood test. He always wants to see at least two results showing a pattern. I've been on 50 mcg since my thyroid issues started after menopause around seven years ago. Now I'm wondering if my thyroid is working a little on it's own since I've been on this low a dose since I started.
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Old 01-12-2018, 04:53 PM   #8
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Ronnie-
How often do you have labs? And do you keep copies?

I ask because the thyroid doesn't regenerate, and I've never had a doctor who waited to see a 'pattern' before adjusting dosage. If I need a dosage increase, I usually have symptoms (sometimes severe), so it's important to make the change ASAP.

Because my primary failed to diagnose me for over 5 years, I have become very pro-active in my care and learned a lot about thyroid issues.

If your dosage has remained the same, then your T4 and T3 levels should be OK, but you only know that if you check the labs.
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Old 01-12-2018, 05:24 PM   #9
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Ronnie-
How often do you have labs? And do you keep copies?

I ask because the thyroid doesn't regenerate, and I've never had a doctor who waited to see a 'pattern' before adjusting dosage. If I need a dosage increase, I usually have symptoms (sometimes severe), so it's important to make the change ASAP.

Because my primary failed to diagnose me for over 5 years, I have become very pro-active in my care and learned a lot about thyroid issues.

If your dosage has remained the same, then your T4 and T3 levels should be OK, but you only know that if you check the labs.
My doctor orders labs every 3 months, but he rarely checks T3 and T4. One time I tested somewhat high on my TSH, and the next time I was in range (of course the lab still uses the old range which is considered high now), so my doctor didn't do anything. I may very well need an adjustment in dosage, but my doctor strictly goes by my TSH and the lab range. You know, I don't even know what the symptoms would be if I needed a dosage increase. What would I be feeling if that were the case? Also, would my other labs show a change, e.g., my cholesterol levels, glucose, etc.? And blood pressure?
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Old 01-13-2018, 03:29 AM   #10
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Ronnie:
I think you need a better thyroid doctor. First of all, if you are taking thyroid Rx (which you are), doctors aim for a TSH of 1.0 as an indication of optimal dosage. If your TSH is higher, that usually means your dosage is too low.

The issue of being 'in range' with TSH is only for diagnostic purposes for those who suspect thyroid problems. That's when the TSH is really important because it's a measure of how hard your pituitary gland has to work to stimulate your thyroid. If the number is higher than 2.5, then your thyroid is slowing. Once you are diagnosed and taking Rx, then the TSH level is a good indicator of whether or not your dosage is optimal. Again, 1.0 (or lower) is considered a goal.

Secondly, your T4 and T3 levels should always be checked when you are on Rx because they indicate your actual thyroid hormone level. And that's important because your thyroid runs your body. Here, too, it's important to learn what's best for you personally. Lab ranges simply indicate where most people function best, but everyone is individual. For example, you can read online that everyone should be in the upper third of the range, but I do well when my T4 and T3 are at half the range or slightly below. I know this from reviewing my labs over time.

As to how you will 'feel' if you are not taking sufficient Rx, it depends on the person. Low thyroid symptoms can be vague and often overlooked. My primary used to tell me all the time that they were just 'normal aging.' My own major symptoms is fatigue--unusual tiredness, but people have different symptoms.

Last edited by Leo41; 01-13-2018 at 03:32 AM..
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Old 01-13-2018, 10:19 AM   #11
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Leo, I appreciate you sharing your knowledge of thyroid issues with me. Timing is on my side because I am in the process of changing doctors as it's gotten too difficult to drive 40 miles one way every three months to see my old doctor. We moved two years ago and DH immediately switched PCP's, while I didn't. I'm ready now. I will talk to my new doctor about my labs. You know, I do feel quite tired, I wake up tired, but I just chalked it up to getting older (like your old PCP did). I'll see what the new doctor says. Good health to you!
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Old 01-13-2018, 12:42 PM   #12
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I lost a lot of hair, was cold all the time, and had very dry skin in addition to be tired most of the time.
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Old 01-13-2018, 01:16 PM   #13
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I lost a lot of hair, was cold all the time, and had very dry skin in addition to be tired most of the time.
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