[elisebeary]

#1018838

Hi,

Like a lot of people on this board, I’ve been struggling for a while to find the correct dosage (I’m on methimazole) to get to equilibrium.

Since July, my total T3 and total T4 have been normal, but my TSH is still <.015. (The TSH did go up to .25 in July, when my dosage was 15mg, but I was starting to feel hypo symptoms, so my doctor OK’d me to reduce my medicine to 10 and then 5, and then since then my tests have all put TSH back to <.015).
My question is, how long can it take for TSH to get into a normal range after you are actually in balance? I’m worried about raising my dosage both because I don’t feel particularly hyper (though I don’t feel very well in general) as well as because both total T3 and total T4 are actually moving to the low end of the range and I really would like to avoid going totally hypo.

thanks for any advice….

Elise

[Kimberly]

#1067413

Hi Elise – Everyone is different, but it *can* take quite some time for the TSH to rebound.

You are correct that increasing your methimazole while your Free T3 and Free T4 are at the bottom of the "normal" range could pull your FT3 and FT4 down even further.

I would definitely have a frank discussion with your doctor if he/she wants to go this route. If your doctor can make a compelling argument for increasing the dose, I would at least insist on getting labs done very frequently to make sure you stay out of "hypO land".

Best of luck!

[Bobbi]

#1067414

Something that I read — in a publication of one of the thyroid associations — might put a bit of perspective on things. The doctor writing stated that the consequences of even minor levels of hyperthyroid are — in the long term — severe. (Osteoporosis, heart complications, etc.) On the other hand, the medical community doesn’t see minor levels of hypo as being AS bad for the long term. So, they want to agressively treat hyper levels — even the "subclinical" range (when the patient is not necessarily exhibiting symptoms, but bloodwork shows a problem).

Second. The actual thyroid levels at any given point in time is simply that: the levels at the time the test was given. TSH, on the other hand, is a type of "moving average," so it’s results show a longer trend. It’s another reason why our doctors really look at that TSH. It does take it longer to "catch up" to the predominant, current levels of hormone, but it gives a broader picture.

I do hope everything evens out for you soon.

[elf]

#1067415

I think this is another case confirming what I have been observing with myself and several others:

sometimes, when a person is hypo (whether through RAI, TT, or on ATDs (the burn-out stage on ATDs)), the thyroid supplement helps to keep their free Ts on the normal levels, the person is not particularly feeling unwell or "off", but the TSH is "hyper".

I am post-RAI which means I am hypo, and my Synthroid keeps my free Ts in the middle of the ranges. However, my TSH looks hyper (0.01). I am feeling fine, and my doctor agrees with me that we should keep dosing by free Ts, not TSH.

He says he is aware of hypo people whose TSH starts behaving in this way, and they disregard it. Maybe my Dr belongs to a new generation of doctors ” title=”Smile” /> ?

I am, too, wary against decreasing my Synthroid (which would be the same as increasing Methimazole).

I wonder if they cover this phenomenon at the conferences, because I see it more and more.

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