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Suggest Treatment For Hypothyroid Symptoms Even After Levothyroxine Intake
Question: I have been on the same dose of Levothyroxine for over the last 10 years. My last blood test came back in the normal range, but I still exhibit all the signs of hypothyroid. How can I get a doctor to increase my dose? I am currently taking one 50mcg tablet per day.
Brief Answer:
Levothyroxine dose
Detailed Answer:
Sorry to note you still have symptoms suggestive of hypothyroidism.
Some thyroid experts suggest that individuals on levothyroxine feel best when their TSH is in the range of 0.4 to 2.5 , along with a Free T4 level that is just over the upper limit of normal.
This blood test for TSH and free T4 does not require fasting. It can be done at any time of the day. However, it is desirable that on the day of the test, you do not have the blood sample taken right after you have taken levothyroxine ie in the 2 to 4 hours prior to test.
So for example you could delay taking the levothyroxine on one morning and have the blood sample taken, then take the medication only after that even if it is outside of the routine. Doing so on one day will not impact the steadiness of the blood thyroid hormone levels.
Now the targets mentioned above for TSH and free T4 are generally applicable to relatively healthy individuals. If any of the following conditions are present then less stringent goals are applied on an individualized basis.
1 Severe untreated osteoporosis
2 Irregular heart rhythm problems
3 Chest pains from heart disease such as coronary artery disease (blockages)
So if you dont have these medical conditions, and your TSH and free T4 are not at goal, you could request your endocrinologist to consider an increase in dose.
Further it helps to be on a consistent brand of levothyroxine to avoid fluctuations in the blood levels that may potentially occur with generics because their precise levothyroxine content may vary from batch to batch especially if it is procured from different manufacturers.
Such variations in the blood levels can sometimes explain the symptoms you have.
Levothyroxine dose
Detailed Answer:
Sorry to note you still have symptoms suggestive of hypothyroidism.
Some thyroid experts suggest that individuals on levothyroxine feel best when their TSH is in the range of 0.4 to 2.5 , along with a Free T4 level that is just over the upper limit of normal.
This blood test for TSH and free T4 does not require fasting. It can be done at any time of the day. However, it is desirable that on the day of the test, you do not have the blood sample taken right after you have taken levothyroxine ie in the 2 to 4 hours prior to test.
So for example you could delay taking the levothyroxine on one morning and have the blood sample taken, then take the medication only after that even if it is outside of the routine. Doing so on one day will not impact the steadiness of the blood thyroid hormone levels.
Now the targets mentioned above for TSH and free T4 are generally applicable to relatively healthy individuals. If any of the following conditions are present then less stringent goals are applied on an individualized basis.
1 Severe untreated osteoporosis
2 Irregular heart rhythm problems
3 Chest pains from heart disease such as coronary artery disease (blockages)
So if you dont have these medical conditions, and your TSH and free T4 are not at goal, you could request your endocrinologist to consider an increase in dose.
Further it helps to be on a consistent brand of levothyroxine to avoid fluctuations in the blood levels that may potentially occur with generics because their precise levothyroxine content may vary from batch to batch especially if it is procured from different manufacturers.
Such variations in the blood levels can sometimes explain the symptoms you have.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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