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Hello everyone,

I would like to seek your advice. A thyroidectomy was done in September 2016 for my graves disease and eyes. I was put on 125 mcg of levothyroxine.

Labs in October (One month post thyroidectomy)-

t4 free - 2.0 (out of range) Reference Range: 0.8-1.8ng/dL

TSH - 0.01 (out of range) Reference Range: 0.4-4.5mIU/L

t3 free-4.4 (out of range) Reference Range: 2.3-4.2pg/mL

Doctor's conclusion: lower to 112 mcg of levo.

Labs in December (apprx 3 months post thyroidectomy)-

t4free - 1.8 (in range per lab result sheet; upper borderline point) Reference Range: 0.8-1.8ng/dL

t3- 3.6 (in range per lab result sheet. 3/4 of range). Reference Range: 0.4-4.5mIU/L

tsi- 363 (out of range) Reference: around 100

TSH- 0.02 Reference Range: 0.4-4.5mIU/L

Doctor's conclusion: lower to 100 mcg of levo.

My eyes have been better up until maybe halfway into transition to 100 mcg, which would be in early February. I am not sure if this is even related.

My question is:

-Eyes have been acting up for more than a year. Felt very hopeful post thyroidectomy due to eyes slowly getting better, but sudden change for the worst early/mid February is worrying. What insights do you have/ recommend?

-I will soon have more up to date labs, but would you say I am on the right dosage?

-Will incorrect dosing affect eyes? Eyes felt better on the 112, but not sure if purely coincidence and closer proximity to post thyroidectomy.

Please advise and share your story of post-thyroidectomy effects on the eyes?

Thank you for kindly being a resource.
 

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Can you please edit your post and include the ranges for your lab results?

Are your labs drawn around the same time of day?

Do you take your levothyroxine prior to your lab draw?

Goal is to fall somewhere between 1/2-3/4 of range for both FT-4 and FT-3.

Stable labs should help unstable eye's. You have had alot of dose changes since your TT.
 

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Can you please edit your post and include the ranges for your lab results?

Are your labs drawn around the same time of day?

Do you take your levothyroxine prior to your lab draw?

Goal is to fall somewhere between 1/2-3/4 of range for both FT-4 and FT-3.

Stable labs should help unstable eye's. You have had alot of dose changes since your TT.
Yes, thank you I have included it.

Yes, generally around the same time.

Yes, I take levo prior to draw.

Thank you. Any other insights?
 

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We suggest taking hormone replacement after the lab draw.

Your dose of 112mcg is what I would suggest - take for 6 weeks and lab - this time take your lab prior to taking your hormone replacement. Your FT-3 was in a great place but your FT-4 was top of range - quite possibly because you took your levothyroxine prior to the draw.
 

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In Oct she was told to take 112mcg.

Dec labs taking med's prior to draw show FT-4 at top range assuming she was on the 112mcg dose.

FT-3 at 3.6 where 1/2-3/4 of range s ((3.26-3.74))

Staying on the 112mcg for 6 weeks and having a lab - NOT taking the thyroid hormone before draw will show a better more realistic result.

With so many dose changes, she has to start someplace and the 112mcg seems most logical.

free t3 shows slightly hyper so how is it in a good place?
What do you mean by slightly hyper?
 

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Her lab indicates free t3 4.4 above range that's what I mean
I was put on 125 mcg of levothyroxine.

Labs in October (One month post thyroidectomy)-

t4 free - 2.0 (out of range) Reference Range: 0.8-1.8ng/dL

TSH - 0.01 (out of range) Reference Range: 0.4-4.5mIU/L

t3 free-4.4 (out of range) Reference Range: 2.3-4.2pg/mL

Doctor's conclusion: lower to 112 mcg of levo.
Med's were lowered from 125mcg to 112mcg after the FT-3 was 4.4
 
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