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Skipping dose every sunday

8436 Views 52 Replies 6 Participants Last post by  thybo
Hello. I started taking 25 mcg levothyroxine two years ago when I felt lethargic and my TSH came back 9.8, 0.45-4.5 being normal. At least three people in my family have thyroid issues also. As it built up in my body, I felt immediately better. However, I never went for follow up blood tests because I have vasovagal syncope and dread having them done as a result. I just go with how I feel, and since it's a lowest dosage and I feel fine, I'm assuming there is no need to adjust. In the first few weeks, I actually felt I had too much in my system because I had trouble falling asleep and had similar hyperthyroid symptoms. As a result, I've been skipping a dose on Sunday for months now. Am I causing problems down the line doing this?
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Goal is to have both FT-4 and FT-3 to fall somewhere between 1/2-3/4 of the ranges.

Alot of people report a TSH of 1 is optimal. I for one do not run TSH due to stimulating antibodies.

If your FT-4 or FT-3 is too high - most people would report higher TSH.

If you get your FT-4 a tad higher your TSH will likely fall.
I see. So I'd need FT4 to be slightly higher and my TSH to be around 1. Should I increase dosage to 50 mcg?
How do you "feel"?

For some, having a in range FT-3 is good enough to feel well.

Since you only had a ZRT blood spot test If it were me I would have actual lab blood draw tests to make sure the lab results are correct. I don;t believe a blood spot is enough for an accurate lab - but I really don;t know anything about blood spot labs nor have I ever had them run.
How do you "feel"?

For some, having a in range FT-3 is good enough to feel well.

Since you only had a ZRT blood spot test If it were me I would have actual lab blood draw tests to make sure the lab results are correct. I don;t believe a blood spot is enough for an accurate lab - but I really don;t know anything about blood spot labs nor have I ever had them run.
I feel a lot better than before I started taking the pills, but it could be better. So I'd rather try to get the ranges to optimal levels. For actual blood draws, they don't order the FT3 even when I tell them to. Blood spots are supposed to be just as accurate, and that lab specializes in such tests.
How do you "feel"?

For some, having a in range FT-3 is good enough to feel well.

Since you only had a ZRT blood spot test If it were me I would have actual lab blood draw tests to make sure the lab results are correct. I don;t believe a blood spot is enough for an accurate lab - but I really don;t know anything about blood spot labs nor have I ever had them run.
Do I have any other option to tweak my levels besides increasing the Levothyroxine dose?
Do I have any other option to tweak my levels besides increasing the Levothyroxine dose?
If you want to get your FT-4 up then you need to raise your levothyroxine. You can start by increasing 1/2 pill a day or double up dose every other day. Be sure to retest in 4-6 weeks.
I didn't take extra hormone and just did another blood spot test.

FT4: 2.7 (was 1.1 last time)
FT3: 2.6 (was 3.6)
TSH: 3.4 (was 2.5)
TPOab: 221 (was 108)

FT4 increased but FT3 lowered and TSH/TPOab increased too. I am assuming I have Hashimoto's that's getting worse which increased TSH/FT4. What do you guys think? I will follow a diet Amy Myers came up with for a month and retest.
Thybo, suggest including your ranges for your tests. They can vary lab to lab. Especially FT4 and FT3.

Yes you have Hashimotos. Those TPO levels may seem bad, but they are not too high in the grand scheme of things. Functional doctors like to see them under 500.

Looks like an increase in medication is probably something to consider. Need those ranges though. You could try diet and it can cause a need for less hormone. But it's also not easy to do. You may want to have a nutritionist help you. They may think you are a bit crazy, but just say you want help finding alternative things to eat if you will be cutting things like gluten and dairy. Maybe pick one thing to do. For instance, you could either try a dose increase or just cut Gluten for a trial. Otherwise it is hard to tell what is helping.

Try to keep stress low, exercise like walking a bit, balanced nutrition, eat less processed foods, sleep well, less added sugars, etc.

Just going by FT4 going up and FT3 going down, it would appear you are not converting T4 into T3 as well. Exercise, selenium (have a Brazil nut or two a day), lower stress, are a few methods to increase this.

Have you had recent stress?
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Thybo, suggest including your ranges for your tests. They can vary lab to lab. Especially FT4 and FT3.

Yes you have Hashimotos. Those TPO levels may seem bad, but they are not too high in the grand scheme of things. Functional doctors like to see them under 500.

Looks like an increase in medication is probably something to consider. Need those ranges though. You could try diet and it can cause a need for less hormone. But it's also not easy to do. You may want to have a nutritionist help you. They may think you are a bit crazy, but just say you want help finding alternative things to eat if you will be cutting things like gluten and dairy. Maybe pick one thing to do. For instance, you could either try a dose increase or just cut Gluten for a trial. Otherwise it is hard to tell what is helping.

Try to keep stress low, exercise like walking a bit, balanced nutrition, eat less processed foods, sleep well, less added sugars, etc.

Just going by FT4 going up and FT3 going down, it would appear you are not converting T4 into T3 as well. Exercise, selenium (have a Brazil nut or two a day), lower stress, are a few methods to increase this.

Have you had recent stress?
The ranges are here, the numbers in the middle are from the last test. It is proven that adjusting your diet can improve thyroid function, and I'd rather try that first instead of increasing medication. The diet I would do eliminates everything that can negatively affect the thyroid (grains, dairy, legumes, etc.) for a month and then retesting, and if the numbers improved, possibly reintroducing them slowly.

You are right about the T4-> T3 conversion, and I have been stressed lately. I will try to manage it and I started taking selenium already as well, thanks for the insight!

1436
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Looks like you are having conversion issues. This is a random website talking to this from a functional medicine perspective: Conversion of T4 to T3 Thyroid Hormone - Root Functional Medicine

Look also into some of the normal deficiencies for hashimotos patients. Vitamin D, B12, Iron (all four tests and Ferritin).

If you are stressed try some meditation. I like Tara Brach. Tons of free videos on Youtube and her website. She's a bit Buddha like, but I swear those meditations helped me get through the worst situations I had...anxiety, PTSD, etc. There are other meditations out there as well that can lower stress. Deep breathing techniques help also. And for me, just taking a lot of warm baths really helps.

Once your thyroid levels improve, you may not need to do these anymore...though they are always a good idea.

I had this going on at first also. High FT4 and low FT3. One thing that actually made a big difference for me was switching to name brand Synthroid instead of generic Levothyroxine. They are not equivalent. In fact, 100 was too much Levo for me, but I'm on 112 Synthroid now. So that could take some time to settle if you did decide to switch. However, best to try one thing at a time. Keep this in mind if things don't improve. Tirosint is another popular one (probably more popular than Synthroid). Both are quite a bit more expensive. Use coupons on their website to help. Still will be much more expensive than generic.

Keep this in mind also. It can take a long time for things to settle after any dose change. Some say it takes a month, but I personally think it takes 3 months+ for things to settle. Not fun, but you can try adjusting diet and addressing nutrition and see how that goes. It can make a pretty dramatic difference for some folks.
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Looks like you are having conversion issues. This is a random website talking to this from a functional medicine perspective: Conversion of T4 to T3 Thyroid Hormone - Root Functional Medicine

Look also into some of the normal deficiencies for hashimotos patients. Vitamin D, B12, Iron (all four tests and Ferritin).

If you are stressed try some meditation. I like Tara Brach. Tons of free videos on Youtube and her website. She's a bit Buddha like, but I swear those meditations helped me get through the worst situations I had...anxiety, PTSD, etc. There are other meditations out there as well that can lower stress. Deep breathing techniques help also. And for me, just taking a lot of warm baths really helps.

Once your thyroid levels improve, you may not need to do these anymore...though they are always a good idea.

I had this going on at first also. High FT4 and low FT3. One thing that actually made a big difference for me was switching to name brand Synthroid instead of generic Levothyroxine. They are not equivalent. In fact, 100 was too much Levo for me, but I'm on 112 Synthroid now. So that could take some time to settle if you did decide to switch. However, best to try one thing at a time. Keep this in mind if things don't improve. Tirosint is another popular one (probably more popular than Synthroid). Both are quite a bit more expensive. Use coupons on their website to help. Still will be much more expensive than generic.

Keep this in mind also. It can take a long time for things to settle after any dose change. Some say it takes a month, but I personally think it takes 3 months+ for things to settle. Not fun, but you can try adjusting diet and addressing nutrition and see how that goes. It can make a pretty dramatic difference for some folks.
I actually read that website. I will have to check my vitamin levels too, haven't done that yet. By all four you mean Vitamin D, B12, Iron, and Ferritin right? Because you put all four and Ferritin, thought maybe one is missing.

I will try those things, thanks. I have used Synthroid for a month before but didn't notice much of a change, I will try again for longer though. However, if adjusting the diet fixes the Hashimoto's and my levels are good then I will stop taking it altogether.

The feedback is greatly appreciated!
Sorry, all 4 Iron tests. And then Ferritin is a separate test. Good luck!
I'm going to stop taking the 25 mcg levothyroxine and see how I feel. Would it be a problem to stop abruptly? Or do I have to wean off?
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Hello all, so I stopped taking the pills (25 mcg levothyroxine) on 11/12/22. I did another blood spot test a couple of days ago and here are the results (includes results of previous tests):

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How would you interpret these results? They seem really odd. Maybe I should do the antibody test for Graves' Disease also.

EDIT: Adding lab comments. Seems like the last paragraph addresses the problem, Hashimoto's is attacking my thyroid gland and that causes FT3 and FT4 to be released, although my FT4 is normal.

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