Question:

You see, I did, but it disappeared and customer service is unresponsive to correct the error or to tell me what happened with the post. Anyhow, I'm a 39 year old, 5'3" (160 cm) tall, 136 lb (60 kgs), Caucasian woman with some history of hypothyroidism. I had 18.1 TSH level at age 28-30 with normal T3, T4, free T4 and antibody so instead of taking hormones I just increased my iodine intake, which fixed my TSH w/n 2 years and then it stayed within normal range for 7-9 years. I'm also not aware of Hashimoto disease on either side of my family tree or any auto-immune disease for that matter. Last August I still had my TSH within normal range, 3.4. This April, however, my TSH went up to 5.66 (see report), so my fertility doctor (as I'm trying to conceive) prescribed 75 mcg Levothyroxine. I was taking it for about 3 months when the new result showed that my TSH was 0.01, free T4 2.0 (see report attached), and I was experiencing hyperthyroidism symptoms (hair loss, dierreah, insomnia, etc). So we reduced my doseage to 25 mcg and now, after 5 weeks, my TSH is 11-something and free T4 is lower than normal range (see report). Before taking hormone supplements, even with very high TSH levels, my T3, T4, free T4 always stayed within normal range. My doctor will probably increase my dosage again to somewhere between 25 mcg and 75 mcg, but I'm afraid that changing the hormones so frequently would create a havoc in my system and mess up my natural hormone production for good. Reducing 75% hormone replacement (1.6 mcg/kg) suddenly to 25%, of course my body now does not produce enough hormone on its own right now as it got used to getting all the hormones from outside sources. So my question is what is your opinion? Should I give a bit more time for my body to adjust to a lower dose and keep taking the 25 mcg? Or is it clear that 25 mcg is not enough? Because I feel if I had been taking 25 mcg when my TSH was 5.66, I should probably be fine by now.....75.mcg was ovwrdosing. Should I go to an endocrinologist and return to my fertility doctor only after my thyroid level is stable and fixed or is it normal that results are so off at the beginning and the fertility doctor knows what he's doing? I am concerned, b/c like I said even when my TSH was really high, all of other indicators were in normal range, but now even the free T4 is off, so first time ever, I reallydo not have enough hormone in my system.... But maybe it is all normal and I'm overreacting.... What dosage should I take?

You see, I did, but it disappeared and customer service is unresponsive to correct the error or to tell me what happened with the post. Anyhow, I'm a 39 year old, 5'3" (160 cm) tall, 136 lb (60 kgs), Caucasian woman with some history of hypothyroidism. I had 18.1 TSH level at age 28-30 with normal T3, T4, free T4 and antibody so instead of taking hormones I just increased my iodine intake, which fixed my TSH w/n 2 years and then it stayed within normal range for 7-9 years. I'm also not aware of Hashimoto disease on either side of my family tree or any auto-immune disease for that matter. Last August I still had my TSH within normal range, 3.4. This April, however, my TSH went up to 5.66 (see report), so my fertility doctor (as I'm trying to conceive) prescribed 75 mcg Levothyroxine. I was taking it for about 3 months when the new result showed that my TSH was 0.01, free T4 2.0 (see report attached), and I was experiencing hyperthyroidism symptoms (hair loss, dierreah, insomnia, etc). So we reduced my doseage to 25 mcg and now, after 5 weeks, my TSH is 11-something and free T4 is lower than normal range (see report). Before taking hormone supplements, even with very high TSH levels, my T3, T4, free T4 always stayed within normal range. My doctor will probably increase my dosage again to somewhere between 25 mcg and 75 mcg, but I'm afraid that changing the hormones so frequently would create a havoc in my system and mess up my natural hormone production for good. Reducing 75% hormone replacement (1.6 mcg/kg) suddenly to 25%, of course my body now does not produce enough hormone on its own right now as it got used to getting all the hormones from outside sources. So my question is what is your opinion? Should I give a bit more time for my body to adjust to a lower dose and keep taking the 25 mcg? Or is it clear that 25 mcg is not enough? Because I feel if I had been taking 25 mcg when my TSH was 5.66, I should probably be fine by now.....75.mcg was ovwrdosing. Should I go to an endocrinologist and return to my fertility doctor only after my thyroid level is stable and fixed or is it normal that results are so off at the beginning and the fertility doctor knows what he's doing? I am concerned, b/c like I said even when my TSH was really high, all of other indicators were in normal range, but now even the free T4 is off, so first time ever, I reallydo not have enough hormone in my system.... But maybe it is all normal and I'm overreacting.... What dosage should I take?

Thank you so much for your detailed reply. So just to clarify, I checked the TSH 5 weeks after starting to take 25 mcg. Do you think it was checked too soon? Also, if it takes 6 weeks for TSH to react, than is it not that my TSH level is just catching up with the fact (reacting to the fact) that hormone is not coming from outside sources (75mcg) and I should check it again in 6 weeks to see how it is reacting now to the reduced 25 mcg? Or does it reacts to both at the same time? What confuses me is what is 6 weeks and what is 3 months? If it takes 6 weeks for my TSH to react and give "new hormone production order", then right now it is just instructing my body to produce more hormone, right? Which is quite normal, afterall 5 weeks ago I had excess free T4 and enough hormones withot any 0 stimulations (TSH 0.01)... So should we not just wait to see if my TSH normalized after 3 months, once my body had a chance to follow the new TSH "production instructions "? Or TSH should be w/n normal range throughout the entire process? Or what is 6 weeks and what is 3 months? Because right now I understand that it 6 weeks for TSH to give new stimulating "instructions" to my body and then my body complies with the "order" in 3 months. If that is the case, should we not wait a bit without changing anything and recheck TSH to see if it is going down in another 6 weeks with keeping the same 25 mcg dose and then keep checking it to see if in 3 months everything is back to normal? Because if we keep changing the dose every 6 weeks, how do we figure out what is the right dose? Or if 6 weeks is enough to figure out the dose then what is the 3 months mark? Sorry, but it is quite confusing for me right now and I really do want to understand. Thank you.

Thank you so much for your detailed reply. So just to clarify, I checked the TSH 5 weeks after starting to take 25 mcg. Do you think it was checked too soon? Also, if it takes 6 weeks for TSH to react, than is it not that my TSH level is just catching up with the fact (reacting to the fact) that hormone is not coming from outside sources (75mcg) and I should check it again in 6 weeks to see how it is reacting now to the reduced 25 mcg? Or does it reacts to both at the same time? What confuses me is what is 6 weeks and what is 3 months? If it takes 6 weeks for my TSH to react and give "new hormone production order", then right now it is just instructing my body to produce more hormone, right? Which is quite normal, afterall 5 weeks ago I had excess free T4 and enough hormones withot any 0 stimulations (TSH 0.01)... So should we not just wait to see if my TSH normalized after 3 months, once my body had a chance to follow the new TSH "production instructions "? Or TSH should be w/n normal range throughout the entire process? Or what is 6 weeks and what is 3 months? Because right now I understand that it 6 weeks for TSH to give new stimulating "instructions" to my body and then my body complies with the "order" in 3 months. If that is the case, should we not wait a bit without changing anything and recheck TSH to see if it is going down in another 6 weeks with keeping the same 25 mcg dose and then keep checking it to see if in 3 months everything is back to normal? Because if we keep changing the dose every 6 weeks, how do we figure out what is the right dose? Or if 6 weeks is enough to figure out the dose then what is the 3 months mark? Sorry, but it is quite confusing for me right now and I really do want to understand. Thank you.