Yes, those numbers are ever evolving as more research is done. Every endocrinologist will have a certain spread as to what they think is best, but most of them also take into account how someone feels.
The good thing is that synthroid, et al, is about the cheapest drug out there, so if you are started on a dose, and within a few weeks find it’s not the right one, just throw them out and start over… it’s not like you’ve spent much money on it.
My GP prescribed 25 mcg of synthroid which I thought was low for 5.7? Said he would test again in 6 weeks. He seemed to think the wired/anxiety feeling wasn’t a symptom of hypo? Wondering if I should do 50 mcg and see how the test turns out. He didn’t think I was that high and I got the feeling he just prescribed it just to placate me.
They will always start low, test and retest and increase in small doses until you are stable. I wouldn’t “self treat” because if you go too high you could be in worse shape than too low. I was diagnosed with severe anemia and a TSH over 300 when I was young - went to the doctor because I thought I had mono…and started at 50 mcg - increase to 125 and was stable for decades, then up to 150 and 175 all of a sudden then in mid-life started getting heart palpitations and anxious and jittery and gradually reduced back to 125 mcg. Don’t mess around “self medicating.” And agree, for years i was “kept” right around 4.5 - 5 on TSH (T3 and T4 in normal range) but in mid-life on 125 mcg I’m around 1 and I feel better than I have in decades. I also felt great when I was pregnant and my TSH would fall down to below 2. Felt great. Everyone is different, but for me lower is better. I start “feeling” it when I creep up between 5-8 on my TSH tests. My first symptom of out of wack thyroid is depression and hair loss. I’ve gotten pretty good at “guessing” my TSH - it’s was a game with my doctor until we got patient portals…now I know before the doctor tells me because my lab tests generally are posted before my appointment 
No. Just no.
He is correct.
Good advice. My wife already vetoed that idea
While some people just go to their GP for Thyroid problems I would go to an endocrinologist. My husband started having thyroid problems a few years ago. Late last year they found some nodules and it turned out he had thyroid cancer. He had his thyroid out and is doing well now. I believe if he had gone to just his GP it wouldn’t have been caught as early. Partially because that’s their specialty but also because they have all the equipment and lab stuff right there on site.
I have been on levothyroxine for almost 40 years. I was diagnosed in high school. I have gone through periods during which I didn’t take very good care of myself … you know, too busy to go to the doctor, that sort of thing. Believe me, it doesn’t take care of itself. I have to be on thyroid to feel my best. After letting things go while my mom was sick, I have been taking my meds as needed for almost 5 years without a lapse - but even so, I did have an adjustment made in October, when my levels increased & I had to cut back a bit on my dosage. The point is, even after decades, I still have to work closely with my doctor to monitor my levels.
Yes, that is correct. Battery of tests at diagnosis, then tsh periodically. Should check tsh approx 6-8 wks after starting synthroid to see where it goes to.
Yes, I’m wondering why this GP is not referring out to an endocrinologist for consult. You really need to rule out the various more dangerous reasons for a change in thyroid function AND get more comprehensive blood work up done. Please don’t mess with this - so many things, if caught early, can be rectified easily.
My GP referred me to an endocrinologist who then referred me back to my GP where its been managed just fine for the past few years. I would also share information with others in your family - I have Hashimotos and made my pediatrician aware as I have a nephew who was diagnosed as a teen with the same condition.
ohio:
Yes. At 25 mcg, your doc is probably prescribing to placate you! But, that’s OK. See where it is at the next test and go from there.
One important point. Not eating for an hour or more before or after taking the synthroid is critical for proper absorption. With food or drink or anything that triggers stomach acids the pill will be dissolved in the stomach rather than pass through intact to the intestine where it can be better absorbed. So finding a workable consistent schedule is part and parcel of getting the dose dialed in. For us old guys, the overnight trip to the bathroom is a good time – well after any bedtime snack. Well before morning coffee.
This is critical. No one mentioned this to me for many years - once someone did mention it to me, and I started taking it properly, I ended up going hyperthyroid because so much more of the medication was actually making it to my blood stream. I had no idea why I was suffering from such acute anxiety, etc., until someone suggested I get my thyroid checked (I’d had it checked less than six months earlier). When I saw how hyper I’d gone, I didn’t understand it; then the doctor who ordered the blood work for me asked me if I’d changed how I was taking it, and I said yes; he said it explained the sudden change in levels. That’s how I went from taking 100 mcg. a day, to taking it 88 mcg. four days a week and got my numbers to improve.
You should be asking these questions to your doctor, rather than random people on the Internet. I’d expect the next step to be a second confirmation blood test, along with getting some additional measures beyond just TSH. He may refer you to an endocrinologist for this testing
Several years ago, I had hyperthyroidism with a TSH of <0.01. Living like this was kind of like a cross between a huge amount of caffeine and the Stephen King movie/book Thinner. My thyroid functionality is normal now, but the couple months I had an overactive thyroid was long enough to lead to some chronic issues that still impact me years later. It’s not something you should ignore.
Mine has gone a little nutty over the years. When the numbers looked fine but I still felt sluggish I took cytomel with it. Then within 6 months I was in the doctor’s office thinking I was having either a heart attack or a major stress attack. I also wasn’t taking it correctly. Now I take it before I go to bed - it’s a good dieting issue to make sure I’m not eating a couple of hours before bed. I keep it on my nightstand. I also don’t sleep through the night so I could do that but I’m usually knocking into walls and stumbling to the bathroom - sleep is elusive enough for me, having to think of taking pills would probably wake me up too much.
What difference does it make how you take it if you take it the same way all the time?
eyemamom, I am really new at this since I’ve only been taking Synthroid for about 3 weeks, but I wonder if taking it at night might be exacerbating your sleep problems. I started out taking it at night because I hated the idea of waiting for my morning coffee. For about four days I barely slept at all and was incredibly anxious. So I switched to morning and immediately slept and felt a bit better.
terriwtt, My pill bottle says to wait an hour before eating but my Dr. said I could wait just half an hour, which is what I’m doing. Do you think that’s a problem?
It’s really best to take it as directed, so the physician can accurately monitor blood results. Future treatment is usually based on the assumption that the patient is doing so, and having the doctor make a false assumption based on inaccurate results isn’t ideal. Absorption can be impacted by what foods you’ve eaten and how they’re digested. (I’ve been taking synthroid since I was 9 and having blood work done every three months since that time).
Consistency is the key. If you consistently took it with food in your stomach and dialed in the dose, that would be OK… except that you would be vulnerable to overdosing, which is more acutely problematic than low thryroid.
It’s just the particular way the hormone is absorbed. It just doesn’t absorb well in the stomach. Needs to sail through, intact, to the intestine. I never understood why taking it on an empty stomach was important 'til I read the reason.
Taking it at bedtime is good option. First thing in the morning doesn’t work for me because I can’t wait an hour for my coffee!
Puzzled. Waiting a half hour is probably fine, especially if you wash it down with a big glass of water.
iDad, my doctor recommends an hour before or two hours after food to be absolutely sure because most individuals aren’t really sure of the rate of digestion of various foods. It probably doesn’t matter that much for the most part, but sometimes it can. Now, my situation was a little different since I was diagnosed as a young child and went through adolescence and pregnancy where precision is more critical, but my doctor is a fan of the ability to measure precisely and be confident in blood test results.