Levothyroxine/Hypothyroid

Glad I'm not alone in having no symptoms. I probably would never have checked my thyroid on my own. It came up during emergency back surgery. It does run in the family though.

I didn't realize the dose was weight-based. I started at 25 mcg while weighing around 200 pounds. They've run T4 several times and it stayed normal until my TSH hit 120 and T4 fell to 0.32 after months off meds. They usually order TSH with reflex free T4 and sometimes free T4. I've never had T3 checked. Since starting semaglutide I've lost over 100 pounds and now stay between 110-120. I'll update after next month's labs.

The scale surprise sounds funny. Curious to hear if they adjust anything next month.

I only learned it was weight-based after reading up because I felt undertreated for years. It's more of a starting guideline than a strict rule since everyone responds differently. Getting my TSH where I feel better and adding T3 because I don't convert well has helped a lot.

I'm going to ask next month about running T3 since I'm curious. My T4 stayed fine until TSH reached 120, so maybe my issue is more with T3. That could explain why I notice no change in how I feel. My recent labs were good but I still feel exactly the same, tired all the time with dry skin and memory problems whether TSH is 40 or 2.

Thyroid problems are often undertreated. T3 testing is rarely done because insurance won't cover it and studies show little difference between T4 alone and combo therapy. Many people with poor thyroid function also convert T4 to T3 poorly. Adding T3 helps a lot of people feel better, and splitting the dose can be useful since it has a short half-life.

That explains a lot and it's frustrating because my state insurance probably won't cover T3. The clinic is low-income so maybe they'll run it anyway if TSH looks fine. I keep wondering if what I feel is from low thyroid or just how I am. It's awkward talking about it because weight-gain jokes make it sound made up.

You might be able to pay out of pocket at a lab for a full panel. T3 is inexpensive from certain sources and a small amount can go far, though you may need to lower T4 because T3 affects TSH more strongly. Thyroid issues are invisible. When mine failed I gained weight fast, felt suicidal, lipids worsened, and lost gym strength. Most doctors only treat the TSH number.

Same here. Adding T3 finally stabilized my TSH after years of wild swings with Hashimoto's. My insurance stopped covering the brand name I was on even though the generic never worked well for me.

Some of us like to find the root cause and end up going down more rabbit holes. Lab normal ranges aren't always optimal. My endo aims for TSH around 1 or lower. Low vitamin D, iron, or ferritin can also cause tiredness. Levo absorption is finicky, which is why many doctors just go by numbers.