thyroid issues? My dosage keeps going up

[NY2011]

I never had my thyroid checked prior to seroconversion (Oct 2011), so I don't have a baseline, but in addition to finding out the fateful news that day, I was also told that my TSH (thyroid stimulating hormone) was 36ml U/L.  Normal range is around 2.5.  I was started on .25mcg of synthroid, then increased to .50mcg, then to .75mcg. 

My doctor just called and my TSH is 15.5ml U/L.  He is increasing dosage again,  to .88mcg.  That seems like a lot for a guy to be taking, especially with the associated risks of osteoporosis attributed to synthroid.

Anyone else experiencing this? All of my lab results are great, except for this TSH level. 

Btw: I've gone for a sonogram, to check for inflammation, nodules, etc, and it showed nothing suspicious.

[Jeff G]

I'm assuming your doctor gave you instructions as to how to take your thyroid meds .

Thyroid meds can be finicky , I know because I have to take synthroid and the labs can really get screwy unless you are taking it on an empty stomach with water only .
My doc upped my dose not long ago most likely because I was taking it with a pot of coffee in the morning . I couldn't tolerate the higher dose and felt like I was going to jump out of my skin I was so jittery . Most times my doc schedules labs in the morning so that I have not eat or drank anything . She instructed me to tell her if I have eaten or drank morning coffee so she can take that into consideration when reviewing my labs and determining my correct dose .

[NY2011]

so, how much of the jitteriness do you think is attributed to the synthroid vs drinking an entire pot of coffee? haha.

[Friday]

Hello NY2011,

I also have to replace thyroid hormone - similar to you I started with a rather low dosage of 50 mcg that was increased to 150 mcg over the course of a couple of months because my TSH level did not get back to the normal range.

At that point my endocrinologist had my steroid hormones checked and it was found that I also have Addison's disease. Since then I take 12.5 mg of hydrocortisone each morning together with levothyroxine - when I'm sick, have a lot of stress or if it is very hot/cold I double the dosis of the hydrocortisone (not very often though). Because of that I was able to lower the dosis of the thyroxine back to 100mcg and I'm feeling a lot better in terms of energy level, strength and even mood.

Not sure if you already had your adrenal glands checked but if not it may be worthwhile to bring this up when you talk with your doctor.

There are of course a lot of other interactions that affect the absorption and metabolism of levothyroxine but I guess you are already aware of that.

[Mishma]

NY2011

Normal TSH range as of 2002 is 0.3-3.0. Old reference values were 0.5-5.

Following removal of my thyroid some 10 years ago I settled on 212 ug (or 0.212 mg). About 4 years ago I was struck with Graves Disease and my synthyroid was again adjusted up to 300 ug. A whooping amount but my TSH holds steady at 1.5.

I've wondered about Addison's (thanks Friday for the reminder) but so far labs are negative. 

[NY2011]

Thank you for this. I will ask to have my adrenal glands tested, and will also get checked for Addison's disease.  I'm aware of the half-hour food restriction after taking  synthroid (or levothyroxin) and I've also read that it's best not to take vitamins until 4 hours after, especially calcium.