Laura’s Questions: I am on 25 mcg of Levothyroxine for 6 yrs with hypo symptoms, every one! My endocrinologist just took a panel, and the results are the following: 

TSH 2.36 uUI/mL        Reference Range = 0.45 to 4.5 uUI/mL 

Free T4 1.1 ng/dL         Reference Range = 0.82 to 1.77 ng/dL 

Free T3 2.9 pg/mL       Reference Range = 2.0 to 4.4 pg/mL

Should we up my dose of Levothyroxine to 50 or should I just switch to Synthroid or Armour? Thanks!

Short Answer: We typically don’t recommend or prescribe Levothyroxine or Synthroid for our patients. Both of these medications only contain the T4 hormone. This is referred to as T4 Monotherapy. These medications do a good job of lowering the TSH level but do not always help the patient feel better. We like to prescribe thyroid medication that contains both the T4 and T3 hormones. In our experience, our patients tend to feel much better on a combination medication, rather than on a T4-only medication.

In our opinion, we feel that sustained-release compounded thyroid medication is the best option most of the time. This type of thyroid medication gives the doctor many dosing options, which is certainly good for the patient and their overall symptom profile. Because this medication is compounded, the T4 and T3 hormones can be changed independently of the other hormone. With a commercial prescription, there are only so many dosing options, and both hormones are affected when raising or lowering the dosage. Also, the sustained-released nature of the medication helps to reduce any unwanted side effects that are common with commercial instant-release thyroid medications.

Related Podcast Episode: 

PYHP Episode 038 –  Do You Have a Low Free T3 Level? 

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If you have questions about your thyroid or any other hormone related issue, feel free to contact us.

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