Success with hypothyroidism?

You can have the TSH, Free T4 and Free T3 checked to assess levels, but TSH should be the level the thyroid medication is adjusted by.

I absolutely disagree with this. All levels should be taken into account, in particular the free T3 level.

Many people who are taking thyroid meds are on synthetic T4-only, and the body's TSH levels react differently to this. It's very common for TSH to be quite suppressed in those taking any thyroid meds; suppressed enough to be called "hyper" by uneducated doctors. If only the TSH is managed this missed a HUGE piece of the puzzle.

As well, many people with thyroid issues have difficulties converting T4 into T3; especially people who have had RAI or a thyroidectomy. Testing and dosing on TSH alone would be completely negligent. As an example, after my thyroidectomy my TSH was at 2.3....so "normal", right? My free T3 was below the bottom of the range, and I was competely symptomatic.

Dosing based on TSH alone also doesn't let people know whether they should be on a different med (synthetic T4 only, adding synthetic T3, or taking a natural/dessicated med).


Yes, TSH is a senstitive test. But that doesn't make it the RIGHT test to base dosage on.

As for the monitoring of your levels, would recommend antibody testing only with the initial diagnosis of the disease as this will help determine the type of thyroid disease. Once you have started thyroid replacement, it provides no benefit.

I disagree with this also. Antibody levels can be an indicator of whether your autoimmune issues are in check or not. It's also incredibly useful information for women in their childbearing years.

(make sure they are testing the Free T4 and Free T3 and not just T4 and T3 as these are protein bound hormones and this can effect levels as well)
as for the types of replacement most medications are T4 replacments (Synthroid, Levoxyl, Levothryoxine and Tirosent) as T4 is the primary hormone produced by the thyroid and it gets converted to T3 by the muscles. Armour thyroid/Nature Thryoid/compounded thyroid are obtained from desicated pig thyroid and provide T4 and T3.

Now this part I agree with - always make sure they're testing your free T's, as this is the amount not bound to carrier proteins and is available for your body to use.

Synthetic T4 only replacements like the ones listed above can be more difficult for the body to convert into usable T3, as they aren't bioidentical to your body's natural T4. As well, many people with hypothyroid (especially if due to RAI or thyroidectomy) have issues with this conversion process. These people generally do much better on the natural/dessicated thyroid meds, and somewhat better when synthetic T3 (like cytomel) is added.

Dessicated meds also contain T2 and T1, and the impact of these is just starting to be researched. The T4 is also identical to your natural T4 hormone and is more easily converted into T3.

Make sure you keep an open line of communication with your provider as to your symptoms (fatigue, hair loss, sleep disorders, memory issues, swelling to feet, tremors, numbness and tingling to the hands and feet, issues with concentration, consitpation/diarrhea, increased irritabiltiy).
Have your levels checked about every 3 months while you are working on losing weight as the lean muscle mass may effect your hormone levels.

Agree with this as well, that symptoms are an important part of the diagnostic process and in monitoring your own levels.

Would also encourage people to get their Vit D, iron, ferritin, and selenium levels checked as these are either part of the process in converting T4->T3, or are part of T3 expression at the cellular level. Vit D in particular is generally low in North America, and research has shown success with Vit D levels in the high-normal range (60-100).