@coz 506 wrote:

As Dr Mariano has mentioned he looks for the following for thyroid hormones;

TSH <= 1.0
Free T3 between 3.3 to 3.9
Total T4 between 8-12

If someones results are not quite withing range for eg;

TSH – 1.5
Free T3 – 3
Total T4 – 6.2

Is it possible to take just enough Levothyroxine to get the levels into range, without supressing your natural thyroid ? Or is it usually necessary to take large amounts to supress and replace your natural thyroid production ?

If possible to just supplement what sort of doses would be a starting point ? And what about to suppress and replace ?

My initial goal with thyroid treatment using Levothyroxine is to increase Total T4 to greater than 8, while watching Free T3 to avoid raising it too high (which can then cause a person to experience hyperthyroid symptoms).

Thyroid replacement at doses necessary to suppress and replace natural thyroid production usually is necessary. Otherwise, one is at a standstill, where replacement results in equivalent reduction in thyroid hormone production, thus one has no increase in thyroid hormone levels. Worse, one can have more reduction in thyroid hormone production than the replacement dose, resulting in a lower thyroid hormone level with treatment than without.

For example, treatment with Armour Thyroid doses below 45 mg usually results in less thyroid hormone overall than before. This is why I usually start at 60 mg, unless circumstances are different.

With Levothyroxine, starting dose depends on the age of a person – and size – which determines the volume of distribution of thyroid hormone. An adult large person can usually start with a larger dose, such as 100 mcg. A smaller or younger person may not.

The starting dose will depend on the practitioner’s experience. There is usually little wrong with starting with a low dose of Levothyroxine and going upwards since it usually doesn’t result in less thyroid hormone in the balance (as opposed to Armour Thyroid), then tritrating the dose upwards over time to get to the break even point where total thyroid hormone is greater with treatment than without treatment.

I try many thing but the best way is tio increase T4 with some T3, my brain prefer high normal T4, many Dr Marianco explain why

I have asked my Dr. to give me a low dose of Synthroid to see if I feel better but he feels because my TSH is below normal I am on too much armour. I am just tired of beating my head agenst the wall with him. I just got out of the hosp. from having bypass heart sugary. My new Heart Dr. was an Endo before becoming a heart Dr.

He is up on my problems being Hypopituitary with low hormones. I am going to see if he feels my Thyroid levels could use some help. My family Dr. told me to lower my armour but the last time I seen my Heart Dr. he said TSH is not a good mesure for dosing people on Armour don’t lower my dose of Armour.