Is it good to reduce the dosage of Levothyroxine for high TSH level?

Question

Hi doctor,

I had hypothyroidism for 24 years. I also have Sjogren's syndrome, but I do not have autoimmune thyroid problems. I was taking .150 mcg of Levothyroxine for 23 years. Six months ago, my doctor told me that I have hyperthyroidism and lowered my dosage to .137 mcg. I had increased fatigue. Again she reduced it to .125 mcg, and I experienced extreme fatigue, weight gain, muscle weakness, and joint pain. I had increased sleeping for 20 hours on weekends. But still, my doctor told me that my TSH is high, and she reduced the dosage of Levothyroxine. My free T4 is normal. I have never tested T3. I am worried regarding the TSH. I had a TSH of 0.05 mIU/mL before five months, 0.02 mIU/mL before three months and 0.1 mIU/mL before a month. Should I have to see an endocrinologist? Please help me.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through the attachment (attachment removed to protect patient identity). Your TSH (thyroid stimulating hormone) is in the lower normal range, just near the border. The dosage of Levothyroxine has to be reduced. Try to maintain TSH around 2 mIU/mL. Please test your FT4 (free thyroxine) levels. I believe that you experience fatigue due a secondary cause. Ask your doctor to get anemia workup done, get vitamin D, and calcium levels. Sjogren syndrome itself is a cause of fatigue, and get ESR (erythrocyte sedimentation rate) and CRP (c-reactive protein) done to check for disease activity. If your results have not shown any abnormalities, then it is better to consult a rheumatologist rather than seeing an endocrinologist in my opinion.

Is it good to reduce the dosage of Levothyroxine for high TSH level?

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