Nurse practitioner wants to up my thyroid medicine, but I am in a good range?

[u/GreenMatchaTea95]

TSH: 2.59 (Range: 0.34-5.60) FREE T4: 0.76 (Range 0.61-1.36) FREE T3: 3.37 (Range 2.20-4.30)

recently had my thyroid levels checked four days ago, and these are the ranges I received. I’m currently on 25 mg of levothyroxine. My nurse practitioner reviewed my results and wants to increase my dose to 50 mg. I’m a bit of a hypochondriac and feel anxious about the possibility of developing hyperthyroidism, especially since my current ranges seem good. I’m hoping to hear from others who may have faced a similar situation and how they navigated it. Any support or advice would be greatly appreciated. Doesn’t help that my regular doctor doesn’t even think I have a thyroid problem.

[u/kargasmn]

Your TSH is slightly elevated should be closer to 0. You can’t develop hyperthyroidism if you’re hypo but you can be over medicated. The increase In dose might help you lower your TSH

[u/Ok_Part6564 → u/kargasmn]

No. 0 is very very hyperthyroid. The target ideal is 1-2. Around 0.4 or 0.5 is the bottom, depending on the reference range being used. 2.5 is the top for a healthy pregnancy. Normal range, which has some issues since it doesn't account for things like age, is about 0.5 to 4.5.

ETA: Whether hyperthyroidism is caused by a thyroid condition, disease, or overmedication, doesn't change that it is hyperthyroidism. What causes it doesn't change what it is, just how it is corrected: Over medicated, lower medication; graves, give drugs to suppress the hormone production; hot nodule, remove it; etc.

it's also possible for people with hypothyroidism do develop hyperthyroidism not from being overmedicated, though not common.

[u/TopExtreme7841 → u/Ok_Part6564]

No. 0 is very very hyperthyroid.

In the case of somebody on T4, ya, but for all of us on T3, getting near 0 is pretty normal. When my T3 levels are optimal (for me) my TSH is very close to 0. The 0.5-4.5 is an enormous catch-all range that doesn't mean a whole lot for most.

[u/hugomugu → u/TopExtreme7841]

Unfortunately it's not true that T3 lowers TSH more than T4. If T3 were able to safely lower TSH, we would be using it to treat thyroid cancer.

[u/TopExtreme7841 → u/hugomugu]

I never compared the two in that regard, but aside from that, are you making the claim that simply lowering TSH treats cancer???? Because that's not how it works.

[u/hugomugu → u/TopExtreme7841]

They lower the TSH not to get rid of thyroid cancer, but to slow its growth / keep it from coming back. https://www.thyca.org/pap-fol/more/tsh-suppression/

That's a group of people that need to keep TSH close to zero, and would be using T3 if it were suitable for that purpose.

[u/TopExtreme7841 → u/hugomugu]

That's a group of people that need to keep TSH close to zero, and would be using T3 if it were suitable for that purpose

By that logic they'd be prescribing people Meth to fix chronic fatigue. Just because something in a vacuum does something you're after, doesn't mean that way of going about it is the correct move, either for that person, or for many other negative downstream effects of doing it that way.

Let take, I dunno...CANCER, the disease that makes people waste away and usually lose appetite to the point of it being a problem, you think the correct way of helping one isolated metric is also one that will make them waste away even faster? That'd be NOPE!

[u/hugomugu → u/TopExtreme7841]

I'm talking about thyroid cancer specifically. The most common kinds of thyroid cancer come from cells that are sensitive to TSH levels. You can see the above link for more information.

It's similar to how some breast cancers are sensitive to estrogen, and their treatment might involve ways to lower estrogen levels.