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relationship between Free T4 levels and meds?

From: justhat - 8 years 7 weeks ago

Last week my rheumatologist called to let me know that my TSH was "very high" and there was "no discernible" circulating T4. In hindsight this makes perfect sense since over the last year stuff had just gotten worse and worse (I'd been blaming it all on Lupus) until a month ago my exhaustion was so bad that I couldn't stay awake while sitting at traffic lights. He gave me steroids, drew blood, and sent me home and then called a few days later with the thyroid results.

He sent out an Rx for levothyroxine at only 50 mcg. I know that it takes weeks for the thyroid to kick in and then it will need to be adjusted, but now that the steroids are fading, I feel like I'm going back into a deep sleep I just recently woke from (don't want to go back there!!!).

I know I need to talk with the rheumy about this, but at the same time it seems an awful low dose of replacement if my blood tests were that low.

Should I just be patient and trust that this fairly low dose of replacement will work or is it time to get myself to an endocrinologist and see if we should be more proactive. I generally like/trust my rheumatologist and realize that coming off the steroids is likely to make me more impatient than usual.

Answer soon, or I may be asleep again :-) Seriously, if anyone has some experience with the ratio between free T4 and levels of replacement thyroid, I'd be interested.

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