There are two things that you can ask your doctor to consider that might help here:

1. Adjust your thyroid medication dose:
There has been considerable debate among endocrinologists about how to know the right dose of thyroid medication to give any individual patient. Recently it seems there is increasing agreement that the old guidelines were causing many patients to be under-treated. There is new evidence that the ideal target for people taking thyroid hormone replacement is to get your TSH (thyroid stimulating hormone) level somewhere between 0.5 and 2.0 mIU/L. (ref 1, 2). If your TSH is currently above 2.0, then you may not be getting an optimal level of thyroid hormone for your needs. Ask your doctor.

2. Balancing T4 and T3 levels:
In my clinical practice, I've found that about 20% of people taking regular thyroid hormones such as Synthroid, Levoxyl or Levothroid have normal TSH and T4 levels but still feel and act hypothyroid. When I've also checked their Free T3 levels, often I find them on the low side. This may be because they lack enough of the enzymes (deiodonase) to break the T4 molecule into two T3 molecules, which is the active form Many people don't know this, but it's actually the T3 hormone that gives your body the most "bang for it's buck" by driving up energy and metabolism.

Adding a very small dose of pure T3 (Cytomel 5 to 10 mcg) can often fix this problem immediately. I can't tell you how many times I've had people come back after just a few weeks and state they feel like a million bucks. It is important to realize that Cytomel is four times as potent as the T4 preparations. So once again, ASK YOUR DOCTOR is this is right for you, or seek the advice of an endocrinologist experienced in using T3 preparations. NEVER make changes in any of your prescription medications without the advice and direction of your treating physician.



ref 1:The National Academy of Clinical Biochemistry, part of the Academy of the American Association for Clinical Chemistry (AACC), Laboratory Medicine Practice Guidelines: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease , 2003

ref 2:"Which thyroid-stimulating hormone level should be sought in hypothyroid patients under L-thyroxine replacement therapy?"
Gursoy A, Ozduman Cin M, Kamel N, Gullu S. Int J Clin Pract. 2006 Jun;60(6):655-9.