hypothyroid folks: timing of taking thyroid medication & late-night effort

[antimony]

To the OP, when you doc check your thyroid levels, does she/he look at both Free T4 and Free T3 or does she/he look only at TSH? To get a complete picture, I'd make sure you get your Frees checked. If T3 is low relative to T4, I'd discuss T3 replacement therapies with the doctor.

She's checked all my levels -- I seem to be OK converting T4 to T3, and the T4 is working great for me in general. It may be a case of having forgotten what normal tiredness feels like, IDK, since I was so exhausted for so long. My doc is fairly awesome with this stuff -- she caught it as soon as I started seeing her, and was all-for aggressively treating it even though I didn't think I had any symptoms. And she listened to me when I described how all the different dosages we tried felt, and with me pushing the dose up to get to a TSH of ~1.5 instead of ~2.5, whereas my previous doc said I couldn't be having any symptoms at ~4.5. (Which, at the time, I believed; I'd only had it tested because of a family history of thyroid issues. In retrospect, I was already suffering symptoms at that point.)

[indysteel]

She's checked all my levels -- I seem to be OK converting T4 to T3, and the T4 is working great for me in general. It may be a case of having forgotten what normal tiredness feels like, IDK, since I was so exhausted for so long. My doc is fairly awesome with this stuff -- she caught it as soon as I started seeing her, and was all-for aggressively treating it even though I didn't think I had any symptoms. And she listened to me when I described how all the different dosages we tried felt, and with me pushing the dose up to get to a TSH of ~1.5 instead of ~2.5, whereas my previous doc said I couldn't be having any symptoms at ~4.5. (Which, at the time, I believed; I'd only had it tested because of a family history of thyroid issues. In retrospect, I was already suffering symptoms at that point.)

That's great that you have a doc like that!!! I'm so glad for you, having struggled with finding a decent endo myself.

[indysteel]

Have you talked to your doc about how you feel come 11 pm? Is it possible that the fatigue you're feeling is caused by something else? Is it possible that you're overtraining? Not enough food or hydration?

I do know what you mean about forgetting what normal feels like? I felt that way most of last year as we tried to regulate my thyroid levels. It took over a year to get them back to normal and I'm not sure how long before that they were abnormal. Several years perhaps? I was mildly hypo for several years before becoming hyper, but I didn't know that at the time because none of my docs thought to tell me that my TSH was over 3 and sometimes over 4.

[antimony]

I finally talked to my doc -- it wasn't worth making a special appointment, so I waited for my next annual. She said it's not abnormal (though not everyone does) to feel a burst of energy about a half-hour after taking it, as the initial spike of levothyroxine starts to convert. Then it evens out. The tiredness is almost assuredly normal fatigue, now that I have gotten used to "normal" again, and I can push past it if I need to.

She said she thinks there's no problem at all doing whatever I want on 24+ hour events, so long as it mostly averages out. And if I want a boost at 3am, go ahead and take it early, and not to worry about taking it on an empty stomach then.