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Old 09-04-2008, 02:21 PM   #1
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Thought I got a good Dr!

I was so happy thought I found a good endo Dr, he seemed so efficient & I'm new at this. My TSH was 4.89, he ordered all the right tests & even an Iodine uptate test since I have a nodule in my thyroid. Started me on .25mcg of syntroid & after awhile I flet alot better. It has been 2wks now & I am so tired & yawning alot, getting headaches (which I never get) & hot flashes, my blood pressure has been climbing now it's 159/78, I always had great BP. I started calling his office yesterday & got his nurses voice mail, heard nothing. I called 2x's today & later on she called me & sd the messages are on his desk! I sd I can deal w/all the symptoms for awhile but not my BP raising like it is she sd she will put another note on his desk. It is now 5:20 so I doubt I'll hear from him & it really annoys me. Wondering now if I picked the right Dr.

 
Old 09-05-2008, 06:14 AM   #2
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Re: Thought I got a good Dr!

You may want to look into getting a Cardiologist on your side to work with you and your Endocrinologist in managing the side effects of medicating your thyroid condition. In many cases we may have to take a small amounts of a beta-blocker to manage any adverse side effects of the T4 supplementation. My BP goes down on thyroid medication.. but my blood chemistry is all screwed up.

What were your last Free T3/T4 results? 25 mcgs of synthroid is a very small dosage of synthroid. your MD should also test you for adrenal and pituitary dysfunction. I had a family friend that had went through menopause and went suffering from thyroid issues for years. When she started on her thyroid supplementation it kicked her reproductive system back on line for a while and she had to go through menopause a second time. This being said it might be worth a complete adrenal hormone profile. Long term untreated hypoT can cause the adrenals to shut down. Adrenals make your stress hormones/steriods Cortisol and Aldosterone. They also make progesterone, testosterone, estrogen, DHEA and much much more.

I wish you the best during this medication optimization phase.

MG
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Old 09-05-2008, 09:15 AM   #3
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Re: Thought I got a good Dr!

Well my nurse friend sd my BP isn't that bad, higher than usual but not bad. The Dr sd when I saw him after all tests the adrenal & pituitary were ok. I don't know what my T3 & T4 is will have to ask for copy. They finally called on the 3rd day, nurse sd the Dr told me to now cut the 25mc in half, is he kidding will be dust! He wants to see me Monday. Someone told me you don't get hot flashes w/thyroid med, is that true? Thanks

 
Old 09-05-2008, 09:24 AM   #4
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Re: Thought I got a good Dr!

I forgot to mention I am in my 60's & from what I heard they don't like to give too much.

 
Old 09-05-2008, 09:36 AM   #5
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Re: Thought I got a good Dr!

You can get flushed or have a flash due to circulation effects with thyroid medications. I can not say what this third persons idea of a hot flash is.. and thus can not state whether or not they are wrong or right.

The thyroid supplement can cause something like a hot flash that is the result of a sudden rush of T4 and T3 into your system. It is not a direct side effect of the thyroid medication.. but a result of the thyroid supplementation causing natural body functions to kick in. It is possible that thyroid medication will initially jump start your reproductive processes and cause many other strange things to happen. Your thyroid is your metabolic over seerer and regulator.. when it is dysfunctional (Hypothyroid) it begins to shut things down or slow them down. This allows for what little T4 and t3 you have to be dedicated to your essential systems like heart, lungs, brain, temperature control. As you get more hypothyroid.. even these systems begin to suffer. Now when the thyroid dysfunction is caught and you add your supplement. It can be like flipping a switch.. some are hyper sensitive to the meds and must take adjustments slow. The older you are the more likely you will have sensitivity issues to medication dosages.

SO let me think of a nice analogy.. AHAH! Think of your endocrine system as a room full of toddlers at nap time. Your toddlers have been sleeping and feel they need to sleep. Your endocrine system has been for all intensive purposes taking a nap.. well now you have added a T4 supplement. This is like flicking on the light, waking the toddlers from their nap EARLY and handing out candy. Your body and the toddlers are not used to such stimulation. What is going to happen? Well it will be a temporary holiday. Your toddlers are going to live large and climb the walls.. and then crash in a BIG way. Does this help?

You may need to take your T4 with food in the morning.. versus on an empty stomach.. this will cut the absorption by 40%. I know it can be difficult to cut the pills in half. After a few weeks you can go back to taking your pills on an empty stomach and see how you handle it. Like any change it will take 2-4 weeks for you body to adjust to your hormonal SUGAR (T4 supplement regime)! I would recommend you go it slow.. take 2 weeks with a light breakfast.. it will need to be the same breakfast every day for this to be a controlled trial.. Then see how you are feeling. If things are getting back in line you may begin to manifest hypoT symptoms again. At this time you can go back to the 25 mcgs on an empty stomach.. hold there for 2-4 weeks and get your Ft3 and Ft4 levels checked again. Now you should call and check with your MD on this plan of attack. They shouldn't have a problem with it.. but it is always best to cross check opinions and advice with a real medical professional that has access to you and your complete medical file.

Good luck and I hope things settle out quickly.
MG
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Last edited by mkgbrook; 09-05-2008 at 09:40 AM.

 
Old 09-05-2008, 09:53 AM   #6
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Re: Thought I got a good Dr!

FDA official data base side effects and information on Synthroid is packed full of goodies:

The following side effects occur since they may indicate an overdose or an allergic reaction:
Headache (severe) in children; skin rash or hives; flushing; chest pain; confusion; fast or irregular heartbeat; mood swings; muscle weakness; psychosis; restlessness (extreme); yellow eyes or skin; shortness of breath

Now these can be temporary and a result of medication adjustment and balancing. Recommendations are that you note any of these symptoms and the severity and talk to your MD about it. In particular for underactive thyroid patients they list the following symptoms to look out for:

Changes in appetite; changes in menstrual periods; diarrhea; fever; hand tremors; headache; increased sensitivity to heat; irritability; leg cramps; nervousness; sweating; trouble in sleeping; vomiting; weight loss.

It is noted that any thyroid medicine supplement usually takes several weeks to have a noticeable effect on your condition. Until it begins to work, you may experience fleeting changes in your symptoms. On average the period for your body to adjust is 4 weeks. As you get older this is going to take longer. On average 4-8 weeks. If after 4-8 weeks on a given dosage the following tell tale symptoms return, check with your doctor.. get more blood work and ask for a dosage increase:

Clumsiness; coldness; constipation; dry, puffy skin; listlessness; muscle aches; sleepiness; tiredness; weakness; weight gain

It is a trial and error process and we are individuals with different body chemistry. Other effects may occur depending on you and your body's interaction with the medication. If the dose of the medicine is not exactly right you are going to have side effects. These side effects will go away after your adjustment period if the dose is right for you.

MG
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Old 09-05-2008, 11:44 AM   #7
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Re: Thought I got a good Dr!

Mg, great analogy on the tods nap time! Gram, I'm 52, hypo/hashi's and only started with a tsh of 7.66 in Jan. Well, meds have not been my friend! levels have dropped way low, and its been every 6wk dose changes. I'm so--frustrated! been on 75mcg synthroid for 4wks and feel like death! no energy, horrid fatigue, never had this before meds! Waiting for a return call on my labs yesterday??? endo argues with me about the fatigue, saying it can't be the meds! well, we'll see what my levels are??? I feel its "adrenal issues" but endo disagrees, he ckd them at 5 pm last visit, dah, that's when I get energy late in the day! anyway, I'm ready to chuck these darn pills out the window! the only thing better is I fall asleep now, but still wake a few times during the night. The fatigue is very bothersome, and an "unexplained" high level of estradiol, no female parts left: hysterectomy, so... that leaves the breasts and adrenals??? also concerned about the biopsy on thyroid in April, showed "hurthle and folicular cells"??? don't know where the estrogen is coming from? also had biopsy on one breast for "microcalcifications" a yr ago, benign, but now worried having estrogen high. It is very frustrating with these doctors!!! not getting return calls, feeling like we're putting a burden on them, etc etc. All we need is answers and or some communication. Hang in there! this is a good place to "vent". hugs, cj
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Old 09-05-2008, 02:26 PM   #8
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Re: Thought I got a good Dr!

Wow you know alot thanks. I feel alot better today then I felt that one day but the Dr's office called & sd I should cut the 25mc in half (what is that sup to do) & see him Monday. I don't even see how I can cut it in half again it's so little to begin with.

 
Old 09-05-2008, 03:33 PM   #9
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Re: Thought I got a good Dr!

Kindspirit,

You need a complete adrenal profile run. Your adrenal glands produce DHEA, progesterone, estrogen/estrodoil, testosterone.. and all the other steriod stress managers like pregnenolone, cortisol, aldosterone.. and many other sub species. In hypoT's the synthesis chains to make cortisol and aldosterone can become damaged. This can result in estrogen dominance.. PCOS with out ovaries and many other issues. It sounds to me like yo umay have a lurking adrenal annoyance to deal with. I wouldn't be up on all this if I hadn't just been down this road with two MDs.

MG
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Old 09-05-2008, 03:42 PM   #10
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Re: Thought I got a good Dr!

It's funny you mention that, I had gone to a Chiro who also did alot of other testing, very smart man. He said I had adrenal burnout which I wasn't surprised at since I have had yrs of horrible stress & shocks that I thought I got thru. I told my reg MD & he laughed at me sd he's not a Dr! I told this endro mDr & he did testing but I'm not sure what I guess blood & sd my adrenals are fine. How are they sup to test for that?

 
Old 09-05-2008, 03:53 PM   #11
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Re: Thought I got a good Dr!

Adrenal testing is time sensitive. You need fasting blood work at 8 am.. cortisol and ACTH. Then you need a 24 rhythm method. I recommend the saliva test which can be used to get estrogen, testosterone, DHEA and more. You normal do the saliva test at 8 am, 12 pm, 5 pm, and 12 am. Then you also should have aldosterone, renin, progesterone and pregnenolone tested in a stimulation method.. IF you are wanting to test every facet of your adrenal. If there is an issue it will show up in the stimulation test or saliva rhythm test. A simple blood cortisol test at any time other than 8 am while fasting isn't going to give you valid results.

SIncerely,
MG
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Old 09-05-2008, 04:18 PM   #12
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Re: Thought I got a good Dr!

I had the cortisol blood test at 8am & 4pm. Nobody has ever given me the saliva test.

 
Old 09-10-2008, 05:32 AM   #13
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Re: Thought I got a good Dr!

Thanks for all good info. I'm not feeling too bad right now, like I had sd I have to be careful not to blame every little thing on the meds. The one thing I would like to know is I am having a hard time getting to sleep. I have always had this problem & took an herb to help but even that is not working now. What do you do about sleep issues?

 
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