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Old 05-16-2012, 06:24 AM   #1
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Synthroid/Thyroid Advice

I realize a lot of opinions have been expressed on this website regarding Synthroid, some of them contradictory, and so, more than anything, I was hoping to get advice on who to see to find out more.

Quick Background: Diagnosed Hypo six or so months ago; put on 50mcg Synthroid in Jan; in Apr., upped to 75mcg Synthroid. I had zero Hypo symptoms before the diagnosis. The TSH numbers simply appeared off in two physicals that I had as part of my routine care at my primary care doc. Now that I'm on Synthroid, I'm experiencing several of the often-complained about effects: severe brain fog, fatigue, hair loss and to add one to the list, very bad acid reflux/sensation of something caught in throat.

I realize that losing thyroid functionality is bad, but why take this drug (especially if it's a low dose) when the side effects are terribly and I was 100% symptom-free before. Should I stop the drug for now and monitor my body's reaction? I have a hard time taking a pill every day and suffering at my age (27, male) when I was perfectly fine before.

Lastly, and I guess the main point of my post, is who should I go see? My primary care doc goes purely by numbers and can't seem to answer any specific questions. Should I go to an endocrinologist? It appears most in my area (metro Atlanta, GA) don't take insurance. Should I try a different primary care doc?

Sorry for the long post and thanks for anyone's time who's kind enough to respond. I could really use some help here... was young and healthy before this situation.

Sidenote: I've taken Propecia (and it's been relatively successful) for hair loss since about 2008.

-MG

 
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Old 05-16-2012, 07:34 AM   #2
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Re: Synthroid/Thyroid Advice

Welcome!

Sorry for the reason you're here but, glad you found us.

I take it that your TSH result was on the high side and your doctor started you on meds?

While you might not have had any symptoms, hypothyroidism causes a lot of "behind-the-scene" types of things such as elevated cholesterol, glucose, heart function abnormalities and more.

What you are experiencing are not side effects per se but, the effects of either too high thyroid hormone levels, too-low thyroid hormone levels or moving thyroid hormone levels.

Things don't start to even out until we are nearing our optimal levels and full symptom elimination doesn't happen until we've been stable at our optimal levels.

For most of us, optimal levels means FreeT4/T3 in the upper half/upper third of the range and sometimes even higher.

Do you have some lab results to share? We can help you interpret them and confirm whether or not your GP has been managing you properly.

Quite frankly, most endos have no idea how to properly treat thyroid disease but, there is always that exception.

After being "cared" for by 3 clueless endos, I found a thyroid-savvy doctor in the form of an internist.

The only way to know if your care is appropriate would be to look at your labs...and, again, I hope your doctor has been looking at your actual thyroid hormone levels - FreeT4 and FreeT3 and not just pituitary hormone TSH.
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Old 05-16-2012, 08:38 AM   #3
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Re: Synthroid/Thyroid Advice

Glad I found the site as well - thanks so much for the prompt response.

So, I'm sure that the doc only tested for TSH levels (not the T4/T3) and these were the results (don't have exact dates, sorry, but just the month):

11/2010: 5.85
2/2011: 4.81
7/2011: 5.52
11/2011: 2.93
4/2012: 2.64

I started on the Synthroid around the Nov. labs date.

I realize that there can be "behind-the-scene" problems and certianly worry about those as well, but at present, I'm having a much more difficult time understanding and deciding what to do about the coinciding effects (whether they're "side" or not) of hair loss, feeling super out of it and terrible acid reflux (which can't be good for the throat long-term). Are their alternative drugs? Obviously, I don't want to ignore a thyroid problem if it's there, but these effects from what seems to be out-of-the-blue right around when I started taking the higher dosage are really getting me down.

To the extent you have time Sammy, could you expand a little bit on the endos and doctor? What made the endos clueless in your eyes, and what makes a thyroid-savvy doctor? I just know zero about all this thyroid-related info. and am at the mercy of anyone who claims to be knowledgable on the subject at this point. Intuitively, seeing an endo makes a ton of sense in my mind, but I don't want to spend a ton of $ for no results either. Would you recommend seeing a 2nd general care doctor first?

Thanks again very much!


Quote:
Originally Posted by sammy64 View Post
Welcome!

Sorry for the reason you're here but, glad you found us.

I take it that your TSH result was on the high side and your doctor started you on meds?

While you might not have had any symptoms, hypothyroidism causes a lot of "behind-the-scene" types of things such as elevated cholesterol, glucose, heart function abnormalities and more.

What you are experiencing are not side effects per se but, the effects of either too high thyroid hormone levels, too-low thyroid hormone levels or moving thyroid hormone levels.

Things don't start to even out until we are nearing our optimal levels and full symptom elimination doesn't happen until we've been stable at our optimal levels.

For most of us, optimal levels means FreeT4/T3 in the upper half/upper third of the range and sometimes even higher.

Do you have some lab results to share? We can help you interpret them and confirm whether or not your GP has been managing you properly.

Quite frankly, most endos have no idea how to properly treat thyroid disease but, there is always that exception.

After being "cared" for by 3 clueless endos, I found a thyroid-savvy doctor in the form of an internist.

The only way to know if your care is appropriate would be to look at your labs...and, again, I hope your doctor has been looking at your actual thyroid hormone levels - FreeT4 and FreeT3 and not just pituitary hormone TSH.

 
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Old 05-16-2012, 12:01 PM   #4
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Re: Synthroid/Thyroid Advice

OK...let's start with your TSH results. All of them indicated hypothyroidism. Reason being: healthy people have TSH 1.0 - 1.5.

The symptoms that you've shared with us can all be symptoms of hypothyroidism. Basically, we can only treat our symptoms until our levels are optimized - then, any symptom being caused by hypothyroidism will slowly dissipate.

The problem with most doctors is the fact that they focus on TSH - they were taught in medical school that TSH is the gold standard for diagnosis and treatment. Doctors who have kept up with things know that research since then has shown that the TSH is horribly inadequate and only the FreeT4 and FreeT3 levels can confirm thyroid status.

Endos are usually the worst - yes, thyroid disease *should* fall within their category of care but, most of them haven't kept up with things.

"Whole-body" doctors (such as a DO, internist, alternative MD and some GP's) tend to understand thyroid function better.
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Old 05-16-2012, 12:08 PM   #5
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Re: Synthroid/Thyroid Advice

I realized I missed a few questions.

There are no true alternative "drugs" since Synthroid isn't a drug per se - it's hormone.

Now, there are different brands of hormone and different formulations.

Most people do well on meds like Synthroid (T4 only)

If your doctor started you on 50mcg in January and didn't increase you until April, he isn't dosing you properly.

Thyroid-savvy doctors have the patient get labs 6 wks. after any dose adjustment (this is the amount of time it takes the body to stabilize after starting meds/dose adjusmtments).

Then, dose increases are made every 6 wks. until the patient's FreeT4/T3 levels are similar to those that healthy people have - upper half/upper third of the range.

By keeping a patient on a too-low dose for too long, all this does is make symptoms worse and delay the healing process.

I suggest you call local pharmacists and get contact info for doctors that Rx Armour and/or Cytomel. Thyroid-savvy doctors tend to prescribe these two types of hormone replacement. Don't be discouraged if you don't get a positive response with your first call. People have had success with this approach in their quest for a thyroid-savvy doctor.

You can also search the top thyroid doctors site for doctors in your area.
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Old 05-17-2012, 07:49 AM   #6
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Re: Synthroid/Thyroid Advice

Thanks again for sharing this Sammy.

Not to beat a dead horse here, but I'm guessing that you think the onset of physical symptoms with the timing of starting the higher dose (75mcg) of Synthroid is pure coincidence??? I want to believe that getting the dosage right will be the cure of what I'm feeling, but given the meds seemed to trigger everything, I'm unfortunately skeptical. Anyhow, thanks for the insight.

I plan to see someone else and get a 2nd opinion with the lab results that I have, although it sounds like I need to go get fresh labwork done and have the t3/t4 results included as well, correct? If, for the sake of conversation, my t3/t4 levels were fine but my TSH is where it is (2.6-ish), would a "thyroid-savvy" doc put me on anything with 0 phyiscal symptoms do you think?

Again, thanks as always.

 
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Old 05-17-2012, 08:52 AM   #7
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Re: Synthroid/Thyroid Advice

I'm still very new and pretty clueless, so an experienced board member will have to clarify. Is the "something stuck in the throat" sensation generally from a nodule? Or does that happen just with hypo-T?

 
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Old 05-17-2012, 10:54 AM   #8
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Re: Synthroid/Thyroid Advice

Quote:
Originally Posted by MGAatl View Post
Not to beat a dead horse here, but I'm guessing that you think the onset of physical symptoms with the timing of starting the higher dose (75mcg) of Synthroid is pure coincidence???
I wouldn't say coincidence, I would say it's expected since your actual thyroid hormone levels are most likely still too low for your body's needs.

Quote:
Originally Posted by MGAatl View Post
it sounds like I need to go get fresh labwork done and have the t3/t4 results included as well, correct?
You need to get the FreeT4 and FreeT3 tests done (not any other type of T4 or T3 test) - the free hormone measurements are the only accurate indicators of thyroid function.


Quote:
Originally Posted by MGAatl View Post
If, for the sake of conversation, my t3/t4 levels were fine but my TSH is where it is (2.6-ish), would a "thyroid-savvy" doc put me on anything with 0 phyiscal symptoms do you think?
"Fine" FreeT4/T3 levels can mean any level within the normal range to a less-than-thyroid-savvy doctor.

Most healthy people have FreeT4/T3 levels in the upper half/upper third of the range so, if either of your levels is below lab median, a thyroid-savvy doctor would start you on appropriate thyroid hormone replacement.

(while I know there are many possible causes of hair loss, hypothyroidism is definitely one of them)
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Last edited by sammy64; 05-17-2012 at 11:01 AM.

 
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Old 05-17-2012, 10:56 AM   #9
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Re: Synthroid/Thyroid Advice

On a side note - if you haven't had antibody testing thus far, I suggest you ask to be tested for the various types of antibodies that can cause hypothyroidism. If you test positive for ANY of the antibodies, continuing with treatment now will only benefit you since the antibodies affect thyroid function (in a negative way)

Here's the tests you'd want:

TPOab (thyroid peroxidase antibody)
TGab (thyroglobulin antibody)
TRab (TSH receptor antibody)
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Last edited by sammy64; 05-17-2012 at 11:02 AM.

 
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