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    Old 02-12-2008, 07:30 PM   #1
    texana
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    Are treatments for hypothyroid risky?

    As I continue reading, it seems like many people experience difficulty getting treatment for their hypothyroid conditions.

    A question pressing on my mind is this: does something really bad happen if a person takes meds for hypothyroid and then it turns out later that the malady is something else? Why are doctors so reluctant to treat?

     
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    Old 02-12-2008, 10:45 PM   #2
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    Re: Are treatments for hypothyroid risky?

    I've been wondaering this too. I've seen a few studies suggesting osteoporosis maybe and a slight chance of swinging your thyroid the other way perhaps. But it seems like its mostly just conjecture. I'm really puzzled by this. Anyone else?

     
    Old 02-13-2008, 06:17 AM   #3
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    Re: Are treatments for hypothyroid risky?

    If your Ft3 and Ft4 levels are low then there is no harm with slow supplementation of thyroid hormones. It is a natural product of your body that is essential for your body to maintain itself and function.

    The issue most MDs have in my opinion is that they are sticking to old out dated information and that they really truly fear taking on your metabolic overseer. The thyroid hormones are essential from brain function, muscle maintenance, digestion, reproductive system.. the list goes on. If you give someone too much thyroid hormone you run the risk of hyperT which can burn out our systems quickly. Overall medicating a thyroid dysfunctional patient is a long term delicate balance and most MDs do not want to get involved. Think of patient load and such.. your talking about routine blood work, constant checking on levels, symptoms, and status of this person.. it is a lot to deal with. My favorite was my previous IM who basically was just shy of pulling out a cross and garlic when my bullying for a complete thyroid panel proved that I had Hashimoto's. His answer.. uh.. everything is still in normal range. Symptoms don't matter. You are at an increased rate for miscarriage and fetal birth defects. Let us wait and see what happens. Huh? We all know what happens with Hashi's.. your thyroid is methodically slaughtered and you need hormone replacement.

    Not medicating thyroid dysfunction is guaranteed to have long life repercussions. Medicating it is the only answer. Finding an MD willing to do the tests necessary to determine the issue and medicating you after the fact is the real challenge. Many studies are out there about the cost effectiveness of employing more than TSH testing after age X. Well for those of us out there under the age of 40 with issue this is a **** poor reason to suffer.

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    Last edited by mkgb; 02-13-2008 at 06:19 AM.

     
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    Old 02-13-2008, 12:57 PM   #4
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    Re: Are treatments for hypothyroid risky?

    Actually, the hormone is risky, especially if you are a bit older, and/or you have blood pressure issues.

    My tsh is kept supressed, and I'm a bit hyper, and my doctor monitors my blood pressure.

    Too much hormone can do damage, it could cause a stroke or heart attack if you had way more hormone than your body requires.

     
    Old 02-13-2008, 03:51 PM   #5
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    Re: Are treatments for hypothyroid risky?

    Quote:
    Originally Posted by Reece View Post
    ................

    Too much hormone can do damage, it could cause a stroke or heart attack if you had way more hormone than your body requires.
    Maybe so. On the other hand, I couldn't help overhearing in a Dr's hallway, my exam room door being open, the husband of an elderly woman, being admitted to a hospital whose heart was hesitating two seconds between beats, that she's often freezing in summer when he's burning up, so the Dr. either had never tested her thyroid function or maybe she was a new patient. When you're really hypo you may not even think to tell Drs things like you're cold, and once when a drug company lowered potency without notifying doctors, I had to take a 4X a day muscle relaxant. Then a visiting doctor noticed why and put me on a different brand. After that the gov't "tightened" all brands, I read somewhere online, but also lowered the bottom of the "range" to .2, not that labs are ever going to spend to update their forms. So many people can't get treated. It probably still says .5 on all the lab forms.

    Do you know anything about "frees"? I'm an elderly person and never have thought to have that included on my yearly test before but am going to next time. It's mentioned above by the person with Hashimoto's. I'll read that again and hope she posts again.

    In my lifetime of experience, many doctors just say flat out they only studied thyroid about 10 min in med school, that you just prescribe 1 gr of synthroid, and they're often not interested in learning any more, so one of the persons above is right about outdated info and methods, but if you do an online search, there are some doctors who write sensibly about this.

    I don't know if we can judge the situation from just one case, that elderly couple. Also don't know if it might be a myth, many of the 10-min doctors have believed, that too much medication causes heart attacks and the like.

    Doesn't it seem patients would notice if their eyes started bulging, and the other hyper symptoms would be uncomfortable so they would tell their doctor?

    Last edited by Eagle; 02-13-2008 at 03:57 PM.

     
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    Old 02-13-2008, 04:16 PM   #6
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    Re: Are treatments for hypothyroid risky?

    Your eyes wouldn't bulge from too much medication, that's from antibodies and a condition called graves which produces antibodies that attack the eyes, it's called thyroid eye disease, that makes the eyes bulge, and the thyroid overactive.

    Many people have much more success with osteopathic and holistic doctors here, if there's anyone you can find in your area, that would help. My doctor is pretty liberal with medication increases, as long as he tests your blood and checks blood pressure on a regular basis, but he's a regular endocronologist.

    I think Free T4 and free T3 tests measure the amount of those hormones running through your bloodstream in a different way than totals which are usually measured and less accurate.

     
    Old 02-14-2008, 02:56 PM   #7
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    Re: Are treatments for hypothyroid risky?

    So you're saying only if you have Graves, from chronic overmedicating or natural overactive thyroid will your eyes bulge. I didn't know that. Hm....

    BTW the elderly lady's heartbeat probably was just every one second, don't you think, rather than two, and maybe they were exaggerating a bit to make sure she'd get adequate timely attention.

    About alternative medicine, I have a doctor at the moment who's okay, but also I get the Wilson newsletter, and there aren't any Wilson's Syndrome doctors is this area, SE Michigan, Detroit to Ann Arbor.

    I once consulted an endocrinologist, but he was just proccupied with his own shortness problem, and I frankly didn't think he was any better than the ones boasting that they only studied thyroid 10 minutes and prescribed synthroid. So I never did hunt up another one. I'm getting along okay. Some general practitioners have a lot of common sense.

    So do you take a b.p. medication? There's a lisinopril that's supposed to protect kidneys when you're diabetic. From kidney failure, I hope. Thanks for the information.

     
    Old 02-14-2008, 04:42 PM   #8
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    Re: Are treatments for hypothyroid risky?

    Okay, I will take another bite here.

    Free T3 and T4 are a direct measure of active thyroid hormone levels. The accuracye is 5-2.5% depending on analytical method applied. Free T's are also not affected by your diet, medications, or artificial hormone supplements.

    Total Ts are affected by diet, birth control pills and certain other medications. In particular estrogen and progesterone supplements artificially inflat T3/4 levels. The error in the T3/4 analysis is also about 20%.. so I always fight for FTs.. that and taking birth controls makes my T3 and T4 results 30% higher.

    Now as to medicating a dysfunctional thyroid. Yes there are risks but the risks of untreated or under treated thyroid levels are bad. A simplified summary of the risks of staying hypoT are:

    Severe, prolonged hypothyroidism can lead to multiple abnormalities within any system of the body including heart (congestive heart failure), brain (dementia), and skin(leisions and open wounds due to extremely dry skin/hives). It is a fact that untreated hypothyroidism can cause heart disease, osteoporosis or thinning of the bones, decreased cognetive ability, and infertility in women. If left untreated for many years, severe hypothyroidism can eventually lead to death.

    Of interest to me at the age of 32 with the desire to have a second child is the following fact. Recent studies have shown that pregnant women with hypothyroidism have 4 times the risk of miscarriage in the second trimester compared to other women. If hypothyroidism in pregnancy is not treated appropriately, it can lead to mental retardation in the child. A 30% increase in suppressed cognetive development!

    Now when medication is applied you have to be careful. You have to start slow and test your blood levels every four - six weeks before increasing your medication. Also you should keep a symptom log where you evaluate your heart rate, blood pressure, temperature and any other physical symptoms you had been suffering from. This will allow you to gauge how your treatment is progressing and how close you are getting toward optimal levels.

    Yes there is a chance you will push your self hyperT at some point in the medication process. But if you are adjusting slowly and monitoring your physical state it will not be bad on you. If a person has had hypothyroidism for many years, the replacement of thyroid hormone may be started slowly and eventually increased to normal levels. Because the thyroid hormone medication is chemically identical to the body's thyroid hormone, side effects or allergic reactions to the medications are quite rare. Allergic responses if they occure are a result of a response to dyes or inert ingrediants. If too much thyroid hormone is given, the person may develop arrhythmias, or irregular heartbeats, and osteoporosis, or thinning of the bones. Routine checks and careful observation of your own symptoms will catch any push to a hyperT state quickly.

    You must be proactvie in your own care and thyroid health management. You can not trust you MDs to get the whole picture and understand what you are going through completely. You have to use them as a reference and know enough to guide yourself to medication optimization. If your MD doesn't want to work with you.. then find a new one. It is important that your MD sees you as a manager of your own thyroid health and works with your FT levels and symptoms to optimize you. If not you run the risk of being under or over treated out of a lack of thorough medical procedure.

    MG

    PS TED is not limited to Graves alone.. it can be caused by Hashi's and a few other rare AI conditions. My neuroopt****logist has determined that I have all the indicators given the increased spinal fluid pressure and optic nerve degradation.
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    Last edited by mkgb; 02-14-2008 at 04:45 PM.

     
    Old 02-14-2008, 05:01 PM   #9
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    Re: Are treatments for hypothyroid risky?

    The reason doctors are so reluctant to treat is that
    a.) they have no experience in the area of thyroid
    b.) they think you are making it up to get pills that will "make you lose weight." I had a dr. repeatedly tell me that synthroid will not help you lose weight.

    c.) The most likely solution - A good Dr. before treating something, will come up with concrete evidence that it is what it is. In this case - they do a full thyroid panel to determine the TSH (thyroid stimulating hormone), T4 and T3 levels. If they see something amiss in any of the levels - it is thyroid. If they are very normal - then it is not. Since thyroid is treated with a hormone that would have potentialy deadly consequenses in the case of misdiagnosis, a good dr. is very careful to not simply give out drugs. This is why treatments for hypothyroid aren't risky - if your dr. is a good one. I've been on synthroid for about 15 years - no side effects.

    You are right - it is very hard to get good treatment for hypothyroid. Thankfully I found a good dr.

    GrandmaV

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    Old 02-15-2008, 01:46 AM   #10
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    Re: Are treatments for hypothyroid risky?

    Quote:
    Originally Posted by ******** View Post

    ...........Yes there are risks, but the risks of untreated or under treated thyroid levels are bad. A simplified summary of the risks of staying hypoT are:

    Severe, prolonged hypothyroidism can lead to multiple abnormalities within any system of the body including heart (congestive heart failure), brain (dementia), and skin(leisions and open wounds due to extremely dry skin/hives). It is a fact that untreated hypothyroidism can cause heart disease, osteoporosis or thinning of the bones, decreased cognetive ability, and infertility in women. If left untreated for many years, severe hypothyroidism can eventually lead to death. .............

    If a person has had hypothyroidism for many years, the replacement of thyroid hormone may be started slowly and eventually increased to normal levels............. If too much thyroid hormone is given, the person may develop arrhythmias, or irregular heartbeats, and osteoporosis, or thinning of the bones. Routine checks and careful observation of your own symptoms will catch any push to a hyperT state quickly.

    ............. It is important that your MD sees you as a manager of your own thyroid health and works with your FT levels and symptoms to optimize you. If not you run the risk of being under or over treated out of a lack of thorough medical procedure.

    MG

    PS TED is not limited to Graves alone.. it can be caused by Hashi's and a few other rare AI conditions.

    My neuroopt****logist has determined that I have all the indicators given the increased spinal fluid pressure and optic nerve degradation.
    I've selected a few things from your post to ask for more clarification about, if you don't mind. What does "MG, PS TED" mean?

    You're saying low thyroid also causes eye damage? I have eye problems, due to long-term diabetes, frequently have laser sealing of extra blood vessels in eyes, proliferative retinopathy. Laser treatments caused cataracts of course, so I've had lens implants, no multi-focal option because they need to be able to get in there often. You mourn the loss of your near vision for a year or longer, not having been told in advance. Young surgeons say flip things like "People live OUT THERE", grand sweep of the arm, but some of us have always been readers, and we live much closer, feel we should have been asked which type we are. You never can get the perfect reading glasses. Mumble, mumble. You're saying some of this may have been due to thyroid problems as well as diabetes? You sound very knowledgeable. Thanks.

     
    Old 02-15-2008, 06:14 AM   #11
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    Re: Are treatments for hypothyroid risky?

    Quote:
    Originally Posted by Eagle View Post
    I've selected a few things from your post to ask for more clarification about, if you don't mind. What does "MG, PS TED" mean?
    P.S. = PS I was rushing it a bit.

    TED = Thyroid Eye Disease = an autoimmune eye condition that, while separate from thyroid disease, is often seen in conjunction with Graves' Disease. The condition, however, is seen in people with no other evidence of thyroid dysfunction, and occasionally in patients who have Hashimoto's Disease. Most thyroid patients, however, will not develop thyroid eye disease, and if so, only mildly so.

    I did not say TED was caused by hypoT, I did say in rare cases other autoimmune disorders in particular Hashimoto's or Psuedotumor Cerebri can cause TED. The bulging eyes tends to be dominant in Graves Disease (GD).. however the other effects of TED can be caused by other autoimmune attacks on the optic nerve, face and eye tissues in general. Smoking has an 8 fold increase in the likelihood of TED development! Smoking is not good for the eyes and my neuro-opthamologist(NO) recommends that no one smoke or live around smokers if they have any eye issues. I am a non-smoker and can not stand walking into the room next to a smoker.. but since it has been an interest with others of late I will ask my NO why when I see him in five months.

    My eye issue began with my first pregnancy. I was told they were hormonal migraines and would go away. They just got worse. My newest MD supports me in the finding that my first pregnancy trigger my latent Hashimoto's. The way the symptoms spiral out of control after that point can not be coincidence. I would loose the ability to see for days at a time. Not a good thing when you have a child to take care of and work to do. Luckily oft times it hit over a weekend so my husband could take up the slack. Before pregnancy my vision was 20-17.. perfect for up close and far away. Now my vision isn't too bad.. 20-40.. but my stigmatism is pretty bad. One good thing. Since starting medication.. I have not had a migraine cause complete vision loss. I still have the floaters and pressure headaches and migraines, but no more sheets of shiny white wavering nothingness for days on end.

    If you suspect issues I strongly recommend you go to a neuro-opthamologist. Let them no of your thyroid disorder and discuss your concern over your eyes. Luckily when my symptoms were hitting I had good MDs to treat the symptoms. My allergist gave me steroids to help with swelling, my ENT has me on some heavy duty decongestants. My Dermatologist gave me topical steroidal and antibiotic facial creams, and my NO gave me special eye drops. This was keeping me in check during periods of flare and I am grateful for it. As soon as symptoms began to occur I attacked the issue. I have nurses and MDs in my family and I know when something feels wrong.. so I ask and refuse to settle for it is just a phase or it will pass. I want facts, Why, How, Cause.. then treatment. My experimental nature settles for no less. It wasn't til after my Hashimoto's was officially identified that the Neuro-opthamologist suspected TED/Psuedotumor Cerebri as the source. My lumbar puncture results which I should get today or tomorrow should tell the tale. Protien levels elevated.. Hashi's is the culprit - TED. No excessive protien present, just elevated pressure.. Psuedotumor Cerebri. Either way it is aggravated by my thyroid state and I have one more I told you so for my Endo. She was so wrong with the your symptoms can not be due to your thyroid... Just goes to show you never make a statement like that instead say, "It is highly unlikely, but let us find out what is the source of the problem." I think more MDs should also have engineering degrees.. then maybe the would treat the source of the issues versus cover the symptoms with band aides.

    MG
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    Old 02-16-2008, 03:59 AM   #12
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    Thyroid Eye Disease

    Quote:
    Originally Posted by ******** View Post
    P.S. = PS I was rushing it a bit.

    TED = Thyroid Eye Disease = an autoimmune eye condition that, while separate from thyroid disease, is often seen in conjunction with Graves' Disease. The condition, however, is seen in people with no other evidence of thyroid dysfunction, and occasionally in patients who have Hashimoto's Disease. Most thyroid patients, however, will not develop thyroid eye disease, and if so, only mildly so. .............

    ......... my latent Hashimoto's. The way the symptoms spiral out of control after that point can not be coincidence. I would loose the ability to see for days at a time. Not a good thing when you have a child to take care of and work to do. Luckily oft times it hit over a weekend so my husband could take up the slack. Before pregnancy my vision was 20-17.. perfect for up close and far away. Now my vision isn't too bad.. 20-40.. but my stigmatism is pretty bad. One good thing. Since starting medication.. I have not had a migraine cause complete vision loss. I still have the floaters and pressure headaches and migraines, but no more sheets of shiny white wavering nothingness for days on end.

    If you suspect issues I strongly recommend you go to a neuro-opthamologist. Let them know of your thyroid disorder and discuss your concern over your eyes. Luckily when my symptoms were hitting I had good MDs to treat the symptoms.

    My allergist gave me steroids to help with swelling, my ENT has me on some heavy duty decongestants. My Dermatologist gave me topical steroidal and antibiotic facial creams, and my NO gave me special eye drops. This was keeping me in check during periods of flare and I am grateful for it. As soon as symptoms began to occur I attacked the issue. I have nurses and MDs in my family and I know when something feels wrong.. so I ask and refuse to settle for it is just a phase or it will pass. I want facts, Why, How, Cause.. then treatment. My experimental nature settles for no less. It wasn't til after my Hashimoto's was officially identified that the Neuro-opthamologist suspected TED/Psuedotumor Cerebri as the source. My lumbar puncture results which I should get today or tomorrow should tell the tale. Protien levels elevated.. Hashi's is the culprit - TED.

    No excessive protien present, just elevated pressure.. Psuedotumor Cerebri. Either way it is aggravated by my thyroid state and I have one more I told you so for my Endo. She was so wrong with the your symptoms can not be due to your thyroid... Just goes to show you never make a statement like that instead say, "It is highly unlikely, but let us find out what is the source of the problem." I think more MDs should also have engineering degrees.. then maybe the would treat the source of the issues versus cover the symptoms with band aides.

    MG
    This is very informative. Thanks. Goes to show you Endo's aren't always better than G.P.'s. My allergist also prescribes steroids even if you know from decades of experience you need an antibiotic, and I'm a bit wary of side effects of steroids, maybe years later. (Recently it turned out to be a good thing I had a diabetic foot infection and was given a much-needed antibiotic by the podiatrist which helped my lungs tremendously so I haven't had to return to the allergist.)

    One thing about opthalmologists, my Retina specialist sometimes uses a Kennalog injection into the eyeball for swelling, protecting me for about 2 yrs so far, each eye. I have frequent laser treatments to seal off proliferating rogue blood vessels, diabetic retinopathy. Had a flue shot in Nov., but a bit of upper respiratory now in mid-Feb., I"m treating with odorless garlic pills, rather than go to the GP and maybe spread something around or get something worse. That's probably what's causing some obstruction of vision in the inner corner of my worst eye, 20/80, often can't see the first letter of each line on eye chart. She said when I first found her that it was already too late for some of the damage, but at times it seems I've had improvement. Never even thought of possible thyroid involvement, will be having a new blood panel soon, including frees for the first time in my life, so that should tell if I have Hashi's, right? Would the very-busy Retina specialist know, if my foreign GP isn't up on all the thyroid details?

     
    Old 02-16-2008, 05:13 AM   #13
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    Re: Are treatments for hypothyroid risky?

    FTs will just tell you your active T4 and T3 blood concentrations within 2-5%. Versus the total Ts having a deviation of around 20%.

    To identify Hashimoto's you have to have your antibodies tested.

    Hashimoto's antibodies are TPOAb and TGAb. They are not 100% identifiers. TPOAb is a 90-95% positive identifier and TGAb is a 65-70% positive identifier. The only 100% identification measure is a biosy of the thyroid tissue. The tissue retrieved would shpw definite degradation from antibody attack. It wouldn't hurt to have a full thyroid panel pulled including antibodies.

    MG
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    Old 02-16-2008, 07:18 AM   #14
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    Antibodies to Detect Hashi's

    Okay, I"m going to print this out to take by the Dr's ofc to add it to my script for testing. Good thing I waited a while. Thanks.

     
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