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  • TSH 14.50, I'd say that's hypo

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    Old 06-15-2013, 08:32 PM   #1
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    TSH 14.50, I'd say that's hypo

    I got a thyroid panel back in March and my TSH was "only" 5.8 and my doctor said it wasn't abnormal enough to treat. I got re-tested recently and my TSH had shot up to 14.50, which was enough to convince my doctor that it's time to discuss medication options.

    The doctor who ordered the tests was not an endocrinologist or even my GP - she's an OB/GYN, so I don't think she'd be prescribing me the actual medication. But is there anything I should bring up to her when I go see her again, or anything I should bring up to a specialist if I get a referral to one?

    Two big questions I'd like to ask about, I'm not sure if folks here would be able to answer: How long would you say it takes (on average) for the meds to kick in? I understand that it might differ between individual people. Also, while I figure thyroid pills would not be some kind of magic weight loss pill, would they at least make it a little easier to lose weight via diet and exercise?

     
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    Old 06-15-2013, 10:30 PM   #2
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    Re: TSH 14.50, I'd say that's hypo

    You definitely need treatment, and the sooner you start, the better. Some people actually feel a difference beginning within 3-5 days, other times it takes a few weeks, depending on what dose you start at and have to build up to. It will definitely make it easier to lose weight once you are on an adequate dose. The goal should be to feel back to normal and have your TSH down to around 1.0-1.5. That would be ideal. It's a shame treatment wasn't started when TSH was 5.8, but at least you know now it will be soon.

     
    Old 06-16-2013, 01:37 PM   #3
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    Re: TSH 14.50, I'd say that's hypo

    Would it be a big problem if I had to quit taking whatever medication I am prescribed? The issue is I'm going to lose my insurance in August (I'm on my parents' insurance while a student and/or until I'm 26), I have no job and whatever piddly amount of money I can get via other means will be going toward student loans. My lenders demand more money for a monthly payment than I could ever make in a month and they will absolutely not work with me.

    I don't know if I'll even be able to afford generic pills, nor will I be able to afford annual checkups and blood tests to see if I need a dose change. Without insurance, it would just be too much money. So I wonder if I should even bother taking it when I'm going to have to go off it shortly anyway. I won't even be able to take it long enough to feel better. I'm sure brand-name thyroid meds cost quite a bit sans insurance.

    Ugh, I could not have gotten sick at a worse time. Of course I have to develop something that requires lifelong medication right before I'm about to lose my insurance. I might just tell my doctor I don't even want to take any meds because I'll have to quit taking them anyway. I don't have a lot of faith in my ability to find a job, so I am not expecting any sort of reliable income anytime soon. I hear Walmart has cheap generic thyroid drugs, but I don't know if "cheap" is with or without insurance. I don't even know if the Walmart where I live even has a pharmacy, and doctors at the local hospital are pricks. They'll lie and say there is no generic version of something when there actually is (like them telling me no generic version of Ortho Tri Cyclen Lo exists when it does), or they'll give you the generic brand when you ask for a specific medication (asking for Biaxin for a sinus infection and being given the generic one, which did nothing at all for me).

     
    Old 06-16-2013, 06:47 PM   #4
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    Re: TSH 14.50, I'd say that's hypo

    I have a couple of thoughts for you.

    One is to try and get any $$$ diagnostic tests out of the way before your insurance dries up. Note however Obamacare kicks in next year, which cross fingers may end some of the non-sense we've had to put up with, specifically preexisting conditions.

    Two tests you can get are a thyroid ultrasound, and thyroid antibody panel lab test. Hopefully those will just show evidence of standard hashimoto's disease.

    Since cost is an issue, start with a generic brand of thyroid meds and stay with it. Meaning don't start with a branded version when you are on insurance and then switch to a generic, you'll have to reset your dose if you do that, which means feeling crappy and having to pay $$$ for more labs.

    With a generic the cost is likely less than $30/month, you should be able to swing that. The other way to save $$$ is via lab tests. Lab tests done in a hospital tend to be very expensive. You can save quite a bit shopping around. If you have to pay out of pocket, some labs give very steep discounts if you pay cash.

    Good Luck.

    PS: I'm old but I was first looking for work in 1983 during the big recession. I had a very hard time finding work and felt really down on myself. Didn't help that my parents didn't understand really why I was having trouble. Things are so much worse today than back then. That doesn't sound very uplifting, but remember this hardship isn't really about you.

     
    Old 06-16-2013, 07:47 PM   #5
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    Re: TSH 14.50, I'd say that's hypo

    If you get a generic like levothyroxine, you can also save by ordering a 90 day supply, which will last a little longer than your insurance. Copays are less per month usually than if you get 3 30day Rx filled. Is there some reason you are feeling so doubtful about getting a job? You know, hypothryoidism makes some people depressed, another reason to stay on treatment. I hope this works out for you. Any chance your parents could help you out for a bit?

     
    Old 06-16-2013, 08:28 PM   #6
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    Re: TSH 14.50, I'd say that's hypo

    @ladybud, yes. Two useless degrees (one of which is a master's), very little experience in my field, unreliable transportation (so I can't work out of town or doing anything involving travel) and I've had one real job my whole life, which I was fired from after only two months. If a 26-year-old walked into my business with that kind of work history, I'd be putting their application and resume right in the trash. I try, but no one is willing to give me a chance. At best I could get a minimum wage job, but very doubtful with that master's degree.

    I live with my mother, but I want to get out as soon as possible. She's a control freak and it makes me nuts to have to stay here under the same roof. But between having no job, no money, and no car of my own, I don't see myself being able to leave any time soon.

    I will definitely ask for generic drugs, assuming of course the doctor(s) I see are willing to prescribe them. As said before, sometimes they will lie about the existence of generics and I don't know if any of the local pharmacies will prescribe a generic instead of a brand name.

    I've also heard you can order blood tests online, but I'm not sure how exactly you go about getting the blood out of your body in order to send it away.

     
    Old 06-16-2013, 08:54 PM   #7
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    Re: TSH 14.50, I'd say that's hypo

    As for generic drugs, you might just go to your local pharmacist and ask if you can substitute generic synthroid if the doctor prescribes a brand name. In your world nothing like this has ever come up, in a pharmacists world this happens all the time. So he should be able to tell you want you can do.

    For blood tests, usually the doctor will give you an order on a piece of paper, you can take that anywhere. You might try planned parenthood. They may be able handle that for you, or will know who can do it for cheap.

     
    Old 06-17-2013, 08:50 AM   #8
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    Re: TSH 14.50, I'd say that's hypo

    You may need to take an entry level job for awhile just to establish a work history. I'd be picky to get one with health insurance that will relate to your eventual career. Many volunteer opportunities lead to jobs when they get to know and like you. It would get you out of house and away from Mom! Do you have public transportation nearby until you can get a car? How about a bicycle? It is frustrating to be denied jobs because you are "overqualified". I would just omit the masters degree on select applications to avoid that problem. Good luck. You have some obstacles, but not impossible ones.

     
    Old 06-17-2013, 11:43 PM   #9
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    Re: TSH 14.50, I'd say that's hypo

    I'm not going to be terribly picky about what kind of job I have, though I would probably do my best to avoid waitressing if possible. This is for a few reasons, like how I would be losing money when I don't get tips, I know the first person who stiffed me on a tip I would probably follow them to their house and slash their tires or otherwise make them pay because I have a short fuse when people mess with me. And thirdly...I have a huge butt and I don't think I can squeeze it in between tables without bashing people with trays.

    There's not much in terms of public transportation here besides taxis, and to get from where I live to just downtown would be about $10 one way. No buses or subways - I live in a small town. I don't have a bicycle and am not sure how long one would last since I tihink my mother threw away the one I bought a few years ago, then claimed someone stole it. She feels that everyone will try to run me over if I ride a bike.

    I worry about leaving the master's degree off my resume only because I don't want to have to try and explain what I was doing for those three years. It probably won't sound good if I say I was looking for work and found absolutely nothing. The worst part is so many employers around here demand that applicants have YEARS of experience. Would you believe housecleaners have to have 10 years of experience to just apply? It's insane. The only places I know of that are hiring are local fast food places, and their turnover rates are horrible...which is why they are hiring every single week.

    There's just nothing where I live, and I can't afford to move. I'm just kind of stuck. Hmm, maybe I should make a job topic in the general discussion area since this has nothing to do with my thyroid.

     
    Old 06-18-2013, 06:32 PM   #10
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    Re: TSH 14.50, I'd say that's hypo

    Whoohoo, got my pills! My doctor started me on a low dose of generic Synthroid. Just 25 mg, and I am to return in about a month for another blood test (while I still have insurance) to see how my TSH is doing and how much my dose needs to be adjusted.

    So here's hoping. I don't know what she considers to be an ideal thyroid hormone level, whether it's nearer to 1.0 or if she just wants to get my levels within a "normal" range...like if it goes down to 5.0, she won't up the dose.

     
    Old 06-18-2013, 07:12 PM   #11
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    Re: TSH 14.50, I'd say that's hypo

    I think with women the main worry doctors have osteoporosis. Too much thyroid meds, the bones lose calcium. Less I misremember you are 27, so that's less of a worry.

    A TSH of 5.0 is 2 sigma from the median, ideally the doctor should push your TSH towards the median with relief of symptoms as the actual goal. So really 0.5-2 or some such.

     
    Old 06-23-2013, 12:38 AM   #12
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    Re: TSH 14.50, I'd say that's hypo

    I don't know how ideal it is for a nurse practitioner to be prescribing thyroid meds, so I don't know if my doctor will do the ideal thing and get my TSH toward the low end of normal or just so it's within a normal range. After all, this is the same woman who felt my thyroid wasn't abnormal enough to treat when my TSH was 5.8. I don't know if she'd even be willing to increase the dosage if I said I wasn't feeling better but my TSH was at, say, 5.0.

    From what I'm seeing from other folks on here, 25 mg isn't going to make much of a difference and that I probably should have been on a starting dose of 50 mg instead. I'm guessing my doctor will just increase my dosage by 25 mg until my TSH goes below 5 without regard to how I feel. I told her I've been exhausted for the last five years and she kind of blew it off as school stress (even though I was out of school for some time in that five years).

    But I won't be able to afford a specialist by August, so if need be, I will increase my dosage on my own if my current doctor refuses to. Will it cause any issues if, say, I took double the prescribed dose and ran out of pills halfway through the month? I assume I would just feel like garbage any my symptoms would return when I had no more pills to take, but I mean would it cause me any harm for my thyroid if I'm two weeks on pills and two weeks off?

    I'm not saying I'm doing that right now. But I'm just wondering in the event I need to take a bit more control over my meds if my doctor refuses to do so.

     
    Old 06-23-2013, 12:47 AM   #13
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    Re: TSH 14.50, I'd say that's hypo

    As your dose increases, doubling it on your own could be dangerous, as when you get close to being at your goal, tiny increments in adjustment are needed. So try to work with your NP in getting your TSH well below 5.0 and emphasize how you feel rather than the numbers. It is appropriate for an NP to treat hypothyroidism, but as with Drs., some are more knowlegeable and better at it than others.

     
    Old 06-26-2013, 10:22 AM   #14
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    Re: TSH 14.50, I'd say that's hypo

    If I were you I would start on NDT. Most people don't feel 100% back to normal on t4 like levo or synthroid. I personally can't stand synthroid. I felt horrible on it. It wasn't until I discovered NDT where I started feelign better. I just wish I started with either t3 only or NDT. My .02

     
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