Hypothyroidism

[Sarah147]

Hello,

I've got a related thread over at: (18+ ages board)

[url="http://www.phatmass.com/phorum/index.php?showtopic=113926"]http://www.phatmass....howtopic=113926[/url] [url="http://www.phatmass.com/phorum/index.php?showtopic=113926"]here[/url]



Did y'all have a tough time getting the diagnosis and good treatment?


I'm having a tough time. I've been sumptomatic for years and years. My TSH is often over or near 3.0; Free T3 and Free T4 in the bottom half of the range. According to the AACE, normal TSH is .3-3.0, but I haven't met an up to date doc yet. Dr. Dommisse likes TSH 0.1-1.0 and Free T3 and Free T4 in the upper third of the range.

I'm hoping to find a good doc and get a trial of medicine. And hopefully if that works, get a diagnosis and treatment.

Did y'all have a tough time getting dessicated thyroid and what about T3 medicine?


God bless you.

Edited July 29, 2011 by JoyfulLife

[CatherineM]

I didn't have any trouble getting used to the medicine. It's cheap which is a plus. My thyroid was damaged by having the blood cut off to the artery that supplies it.

[Skinzo]

Sheesh, do I know about this mess! I spent five years suffering fatigue, digestive upsets, etc. Didn't know what it was and no doc ever suggested testing the thyroid. One day, I googled my symptoms and Bingo! hypothyroidism popped up. So I asked my doctor to test me and sure enough, high TSH.
I wish more doctors would routinely test TSH at least, especially when dealing with symptoms they can't figure out. Doctor put me on Synthroid which was horrible as it just made me feel worse. I opted for natural supplements and they were more help than anything. Finally found out last year I am Celiac which sometimes causes the immune system to attack the thryoid. Once I went on the gluten free diet, the hypothyroidism started to reverse itself. My TSH is a little high now (4.5) but I cope. Sometime I would like to try the Armour Thyroid supplement, the natural hormone.
Yeah, most doctors still think anything under 5.0 is OK. Unbelievable at how slow they are to update themselves.
Now I trust Google more than my doctors.

S.

Edited July 29, 2011 by Skinzo

[Deb]

I thought I was going to die when my thyroid went insane. I became the Hindeburg and was in such pain and so tired and so very cold. A year of
doctors babbling and then I saw a nurse practicioner who read off all my symptoms and said I had hypothyroidism. They never looked into why I had that. I have been on synthroid for about 11 years now and it has helped a lot. How do you know if you are celiac? I figure I am just old so all the strange things that happen now are just for the Lord's entertainment for the years I abused my body. I don't think I would trust google though.

[Azriel]

I take synthroid too. (well, the generic) Have for about 7 years? It cleared up a lot of symptoms that I figured were just do to being a new mom. Its a darn cheap med too.

[OnlySunshine]

I've often thought that I have subclinical hypothyroidism which means it is undetectable by certain tests. All of the doctors who have tested me for it have told me that my levels are normal, but they never say what they are. I should have been more aggressive at finding a solution. Hypothyroidism runs in my family--practically everyone on my mom's side, including my mom has it. My dad is under observation since he has a goiter. I still wonder why no doctor has suggested an alternative route or even starting me on a low dose of thyroid medicine to see if we see improvement. I have several of the symptoms (bolded):

* Poor muscle tone (muscle hypotonia)
* [b]Fatigue[/b]
* [b]Any form of menstrual irregularity and fertility problems[/b] (In my case, Polycystic ovaries)
* Elevated serum cholesterol
* Cold intolerance, increased sensitivity to cold
* [b]Constipation[/b]
* [b]Rapid thoughts[/b]
* [b]Depression[/b]
* [b]Muscle cramps and joint pain[/b]
* [b]Thin, brittle fingernails[/b]
* Coarse hair
* Paleness
* Decreased sweating
* [b]Dry, itchy skin[/b]
* [b]Weight gain and water retention[/b]
* Bradycardia (low heart rate – fewer than sixty beats per minute)

All of the doctors I have seen only want to treat the symptoms rather than find the underlying cause. I really hope that when I get the opportunity to see a doctor again that I can find one who is willing to work with me. I am definitely considering alternative medicine solutions.

Edited July 30, 2011 by MaterMisericordiae

[OnlySunshine]

Also, for a time, I tried this supplement which improved my symptoms:

[img]http://images3.souq.com/uploaded/0510/6a27157234ffa8a36e9df11c45f669e4_85056706521273935904.jpg[/img]

[Skinzo]

Deb,
Since you ask, Celiac disease is an auto immune thing in which the immune system reacts to the gluten in wheat. If you have lots of weird digestive upsets and immune system issues you may want to consider testing. They have a blood test now.
As to the thyroid I'm happy for those who can find relief with Synthroid. If not you may want to look at Mary Shomon's website, lots of useful info. there:
http://thyroid.about.com/bio/Mary-Shomon-350.htm

As to Dr. Google, well he at least pointed me in the right direction, more than I can say for the MD's.

S.

[Ash Wednesday]

Don't even get me started on my thyroid. Pretty much every health problem I have has roots in my thyroid disease...

P.S. Mary Shomon is great.

[Sarah147]

[quote name='MaterMisericordiae' timestamp='1311989525' post='2278374']
All of the doctors who have tested me for it have told me that my levels are normal, but they never say what they are. [/quote]

You have the legal right to a copy of all your records. I ALWAYS get a copy of mine and I'm keeping a log of my thyroid. You've got to get recent "TSH", "Free T3" and "Free T4" -- don't get Total T3 or T4, they are useless. You've got to see the three tests done at once to get the full picture of what's going on. Up-to-date doctors want your Free T4/T3 to be in the upper one third of the range; and many doctors keep TSH 0.1-1.0.

Edited August 2, 2011 by JoyfulLife

[Sarah147]

This is very encouraging: [url="http://caloriecount.about.com/anybody-know-anything-cytomel-ft34386"]here[/url][url="http://caloriecount.about.com/anybody-know-anything-cytomel-ft34386"] [/url]

Some people recommend asking pharmacists for names of doctors that prescribe Armour and/or Cytomel (T3), because they tend to be more up-to-date on the thyroid and treating more people for the condition even at more normal numbers.

There is also this site: [url="http://www.thyroid-info.com/topdrs/"]http://www.thyroid-info.com/topdrs/[/url]

Edited August 2, 2011 by JoyfulLife

[Skinzo]

Thanks Joyful, that's interesting. I wonder though if she was running "16-20" miles a week before taking cytomel? It does not seem clear from her story unless I missed something. That much running would take pounds off anyone I should think.
I have read many times though that some people just never feel very good on Synthroid. But it does improve their TSH, and some doctors are happy with that and ignore the patient's complaints otherwise.

[Cherie]

Yes I agree they should test TSH much more routinely than they do, particularly for postpartum women.

Synthroid honestly hasn't been doing a darn thing for my symptoms, even on this higher dose.

Are herbal or otherwise natural remedies ok to take WITH levothyroxine? What are some, and where would I get them? Any that are inexpensive?

[Sarah147]

[quote name='CherieMadame' timestamp='1312335089' post='2280576']
Yes I agree they should test TSH much more routinely than they do, particularly for postpartum women.

Synthroid honestly hasn't been doing a darn thing for my symptoms, even on this higher dose.

Are herbal or otherwise natural remedies ok to take WITH levothyroxine? What are some, and where would I get them? Any that are inexpensive?
[/quote]

Yeah, I've seen things like that at Vitamin Shoppe (physical stores throughout USA and an online store.) iherb.com is super fast and has great prices!


Your Free T3 and Free T4 are probably in the bottom of the range, and that has to do with how you feel. They should be monitoring them and ignoring TSH, because when you treat FT3 and FT4 to be in the upper range, TSH will go suppressed under 1.0 or so, which is great.

I don't know what natural products can do, but I think you really should get a doctor to let you try NP Thyroid by Acella or T4 plus Cytomel, split pills taken at breakfast and dinner due to the short half life. As the website says: "Switch to NP Thyroid and take a break from formulation changes, frustration with availability, and higher costs."

By the way, when asking pharmacists for doctors that prescribe Cytomel or Armour, try a few pharmacies because I had those at CVS refuse to give any, but they gave me some at a smaller chain pharmacy.

Edited August 3, 2011 by JoyfulLife

[Sarah147]

[quote] [left][left] [/left][/left]
[left][left][size=4][b]Hypothyroidism: Diagnosis and Treatment [/b][/size]
[size=3][b]An Overview by Dr. Ted Friedman, October 2003[/b][/size]


[size=2]by Theodore C. Friedman, M.D., Ph.D.[/size]

[size=2] [img]http://www.thyroid-info.com/images/friedman.jpg[/img][i]Dr. Theodore C. Friedman, M.D., Ph.D. is Associate Professor of Medicine-UCLA, Endocrinology Division, and is also an endocrinologist in private practice. For more information about his practice, see [url="http://www.goodhormonehealth.com/"][color=#000066]www.goodhormonehealth.com[/color][/url].[/i][/size]
[size=2][i] [/i][/size]
[size=2][i] In this article, he shares his thoughts about hypothyroidism diagnosis and treatment.[/i][/size]



[size=2] [b]Hypothyroidism Diagnosis[/b][/size]

[size=2] Hypothyroidism is a relatively common disorder. It affects more women then men, but I happen to be one of the men who does have it. Symptoms of hypothyroidism include fatigue, gradual weight gain, constipation, muscle aches, joint pain, feeling cold, menstrual irregularities, weakness, hair loss, dry, cold skin and slow reaction time. Many patients will have a goiter (enlarged thyroid). Although it has received much discussion, I believe low body temperature is not a reliable sign of hypothyroidism.[/size]

[size=2] The incidence of hypothyroidism increases with increasing age. In other words, the older we get, the more likely a thyroid deficiency will show up. The most common cause of primary hypothyroidism (hypothyroidism originating in the thyroid gland itself), is Hashimoto’s Thyroiditis. Hashimoto's is an autoimmune condition. The body's own antibodies attack the thyroid gland and destroy it, leading to hypothyroidism. Hashimoto’s Thyroiditis may be a manifestation of multiple autoimmune syndromes and may occur in families. Hypothyroidism can also be due to a pituitary problem (central hypothyroidism).[/size]

[size=2] Diagnosing all types of hypothyroidism is important, because treatment with thyroid hormone will improve symptoms in patients with hypothyroidism, but is unlikely to help those who do not have hypothyroidism. In primary hypothyroidism, the thyroid gland, located in the neck, is less able to produce the thyroid hormones, T4 and T3. The pituitary gland, located in the head, responds to this deficiency by secreting more TSH. Thus, in more mild cases of primary hypothyroidism, T4 and T3 levels are normal, but the TSH is high. In more severe cases, T4 and T3 levels drop. Although the normal range for TSH is often between 0.5 and 5 mU/mL, [color=#ff0000][b]values at the high end of the normal range may be abnormal.[/b][/color] T3 is the more bioactive hormone compared to T4, but T4 is more stable in the circulation.[/size]

[size=2] My approach to diagnosing hypothyroidism is to start with a careful history and physical. Then an Endocrinologist should perform a hands-on thyroid examination to determine if the patient has a goiter. Blood TSH, free T4, free T3 and anti-TPO antibodies should be tested. Patients with an enlarged thyroid and/or a positive anti-TPO antibody test AND a TSH> 4.0 mU/mL should be considered to have primary hypothyroidism. Patients without an enlarged thyroid and without a positive anti-TPO antibody test but WITH a TSH> 7.5 mU/mL should also be considered to have primary hypothyroidism. Patients with a free T4 of < 0.9 mg/dL and a TSH< 1.0 mU/mL are likely to have central hypothyroidism. Patients with symptoms of hypothyroidism but who do not meet these criterion should be watched and retested in 6 months.[/size]

[size=2] [b]Hypothyroidism Treatment[/b][/size]

[size=2] Once hypothyroidism is diagnosed, there are many treatment options, including synthetic L-thyroxine (T4) preparations (Synthroid, Levoxyl and Unithroid), synthetic L-triiodothyronine (T3) preparations (Cytomel), synthetic T4/T3 combinations (Thyrolar) and dessicated thyroid preparations (Armour, Naturethroid, Bio-Throid, and Westhroid). All of the L-thyroxine preparations contain the same active ingredient, but contain different fillers and have different quality control. Until recently, Synthroid did not have FDA approval, but now all L-thyroxine preparations have FDA approval. Thyrolar and the dessicated thyroid preparations probably have a higher T3/T4 ratio than desirable and thus, I often give a lower amounts of these preparations supplemented with T4.[/size]

[size=2] Most endocrinologists use L-thyroxine preparations for the initial treatment of all forms of hypothyroidism. Although the use of L-thyroxine (T4) compared to L-triiodothyronine (T3) may be surprising as T3 is the more bioactive thyroid hormone, T4 is most frequently used. This is because tissues convert T4 to T3 to maintain physiologic levels of the T3. Thus, administration of T4 results in bioavailable T3 and T4. As T4 is more stable than T3, T4 therapy gives even blood levels, while T3 therapy leads to high levels after taking the medicine and low levels before the next dose. Armour thyroid is the least expensive preparation. Because Armour thyroid comes form pig thyroids, some Endocrinologists feel that there is high pill to pill variability, but this is unlikely to be true.[/size]

[size=2] A study published in the [i]New England Journal of Medicine[/i] in 1999 ([url="http://www.thyroid-info.com/articles/t3drugsnejm.htm"][color=#000066]see article now[/color][/url]) suggested that brain T4 to T3 conversion may be impaired in some patients and that a select group of patients should be treated with both T4 and T3. Other studies published in the [i]Journal of Clinical Endocrinology and Metabolism[/i] in 2003 suggested that addition of T3 to T4 treatment is not needed for most patients with primary hypothyroidism. I recommend that most patients be started on a T4 preparation, which improves symptoms in the large majority of the patients.[b] [color=#ff0000]I have found that most patients prefer Levoxyl or Unithroid to Synthroid, but this varies with each patient. [/color][/b]After initial treatment with T4, I adjust their T4 dose until their TSH is between 0.5 and 2 mU/mL. [color=#ff0000][b]If they remain symptomatic despite an optimized TSH, then low doses of T3 given two or three times a day can be added cautiously to T4. If patients start with a low blood free T3 level, then I am more inclined to treat them with T4 plus T3. On T4 plus T3 therapy, I use blood tests to make sure the free T4 and free T3 are in the upper-normal range. The TSH value is usually suppressed on combination treatment.[/b][/color][/size]
[size=2][b] [/b][/size]
[size=2][b] [color=#ff0000]A percentage of patients will have symptomatic improvement on T4 plus T3 therapy. For those that do not improve, I occasionally recommend treatment with dessicated thyroid preparations, usually Armour, plus synthetic T4.[/color][/b][color=#ff0000] [/color]This combination is needed as desicatted thyroid preparations have a higher T3/T4 ratio than desirable and need to be supplemented with synthetic T4 to achieve normal ranges of both hormones. [color=#ff0000][b]Again, I aim for a free T4 and free T3 in the upper-normal range. [/b][/color][/size]

[size=2] Patients with central hypothyroidism can be treated with any of the preparations available for patients with primary hypothyroidism. [color=#ff0000][b]The difference is that treatment needs to be monitored by aiming for a free T4 and free T3 in the upper-normal range, as TSH is suppressed with proper treatment. [/b][/color]Patients with both central and primary hypothyroidism also needed to be [color=#ff0000][b]treated by aiming for a free T4 and free T3 in the upper-normal range. [/b][/color][/size]

[size=2] I was diagnosed with primary hypothyroidism in February 2003. An endocrinologist performed an examination of my thyroid gland and I was found to have a goiter. My blood values showed a TSH of 8 mU/mL and strongly positive anti-TPO antibodies. I have a strong family history of Hashimoto’s Thyroiditis but I was lucky to be fairly asymptomatic prior to treatment. I am now on 150 mg a day of Levoxyl, have a TSH of 1.9 mU/mL and feel great. I have lost a few pounds on T4 therapy and my cholesterol profile has improved. [/quote][/size]

[size=2] Cherie... So, according to him, you may want to try Levoxyl (T4) and/or Cytomel (T3). I would advise against Armour, Nature-Throid, etc. because of the bad new re-formulation. If you go to dessicated, ask for NP Thyroid by Acella. Some researching shows it works best for many out there. And note how he says that TSH will be suppressed; meaning to test the Free T3/T4, not TSH anymore.[/size]

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