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Thyroid medication and MS
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Thyroid medication and MS

Ok, got an emailed copy of my blood labs from last week. About 5 weeks ago my TSH was high when dr took blood when I had my annual physical.  She told me to come back in and retake in about a month.  My current lab shows TSH at 6.5 (should be in the .30-5.1) so I have under active thyroid.

I am suppose to call tomorrow, but dr's note indicates she will be recommending I go on 50 mcg of Synthroid daily. I know very little about thyroid problems and meds for it.  This seems to be a somewhat common thyroid medication (non generic) based on what I have read.

What questions do I need to ask before taking this medicine?  Anybody with experience with this drug that you can share? Are all thyroid meds about the same? I know women with MS have higher incidences of thyroid problems but is there a better drug to take for thyroid if you have MS?

Thanks in advance for your responses.

Julie
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Hi, Julie. Synthroid is a fine med for thyroid problems. Take this from one who's been using it for a good 30 years. I have had no issues whatever in all that time. Lucky me, though my experience is very common.

Once you have been on it awhile, a month or six weeks, your doc will test your blood again to see if your dosage needs adjusting, as getting it just right may require experimentation. Mine has been at 100 mcg for a very long time. However, things can change over time, so you will probably go in a couple of times a year for blood checks. I do.

This all has very little if anything to do with MS. Hypothyroidism, usually caused by Hashimoto's disease, is the most common autoimmune problem by far. And although it's been shown that those with one autoimmune disease are more likely to have another than the general population is, there are no other implications for MSers. It often runs in families, as it does in mine, and as with many other autoimmune conditions, females are much more affected than men.

There is a thyroid forum here at MH that you might want to check out. There is a relatively small percentage of people who have trouble regulating thyroid levels, but there's no reason to expect you'll be one of them.

Hope this helps.

ess

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Oh yes, your response helps tremendously!  I have a few friends with thyroid problems but not close relatives. Again, I seem to be the trailblazer in the family.

I appreciate you sharing your personal experience with the drug. It is a relief to hear you have been using it so long with sucess.

Will definately be checking out the thyroid forum.  Thanks!

Julie
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Oh, I should add that underactive thyroid can be an MS mimic, as neurological symptoms can result. You don't mention any symptoms with yours. Mine, in fact, was picked up in routine blood work. Never had any symptoms, myself, though my thyroid was pretty badly impaired.

We're lucky that this is one condition for which treatment is really straightforward.

ess
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I was diagnosed with Hashimotos 3 yrs ago and am currently awaiting a MS dx. I started on synthroid but did not like it. It brought my TSH levels down but didn't relieve my symptoms. I'm on armour now which is a combination of t4 and t3, and I absolutely see a difference. Everyone is different though and sometimes it can take a long time to find the right meds and dosage for you.
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I know it can be an MS mimic b/c I posted a question about just that back last August before my MS dx and you guys told me that. lol.  I had my thyroid tested before I got my MS dx. Thyroid last spring was 5.0 which according to some labs qualifies as an underactive thyroid but dr said it was ok.

She did say we would watch and retest at next physical, which happened this year. Tested at 7.0 in mid May of this year. Now at 6.5. I don't feel I have any sx of thyroid problems except recently have noticed a slower metabolism.

No tiredness, no sleeplessness, hair falling out (just graying),etc.  You would think between the MS and the thyroid I would be having more issues.  If you were the same, I am hoping for the same luck in taking medicine sucessfully.

Julie
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What the heck is t4 and t3???  What symtoms (symptoms) did you have?  Yes, I have heard that you have to give it time in your system to see if it works.

Thanks for your response.

Julie
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Hi Julie.  You will probably do fine on the Synthroid but make sure your pharmacy doesn't switch you over to a generic brand of levothyroxine along the line.  This is one of those times when the generics vary quite a bit from the original.  To be sure your dose is absorbed the same way each time, you need to stick to the same formula.  In fact, always make sure your doc writes DAW on the script.  It means "dispense as written".

It will be important to take the medicine at the same time every day and about 0.5 hours before meals but with a full glass of water.  Synthroid reacts with many other drugs so it is usually taken when no other drugs are scheduled.  Many people follow all these rules by taking their Shythrod with a full glass of water before doing anything else in the morning.  

Did I hear you mention eating a lot of fiber?  Check with you doctor or pharmacist, because I think eating fiber can decrease absorbtion of Synthroid too.  Larger amounts might be ok if you are consistent in your total daily intake.

I hope this does end up being an easy adjustment for you.
Mary
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I started Synthroid last November and have had no problems. Thanks Mary for telling me how to take it. I was taking it before meals but with all my other meds yikes!


Alex
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1382889_tn?1404599226
Great tip Mary about the DAW.  See, these are the little things that matter in the end that I would have no idea about if I didn't have you guys.

In regards to the fiber, does this mean that it may be a challenge to balance getting my fiber and getting consitipated to ensure my thryoid med is effective?  Copaxone is the only med I am on so I am not use to having to really think about my intake of anything.

One of the joys of growing older I guess. Thanks so much for the suggestions.

lol Alex, we learn something new everyday, even when I aren't expecting it.

Julie
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1710955_tn?1309450073
T4 and T3 are the hormones produced by the thyroid gland. Synthroid is a synthetic t4 med. Cytomel is the synthetic t3 med. And armour is a natural t4 and t3 med, it's derived from pigs. I've been on synthroid alone, synthroid and cytomel together, and armour. Like I said before I prefer the armour.

My sx were all over the place. Too many to explain. Here are a few:  extreme fatigue and tiredness, dry and brittle hair, dry skin, severe bipolar like mood swings, no sex drive, premature grey hair. That just to name a few!

I think it's extremely important to mention that the correct lab values for TSH is .3-3.0. I think it was changed back in 2003 but so many docs and labs still use the old values. It's also important to mention that a TSH test is not the only test they should be running. Your doc should run a free t4, free t3, and antibody test as well.

The advice of taking your meds first thing in the am and not getting the generic form is dead on. I hope my advice helps too!
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I now have done a bit of research and figured out what the t3 and t4 were but your explaination of what each drug provides was brand new to me.  The thyroid forum is not as interactive as this MS forum is so most of what I am getting is dry reading.

Interesting that gray hair is related to decreased thyroid function????  Wow, that is something I have noticed in the last 9 months or so. Glad to know it was not my imagination.

My sister is in the medical field and she told me about the change in the lab values last year. Last year before dx of my MS I was desperately wanting my sx to be related to my thyroid. I figured with a 5.0 it wasn't beyond reason to think that some of my sx were related to my thyroid.  My gp is very conservative and didn't want to retest b/c it was considered w/in normal range, even if it was borderline.

So, it wasn't unexpected that it was out of normal range this year. There were other tests done but the TSH stood out on the lab. Will look again for the free t3 and t4.

Yes your advice helps a lot. Have my synthroid in my hot little hands (DAW noted on the bottle) and will begin tomorrow morning.  Will see how it goes until I have my follow up with gp in 2 months. Thanks again.

Julie

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The gray hair thing is quite interesting, but if you're just starting now then you're lucky! Most people, from what I've read, find gray hairs by 40.

Not me. I started at 16. By mid to late 30s it was *ugly* so I started coloring it then and have been doing it ever since. My roots are snow white. This is an inheritance from my maternal grandmother, who was white at 30, believe it or not. She also had pernicious anemia, which is tied in somehow with thyroid probs, which I have, as I said. More autoimmune stuff.

It's all quite fascinating, isn't it?

ess
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Quite!  Yeah, a lot of my friends have been coloring their hair for years and years, so I guess in that respect I have been spared the hassle of having to deal with it.

My teenagers want me to color it.  They are in denial about their parents growing older, even though they want to be older themselves. Can't be older w/o your parents also aging I tell them.

My husband told me I am look quite "distinguished" (not the right thing to say) and shouldn't color my hair.  "Accept it", he said.  I am not wanting to color it since swimming gives me as much joy now as my gardening. Even in a swim cap, chlorine messes with your hair.

I cannot believe you started graying at 16!!  Of couse isn't it easier (as in easier to hide when it grows out) to go blonde than it is to color your hair dark?

My Ess, you are a very interesting indeed.  No changing our genetics I guess.

Julie
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I'm 32 and started getting grey hair at 25. I believe I had thyroid problems for YEARS but the docs didn't discover it until after the birth of my middle child.

I also wanted to tell you to look up Mary Shomon on the web. She's a patient advocate for thyroid disease. She's written books, has her own website, writes for about.com, and is on Facebook. She is truly fantastic and breaks down everything in an easy way for common people to understand. I have several of her books and refer back to them all of the time. I would recommend her to any thyroid patient!
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I have been on both the generic and Synthroid versions of this drug. I have actually had better luck with the generic version. when on the Synthroid my doctor had a very difficult time controlling my thyroid blood work. ( one time it was too high with the testing, and the next it was too low). Since being switched to the generic my thyroid readings have been rock solid. I have been on the generic for 5 years and on the brand name for 10 with changes in dosage about every 6 to 9 months.

Dennis
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Thanks for the heads up on that one Dennis. Took my first pill this morning.  Will give it until my follow up on a couple of months. If problems I am willing to try something else. Good to know that generic can be right on for some.  

Julie
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DAW on a script can cost you 15 - 20 times more through your prescription insurance.  Under the US Pharmacopeia, the dissolution and bio-availability of drugs must match.  There is little to no evidence to support the generics are inferior to the branded products.  If in doubt, ask your pharmacist.  

Bob
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