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Have I recovered from my silent thyroiditis?
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Have I recovered from my silent thyroiditis?

Hello, I had an original and then a follow up question.  It's at the very bottom.  Thank you so much, Dr. Lupo!

I was diagnosed August 1, 2010 with silent thyroiditis.

My stats are (Range: TSH 0.40 - 4.50 // Free T4 0.8 - 1.8 )

08/01/10 TSH 0.03

08/09/10 TSH 0.01

09/23/10 TSH 0.41

10/28/10 TSH 1.36 -- T4 0.96

12/6/10 TSH 3.80 -- T4 0.92

12/28/10 TSH 0.99

02/11/11 TSH 2.45 -- Free T4 1.1
*****PUT ON 25 MCG of SYNTHROID*****

03/28/11 TSH 4.18 -- Free T4 0.9
*****PUT ON 50 MCG of SYNTHROID*****

04/28/11 TSH 0.6 -- Free T4 1.1

06/06/11 TSH 1.23 -- Free T4 1.2

06/14/11 *****PUT ON 25 MCG of SYNTHROID, 5 of CYTOMEL*****

07/07/11 TSH 2.91 -- Free T4 0.9

T3 Uptake 34 (Range 22-35 Percent)

Free T3 2.9 (Range 2.3-4.2 pg/mL)

07/14/11 *****PUT ON 50 MCG of SYNTHROID, 10 of CYTOMEL*****

08/04/11 TSH 0.36 -- Free T4 0.9

08/12/11 *****PUT ON 50 MCG of SYNTHROID, 15 of CYTOMEL*****

08/22/11 TSH 0.07 -- Free T4 1.1 -- Free T3 3.3

08/26/11 *****Discontinued Thyroid Medication*****

10/06/11 TSH 2.97 -- Free T4 1.0

I am still symptomatic (exercise intolerance, fatigue, muscle aches, etc.).  I do not feel well.  What do you think I should do?  What do you think may happen at the next labwork in 4 weeks - same lab values, better, or worse?

Do you think it might be wise to do a 24 hour saliva test?  I was tested for A.M. Cortisol of 19.5 on a scale of 4.0-22.0.

Is this as good as it gets?  Is this as good as my thyroid is going to get or is there a chance it will recover more?

YOUR ANSWER:

Would give it more time without medication for additional recovery.
The adrenals are fine (not insufficient with cortisol >17).
Saliva testing is not helpful for thyroid.

If symptoms persist would look into other causes - with muscle aches, a rheumatology evaluation may be indicated eventually.

FINAL QUESTION:

What would be a REASONABLE amount of time to wait for the additional recovery?  How many weeks/months until I really need to examine other possible issues?
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97953_tn?1193367871
Would give it until the end of the year...(2 more months).
3 Comments
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Avatar_n_tn
I know you are not psychic, but I would just like a range or a time frame on what you mean by "would give it more time".  

I was diagnosed as of August 1, 2010 with a TSH of 0.03.

I believe I was officially hypothyroid as of March 28, 2011 with a TSH of 4.18.

I am approaching the 15 month mark from when I was first diagnosed.

How much more time should I wait?
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Avatar_f_tn
i'm still a-o-k.  i've been off synthroid for a little over 6 months or so...  i've been getting checked every 3 months..  that's all you can do...just keep rechecking.  if you need meds, your tsh will show that the next time.  be patent.  i know it's frustrating when you have symptoms, but give your body a chance.

take care,
maria
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
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