Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Thyroid
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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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Thyroid

I'm 47 and have been taking Synthroid for years.  My yearly tests are in the normal range and yet I'm showing all the symptoms of not getting enough thyroid, hair loss, weight gain, dry skin, fuzzy thinking and I'm ready for a nap in the afternoon. What should I do and what kind of doctor should I see,(my Internist keeps telling me that I'm fine.) I've gained 25 pounds and have lost half my hair.
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97953_tn?1193367871
If the levels are in the target range( TSH 0.5-2.5 for most labs) there is not much more to do.  Combining T4/T3 does not usually help and most often there are other causes for the weight gain.  Hair loss also has many causes, sometimes a dermatology evaluation can help.
6 Comments
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Avatar_m_tn
Just being told that your tests were in the normal range is not enough info.  If you were given the actual test results, you can compare them to the so-called normal ranges.  If your T4 and T3 are at the very low end of their range and TSH at the high limit, then you'll probably end up with the kind of symptoms you reported.  That's what I experienced, and I had similar symptoms.    I found out about basal body temp. as an indicator of low metabolism and low thyroid and used my low basal temp. and blood test results to persuade my Dr. at the time to try me on some thyroid med.  He gradually increased the dosage until I was on a full daily replacement level.  My T4 and T3 moved up to the upper end of the normal range, my symptoms went away and I have felt  great for 25 years now.      
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Avatar_n_tn
I feel just like I did when I first started having to take Synthroid.  My guess is that the change in hormones from periomenapause  have made my thyroid more problematic.  You did answer my question though, I'll make sure that my doctor is a woman my age and can better relate to a woman's changing body.
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Avatar_m_tn
How about also checking your basal body temperature and posting the results, to give other people on this site some useful info for their own consideration?  I'm also not sure why Dr. Lupo referred to the old TSH range when the Amer. Thyroid Assn. and the Amer. Assn. of Clinical Endocrinologists are recommending a new, lower range of .3  - 3.0.
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97953_tn?1193367871
I was referring to the suggested replacement target range, not normal range -- see my other post to your new question.

This is not a straight-forward area in thyroid medication and is still greatly debated among experts.
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Avatar_m_tn
Apparently it has been debated for the last 5 years with not much changing.  Hypothyroid patients in the U. S. are starting to catch up on this problem, from what I see and hear.  I would think that after 5 years, the medical community would go ahead and accept that these people need help to alleviate their symptoms.  After all, aren't we trying to alleviate the patients' symptoms, and not just get their TSH readings to fall within some controversial range.  I don't get the reluctance to treat these suffering souls.  Are we so afraid of some potential bone effect when the TSH is extremely low ( a conclusion that has not even been statistically determined to be valid as far as I can find out) that no thyroid is prescribed at all?  It also looks like people in the UK are getting frustrated also.  I saw where a group of patients has just lodged a complaint against the clinical practice of the majority of the medical profession with regard to the diagnosis and management of hypothyroidism on four counts.
1. over reliance on thyroid blood tests and a total lack of reliance on signs, symptoms, history of the patient and a clinical appraisal.
2.The emotional abuse and blatant disregard by the majority of general practitioners and endocrinologists over the suffering experienced by the untreated/incorrectly treated thyroid patients and their lack of compassion over the  fate of these patients.
3.Stubbornness of general practitioners and endocrinologists to treat patients suffering from hypothyroidism with a level of medication that returns the patient to optimum health.  In addition the unwillingness to prescribe alternate thyroid treatment for patients on individual grounds ----such as Armour thyroid.
4. The ongoing reluctance to encourage debate or further research on  hypothyroidism.
This has led a Member of Parliament to take the matter up with the Royal College of Physicians of London.
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