Tolerating increase in Meds

[Denise367]

Diagnosed with Hashimoto's Jan 06 (high positive Antibodies). Endo suggest TSH of 2.0. My  General Dr has been trying to increase my meds to achieve TSH 2.0; however, every time we increase the dose I start having heart racing and jitteryness so I have to go back to my old doseage. Last TSH 7/28/06 was 4.203. Currenty on .025 mg Levoxyl 1/2 tablet 2 days on, one day off. Seem to flop between hypo and hyper symptoms. I am 39 yo female. Any suggestions?

[Denise367]

Thanks for the post. My Endo is the one who started me on 1/2 tablet of .025mg every other day. He thought I would benefit to start and it did help at the beginning. My nodules and goiter have gotten smaller. He released me back to my primary doctor with recommendation to keep my TSH around 2.0. But like I said every time we increase the meds I get heart racing jitteryness. My primary doctor moved out of town because of marriage and I just met with my new doctor yesterday. I love her. She states that we will get to the bottom of the problems; i.e. change brand, maybe go to natural meds and just try different things until I'm better. She also said she looks at the numbers from test results; however, she also treats the whole person by how they are feeling. I was so pleased with what she said. Thanks again for the comments. I have learned so much by monitoring this site.

[Intrigue]

If I read your post correctly, you're taking one-half of a .025 tablet?  That's so low...I can see a full .025 tablet, and even that is low....but one-half of that seems like it wouldn't do anything to relieve symptoms.  I do agree with zyphoid....I always react to increased dosages, but just "tough it out" for a week or two and the palpitations, etc. subside.  Does your Endo know your doctor is alternating days with such a low dosage?  If you've been alternating since July when you had your last TSH check, your body's had sufficient time to adjust and apparently it's not, so an alternative seems appropriate.

Has your doctor tried you on synthroid instead of levoxyl?  Some patients don't tolerate levoxyl, but tolerate synthroid or another medication like Armour.  Might be worth asking about an alternative medication.  There's lots of information on Armour, adrenal function, TSH levels, etc. at:  http://www.stopthethyroidmadness.com.

And just so you know, our doctor here recommends a TSH of 1.0, which would seem to confirm that you do need medication at this point to bring your TSH down and relieve those frustrating symptoms. Best of luck and please keep us informed!

Intrigue

[Mark Lupo, M.D.]

The dose is fairly low.  However it may take a while to titrate upwards.  If you cannot tolerate it, there is no absolute indication for treatment at this point, but would monitor closely.  If you have a nodular goiter (ultrasound) then treatment is more useful potentially.

[zyphoid]

I always have a few weeks of hyper-type symptoms with any increase in Synthroid. These generally are temporary and I just wait for them to go away and to adjust.  

I was hyper years ago, hypo within the last few years (hypo symptoms although TSH was supposedly "normal" - but I knew it was not), so I am very sensitive to those "thyroid" feelings - notice even the tiniest difference. I was concerned that I would have to dose back down after the latest increase in Synthroid due to a more exteme hyper feeling than usual after an increase, but as always it settled down within a few weeks. I did mention this to my dr (TSH was 1.5) and she said that is not at all uncommon and as long as it goes away and I can tolerate it, let it go (but let her know if it continues or gets worse).