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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Adjusting to medication change
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
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.
Adjusting to medication change
by Liz1900, Feb 06, 2008 12:20PM
Hello Doctor,
I have been on Armour thyroid for almost 40 years for hypothyroid with little problem at all. Over the years, the dosage has been adjusted after blood work was done several times and dosage adjusted without any side effects.
In December my blood work showed that I was probably getting a little too much thyroid - taking a 120 mg and a 15 mg tablet daily. But my internist said that since I had no side effects, he wouldn't change it. Right after that I developed heart palpitations, which I know are a sign of thyroid problems). I went to the doctor again, had an EKG and wore a holter monitor for 24 hours - all of which came out normal. The doctor decreased my dosage by 15 mg
January 8th, the heart palpitations started up again. I called the doctor and it was too soon for blood work, so in another week I called again and this was at the 4 week point. , They did another EKG and an eccocardiogram which were normal. The blood work showed that I was still getting too much and they cut me to 90 mg. This was on Jan 18th - about 2 1/2 weeks ago. The heart palpitations slowed down fairly quickly, but then I started feeling lightheaded. In 5 days I added the 15 mg back in. It seemed to help the lightheadedness, but within about 5 days, the heart palpitations started again. I went back to the 90 mg on Sunday, Feb 3rd. It seemed the heart palpitations slowed some and today they are back up again. I think part of it is my nerves too. About 2 days ago, I noticed that my neck on the sides seems swollen . . I have about 3 more weeks before I can get blood work. I am not sure how long it takes to get the 15 mg out of my system. . Yesterday I cut the 45 mg. tablet in half and took half in the morning and half in the afternoon - actually I think I felt better. Any suggestions or do I just need to be patient?
Liz
I have been on Armour thyroid for almost 40 years for hypothyroid with little problem at all. Over the years, the dosage has been adjusted after blood work was done several times and dosage adjusted without any side effects.
In December my blood work showed that I was probably getting a little too much thyroid - taking a 120 mg and a 15 mg tablet daily. But my internist said that since I had no side effects, he wouldn't change it. Right after that I developed heart palpitations, which I know are a sign of thyroid problems). I went to the doctor again, had an EKG and wore a holter monitor for 24 hours - all of which came out normal. The doctor decreased my dosage by 15 mg
January 8th, the heart palpitations started up again. I called the doctor and it was too soon for blood work, so in another week I called again and this was at the 4 week point. , They did another EKG and an eccocardiogram which were normal. The blood work showed that I was still getting too much and they cut me to 90 mg. This was on Jan 18th - about 2 1/2 weeks ago. The heart palpitations slowed down fairly quickly, but then I started feeling lightheaded. In 5 days I added the 15 mg back in. It seemed to help the lightheadedness, but within about 5 days, the heart palpitations started again. I went back to the 90 mg on Sunday, Feb 3rd. It seemed the heart palpitations slowed some and today they are back up again. I think part of it is my nerves too. About 2 days ago, I noticed that my neck on the sides seems swollen . . I have about 3 more weeks before I can get blood work. I am not sure how long it takes to get the 15 mg out of my system. . Yesterday I cut the 45 mg. tablet in half and took half in the morning and half in the afternoon - actually I think I felt better. Any suggestions or do I just need to be patient?
Liz
Doctor's Answer
by Mark Lupo, M.D., Feb 07, 2008 05:52AM
, Feb 07, 2008 05:52AM
Splitting the armour is a good idea -- stick with the 45 2x/day and recheck labs in a few weeks as planned. The T3 in the armour is stimulating to the heart; the heart tolerates this less well with age. So splitting the dose, decreases the T3 peak. If the palpitations continue, it may be time to change to straight T4.
