Hashi and thyroid meds

[gofigerr]

I have had elevated TPO antibodies for about 10 years now. My thyroid levels are always in normal range. I have been told by many doctors that I don't need replacement even though I have symptoms. Recently an Endo told me I was on the low end of T4 (TSH 2.62) and that she thought I was subclinical due to Hashi. She put me on 1/2 75 mcg levothyroxine. Within 3 days I was feeling anxiety, I had adrenaline rushes all night long, I could tell it was the medicine. She said she doesn't think it is the meds and wants me to take the 1/2 every other day. I am very senstitive to meds, I can't drink caffiene. I also have a history of A-fib. Can the medication affect someone that quickly if they don't need it? Is there any harm in not taking it and just waiting until my thyroid actual shows some sign of not working?

Thaks

[Mark Lupo, M.D.]

You have hashi with subclinical hypo - perhaps 37.5mcg was too much to start with --talk to her about 1/2 of the 25mcg and slowly build up.  BUT with the h/o a-fib, I may be tempted to leave a TSH 0f 2.6 alone.  There is no data available that mandates treating this TSH - would be fine to continue to observe with the exception that IF the symptoms are due to thyroid, they woudl persist.  Goal TSH for you may be around 1.0-1.5 IF you stay on treatment.  If observation, would not treat until TSH > ?5 or 10 -- mixed opinions on this -- clearly, treat >10.

[gofigerr]

Sorry one more thing.. my TSH varies all the time on one test it will be 1.93 on another test it will be 4.5 then 2.62.  With varying levels like that won't it be hard to regulate with medicine, don't I have the chance of going hyper now and then?

Thanks

[gofigerr]

My TSH levels have been swinging up and down for years. The highest it has been is 5.65 and the lowest is 1.93 (just last year) It hangs between 2-3  most of the time.  I took 2 weeks off of the synthroid and started up again today at 1/2 of 25 mcg. I noticed that after about 3 hours I started getting the pins and needles feeling in my shoulders and wrists. Is it too soon to be a reaction to the medication. I feel fine otherwise, no racing heart, etc.

I really want to try the med because I had every symptom on her list for hypothyroid and have for the last 9 months, she also said my thyroid feels "gritty" is that consistant with Hashis?

Thanks!

Gina