Hashimoto's with itchy scalp and hair loss

[rubyv]

Hello Dr Lupo,

I have had hypothyroidism, as a result of Hashimoto's, for 5 years now. Symptom management has been difficult. My TSH is currently 1.02. I know that level is considered "perfect", but I am still having problems with itchy scalp, hair loss, joint pain in the hands, mood swings, irritability and anxiety. I've read that some people with Hashimoto's can also have adrenal involvement, could these symptoms be related to that? I know that there is something else going on with my body, but I can't get anyone to listen. My endocrinologist does not seem to think the symptoms are hypo related, but is also unable to give me a reason I am still symptomatic.

My questions are could all of these symptoms be related to the thyroid? Does my TSH need to be on the lower end? Are these indicative of another auto-immune disorder, such as Lupus?  

Also, at what point should I consider seeing a specialist that deals with autoimmune disorders. I can't seem to find an endocrinologist who wants to look at the picture from a holistic perspective.

Any insight or guidance you can provide is extremely welcomed.

Thanks,
Rubyv

[Mark Lupo, M.D.]

Could be many of these things you list -- first work with the general MD to see if it may be a problem with liver, kidney, anemia -- they can also test/screen for Lupus like problems with blood tests.  An am cortisol >11 suggests against adrenal insufficiency -- if <11 - consider acth stim test to evaluate for underactive adrenal --- fortunately this is rare.  The tsh looks good -- consider asking about t4/t3 combo therapy once other work-up is complete.

[Julie65]

What medication are you taking?  I was on Synthroid for about a year and still having all the symptoms you listed.  My D.O. switched me to Armour and the difference for me was incredible.  (No more symptoms after just a week or two!)  

[tbirdlady]

I am taking Synthroid 250.  I still have hair loss, depression, fatigue, and wieght loss is almost impossible.  Levels are in the normal range.  Can someone tell me what the medication Armour does differently than Synthroid?

[Julie65]

It provides "extra stuff" - most notably T3.  If you're not responding well to Synthroid or other synthetics, it's always worth a try on Armour to see if you do better.  Some people seem to have trouble converting the T4 in the synthetics to T3.