Low Thyroid?

[swelter]

I am a 61 yr old male who had radioactive Iodine treatment 4 yrs ago for graves disease. Since then have been on 88 mcg Synthroid.  A year ago started being constantly constipated. Had colonoscopy and was told to  take more fiber.  Thyroid tests were said to be normal.  This year my TSH was 4.12.  Other symtoms are sensitive to cold temps.  Become extremely hot working in hot sun.  Also have sensations in calfs of legs at night.  Do my symtoms indicate I am low on thyroid.  Have always felt 88 mcg was low.  I am 6'3" and weight 160lbs.

[Mark Lupo, M.D.]

Your TSH is too high.  The goal is around 1.0 -- anything greater than 2.5 in a patient on synthroid needs to be addressed.  Talk to your doctor about increasing the dose to 100mcg.  The constipation and cold intolerance may improve - the calf sensation may not be related.

[Ussie]

In my opinion, you could possibly have low thyroid. I have had those same symptoms with hypothyroidism. Also, I get depressed when my thyroid is low.

[sadandscared]

I have a question about synthyroid. I have just had my first surgery and had my right lobe removed. Post surgery the labs showed a 2m follicular cancer. Surgeon says watch it and take synthyroid. The endocronologist says go for another surgery in 1-3 months and get the left side removed. Then go on synthyroid. I am scared about all of this!!! What will I feel like post 2nd surgery. How long will it take for me to feel back to myself when I am on the synthroid. I am very active. Any thoughts.
Shari

[Mark Lupo, M.D.]

If the one lobe was a follicular cancer you should have the rest of the thyroid removed and then have radioactive iodine.  Follicular Cancers are more aggressive than papillary and I would not be comfortable "watching."  The cancer does complicate things quite a bit.  The current standard of care in this situation is

1) completion thyroidectomy and ? lymph node dissection
2) Start cytomel 12.5-25mcg 2x/day for 4 weeks then stop
3) Start low Iodine Diet
4) Once off all thyroid hormones for 10 days check TSH, if >25 then have Radioactive I-131 to "clean-up" any remaining thyroid tissue
5) 4 days after the I-131 start synthroid
6) about 7 days after I-131 have whole body scan and see your endo again.

Good Luck.

[sadandscared]

Hey everyone. Thanks for your thoughts. I agree about going for the second surgery, I am just very scared. My cancer was small. It was 2mm in a 2.5cm tumor. But I know that this cancer is more serious. My family doc scared me last night when we spoke aobut the few months following the second surgery. He said it takes a while to get back to normal. HOw sick will Iget from the synthyroid. Will I gain a lot of weight and be tired. The endo. says I won't start the meds until 2 weeks follwoing the surgery. My other question is if they do the second surgery will they also check the left side to make sure no cancer is over there? I appreciate your thoughts. My dad actually died 2 1/2 years ago from gastric cancer which became metatstatic, so the word cancer alone terrifies me.

[sadandscared]

Hey doodlebug: I think my situation is a little different. I am going on the meds because of the cancer. My thyroid has always been normal. The endo. said he would put me on a synthetic thyroid med 2 weeks after sugery. Then, I would start synthroid after I have the RAI (6 weeks post surgery). Haven't they made improvements in treating people without a thyroid??? Is armour only for people who are hypo-thyroid?

[doodlebug1]

But sadandscared, you WILL become hypo after your RAI..eventually. Yup, your hypo will be the result of the RAI, and some folks are hypo due to an autoimmune disorder (Hashimotos), and some are hypo like me after a pregnancy....etc...but the end result is the same. Synthroid is for the hypo, no matter what the cause..and yes, Armour is for the hypo, no matter what the cause. The problem is that Synthroid and all other T4-only meds are leaving most EVERYONE with symptoms related to inferior treatment. I just wanted you to tuck that info away in the back of your mind when that day comes. :o)

You asked "Haven't they made improvements in treating people without a thyroid???" I think they have made some GRAND improvements in treating some cancers, and I'm sure you're going to be just fine! But as far as thyroid treatment, especially hypo, it's the PITS. The money-grubbing pharmaceuticals did a bang-up job convincing all docs to put people on Synthroid and all other T4-only meds, especially beginning in the early 1960's. Before then, folks were on natural thyroid, either sheep or pig, and folks were successfully dosed by symptoms!!

The TSH was developed around 1975 with a lousy range and a strong new emphasis that dosing by the TSH was the best way to treat them. It's ALL been wrong, and there is more and more documentation to support this. If you could line up the first 100 people you meet who are on Synthroid, AND who are kept in the TSH "range", nearly ALL of them would tell you that STILL have lingering hypo symptoms, which include chronic low-grade depression, less stamina than others, dry skin/hair, hard stools, high cholesterol (I never got the high cholesterol but had all the others.)

So, the bottom line for me and for a growing body of folks-- we've had to become educated and learn for ourselves what has NOT been working (being put on Synthroid, and being held hostage to the TSH), and what DOES (being put on Armour, and dosing by SYMPTOMS first and foremost, and using the free T3 and free T4 as great guides, as well as temps). Treatment with T4-only meds has NOT been giving folks the success that treatment with natural dessicated pig thyroid has (and DID). (The most popular brand name is Armour, but there is also Naturethroid, Westthroid, Time Caps, and a successful brand from Thailand called Thyroid-S.0

Anyway, I hope that helps for your future. You are going to be just fine!