lots of thyroid health questions

[branmac76]

I have recently been diagnosed with a hypothyroid. I have horrible migraines, I do not sleep much.I have a lot of health problems. Four years ago I had the gastric bypass. I have kept the weight off until recently. I continue to gain weight and feel horrible. My doctor prescribed synthroid 100 mg. Everything was fine until I collapsed and was thought to have had an epileptic episode. The doctors ruled out epililepsy and thought it was just for low iron and too high thyroid medication. I have been told by my doctor to discontiue the synthroid. Not sure what to do now. I have degenerative disc disease, scoliosis, migraines, horrible pain, fatigue, insomnia, and weight gain. I know some of these are tied together. I am a single mother and am 29. My health is rather poor from day to day. I am unable to work because of daily pain, which keeps me from walking, standing, and sitting for long periods of time. I do not know what to do next. I continue to go to the doctor but am unsure of what dosage of thyroid medication to go to next. I have done research and have seen mg from 0.3 mg to the high end of 200 mg. I am a mess. Can someone help me to recomend a medication that can help decrease as many syptoms (symptoms) as possible. I do not know who else to contact. It took two weeks to find out from my doctor that my thyroid function is now too high because of the medication. In between the two weeks would be when I was admitted to a hospital for collapsing. I want to find out some medications, side effects, and questions to ask my doctor. Please help.

[Mark Lupo, M.D.]

This is a complicated situation.  The collapse could have had many causes - low sugar, "dumping syndrome", hyperthyroidism, dehydration, anemia, potassium/magnesium problems, neurological issues, etc - standard labs should sort most of these out.  If the thyroid test before starting synthroid documented hypothyroidism, then it may be necessary to be on synthroid again - but at a lower dose.

Other post-bypass issues include B-12 -- make sure you are getting/absorbing enough.  

Which meds do you currently take?

May be difficult to find one medication that will address all the symptoms, but making sure the thyroid is kept normal is imperative and a good place to start.  Dose range is 0.025mg up to 0.3mg (and occassionally higher).

[Jimlow]

Drmark, I have a question as well but am not in a hurry for an answer. Please do so at your convenience.
You may have heard us talk about our joint probelms on here. Pain, stiffness and "crepitus". My pain is not severe although the joint sounds concern me at times. Is it common for thyroid patiets to have the pain and noisy joints, even while on treatment? Mine is more so in my shoulders & cervical spine but strangely, I sometimes get a tenderness feeling in my scalp, top of head, that I feel is from inflammation traveling up. Actually, this strange tenderness at times, can be on my outer skin, on other parts of my upper body. Can the thyroid antibodies be the cause of this or what else?
Thank You.

[Jimlow]

Sorry forgot to mention I tested negative for RA, gout, ESR(was a "5") and ANA. I do not have joint swelling in spite of moderate pain and inflammation feeling.

[Mark Lupo, M.D.]

In my experience, hashimoto patients are more likely to have fibromyalgia - or a least more likely to be labeled with fibromyalgia.  The crepitus, I don't think, is related to thyroid.  Certainly, hypo and hyper both effect tendons, joints and muscle but once corrected - these effects should be minimal.

[Catastrophia]

Since I can't get another question asked by the dr.,I'll ask other members.Autoimmune Disease clusters? Do you believe that while taking ANY meds for Hashi's thyroid,a person can have adverse reactions due to another underlying autoimmune disease such as adrenal gland deficiency?Alot of us are suffering from headaches and joint pain even though we didn't experience this until beginning treatment for hypothyroid disease.Our drs. don't want to address this issue if our adrenal gland tests "appear" to be normal or borderline. They are only interested in thyroid levels,increasing or decreasing the dosage if we complain too much. This only adds fuel to the flame - or more pain. I'm not suggeating that we discontinue medication.I'm suggesting that we look for that "needle in the haystack" dr.Take care.
Cat-

[Catastrophia]

Dr., Do you believe that while taking any meds for Hashi's thyroid, a person can have adverse reactions due to another underlying autoimmune disease such as adrenal gland deficency? Alot of us suffer from pain even though we didn't experience it until beginning treatment for hypothyroid.Our drs. won't address this issue if the adrenal gland test "appears" normal or borderline until we complain enough.They only seem to be interested in thyroid levels,and decreasing or increasing the dosage. This only adds fuel to the flame - or more pain.I really would like your opinion. Thanks.

[Med Help]

Beginning on September 19, 2005, Dr. Mark will answer 2 new QUESTIONS each day in this forum.  To be sure that you receive an answer, you must post your question as a NEW QUESTION, not as a COMMENT to a question posted by someone else.

Thank you for your cooperation.

MED HELP INTERNATIONAL

[Jimlow]

Thanks again Drmark, you have confirmed something I was unable to get answers on by Dr.s for quite some time. I know people in my own City that first were diagnosed hypo, then following treatment, the retained/unrelieved joint/fatigue symptoms were labled  "fibromyalgia". The word actually means simply "muscle-joint pain" and I feel "Fibromyalgia Syndrome", would likely be more in the diagnosis catagory and I feel if it's thyroid related, it's likely not the syndrome (just opinion).
The "Crepitus", I'm probably labling wrong because it actually means "joint grating" (just found out), bone to bone and I do not believe that's what mine is. There is a lot of cracking. popping but I believe mine is simply "stiffness" and maybe a few fluid-bubbles popping.
Thanks much, I appreciate your response.

[catgirl4]

I had my tyroid taken out 7 years ago and ive never been right since. Total removal of tyroid and 1 set of para thyroids. Im always hyper or hypo. Just changed my meds to 175 mg levoxyl. still feel like ****. Tired all the time muscle aches extreme stiffness  and weight gain despite the fact that i work out all the time... any suggestions?  just seeing my gp because i got sick of my endo telling me I was fine.... :(

[Mark Lupo, M.D.]

The only definite case where thyroid treatment worsens the situation is with adrenal disease.  An ACTH stimulation test is the best to sort this out - treatment with steroids is a big deal and should only be done if a person has clear-cut adrenal insuffiency (failure to mount a cortisol level above 17 after 0.25mg of ACTH).

The musculoskeletal symptoms appear to be a very common problem in forum members - this is usually not as prevalent (I have over 1500 hypo/hashi patients in my practice).  In this case treating the TSH to 0.5-1.0 and/or considering T4/T3 combo treatment may help.  Also rule-out adrenal insufficiency (see above), growth hormone problems (check IGF-1) and consider a rheumatology consult to exclude other causes.

[fatfuzzyfrazzled]

if your thyroid is off, then your pituitary and adrenal glands could be out of balance too.  keep up the research.  check out the book feeling fat fuzzy and frazzled.  it goes through and explains what to check for re other hormone glands.  also can order home tests to check your self if you want.  find a good thyroid doctor, not necessarially an endo.  my new doc is a family phys who just so happens to be up to date on thyroid due to his own and his fathers struggles w/the thyroid.  dr. walter woodhouse in temperance MI.  don't settle for anything less than the answers.  it is not fun to live in such pain everday espec at your age.