Hashimotos cant control

[Nat_2010]

I have hashimotos...still have never had a normal tsh...its gone from 400...than it will go down than back up than k down than back up been like this for 6 months. Im on 300 levi. now and just got my lab results back tsh is 20. Mean while I feel like crap...muscles ache, tingleing all over, I have severe cramping in my body and Im so tired. I just need advise. What will the next step be..my doctors keep doing blood work uping the dose and waiting 6 weeks. Ive lost my job, had to move in with my parents and my two young kids have lost there engeretic mom...when do they finally say enough enough and talk about taking it out.

I also have severe collar bone pain, neck pain, cant sit or stand for long periods of time. At times it is hard to swallow and I get a throbbing pain in the right side of my neck. Please any advise would be greatly appericated!!!!

[Nat_2010]

Thanks so much!!!!

[gimel]

I kept thinking that I had another prospect for you and I looked back over my listing of recommended doctors and found one in Austin.  He comes highly recommended by one of our members.  Sending name by PM.

[gimel]

Before increasing your T4 meds any further, you need to be tested for Free T3 and Free T4.  If your FT3 level is low, as I suspect, then just increasing your T4 med is not going to be the answer.  Also, just going to an Endo is not necessarily a solution for you.  They are frequently very rigid in their "Immaculate TSH Belief" and "Reference Range Endocrinology".  As a result they might not want to do anything different than what is not working now.  What you need is a good thyroid doctor, as I previously described.  If you find a good thyroid doctor that is also an Endo that is a real find.  

I do have names of two doctors in the San Antonio area, that were recommended previously by members.  Both happen to also be Endos.  Is that too far away for you to consider?

[Nat_2010]

Thanks for your advise...just spoke with the doctor and she said she is going to up my levothyroxine up to 350mcg. Is that even okay to do? I asked for a referral to a endo. and she said she could I just think I need to start fresh with a new doctor...to much time is a wasteing and my body is suffering.

[gimel]

The T4 test is total T4 which is somewhat outdated and not nearly as informative as a Free T4.  Free T4 is the portion of the Total T4 that is biologically active.  The T3 uptake test is also very outdated and not nearly as informative as a Free T3 test.  Free T3 is the thyroid hormone that largely regulates metabolism and many other body functions.  Scientific studies have shown that FT3 correlated best with hypo symptoms, while FT4 and TSH correlated very poorly.  TSH cause no symptoms.  TSH is only an indicator of the levels of the actual thyroid hormones.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.  You can read some good info on clinical treatment in this link.

http://hormonerestoration.com/files/ThyroidPMD.pdf

So the first thing you need to do is to get the doctor on board for testing your Free T3 and Free T4, along with the TSH.  Then you should make sure that he is willing to treat you clinically as described above.  I expect this will require a change of meds to include a T3 source.  I say this because many times patients taking large amounts of T4 meds still have low levels of FT3, because of inadequate conversion of T4 to T3.  An FT3 test that was in the lower end of the range or lower would be consistent with having hypo symptoms.

If you will get those tests done, when results are available, please post results and reference ranges shown on the lab report and members will be glad to help interpret and advise further.  While there it would also be a good idea to get tested for Vitamin A, D, B12, Zinc, iron/ferritin, RBC magnesium, and selenium.  Selenium can help ease the pain of Hashimoto's, but too much is not good, so before considering supplements, it would be good to test for it.  I suggested the other tests because frequently hypothyroidism is accompanied by deficiencies in those areas as well.  

[Nat_2010]

4/12/2011
8.3       4.4-12.4 UG/DL
30.9     20.0-38.5-%

[gimel]

I can't remember if you have current test results for Free T3 and Free T4.  If so, please post with reference ranges, or whatever thyroid tests you have other than TSH.