The first week after i started thyroxine i noted an improvement in a few symptoms. I was a bit hyperthyroid actually. Then a week later my hypothyroid symptoms worsened for the next month. A "rebound" effect is a good a term as any to describe it. I was in a panic state to be honest until i found an excellent book explaining what was going on. It makes plenty of sense and my relief was profound.
Excerpt from "Running On Empty" by Robyn Koumourou...
"It is not uncommon to start thyroid hormone therapy and find that your symptoms become worse before they get better. When you begin taking thyroxine the areas in the brain that control thyroid hormone production sense the increase in T4 levels within the blood stream. This feedback system will then cause the thyroid glands natural production of thyroid hormones to slow down.
Less natural T4 and T3 will then be produced and released and blood levels may remain stagnant or even decrease temporarily. Less free T3 hormone available to the body will slow down cellular metabolism. The symptoms of hypothyroidism may become worse until an increase in thyroxine is taken or an optimal dose is found."
What on earth was your pcp thinking to take you off the synthroid? Doesn't he know that's what was keeping your TSH in the normal range? And wasn't he testing the Free T3 and Free T4, along with that TSH?
It takes approximately 4-6 weeks for a dosage to take full effect.
200 mcg is a HUGE starting dose. It's always best to start a lower dose, usually 25-50 mcg and work up because it takes time for your body to get used to having hormones it's been doing without.
You might want to talk to your doctor about backing down on the med until you get used to it again.
Was TSH the only thing tested? You also need the Free T3 and Free T4 tests. Those are the actual thyroid hormones and will determine much better than TSH what your dosage should be, though most doctors (even endos) swear by TSH, which is not even a thyroid hormone.
Do you know if you have Hashimoto's?
Oh my gosh, how frightening! I am new to hypothyroidism so I don't know the answer to your question, but since you have lupus, have you run this situation by your rheumie? Are the two docs exchanging info to best get all of this under control? I hope you begin to feel better soon. Good luck!