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Mild Hypothyroidism--do I really need meds?
Hello,
I am 38 years old. and due to a strong familiy history of Hashimoto's (mother, aunts, and sister both diagnosed years ago) I get my thryroid tested by an Endocrinologist at least 1x a year. I have been doing this since 2010--since I was pregnant with my son at that time, she monitored me. My labs were always in the normal range TSH 1.5 pregannt. Then post partum in 2011, they went up to TSH 2.5. (No antibodies.) It was a "watch and wait" at that point.
Now, fast forward to 2014. I really dont have many symptoms except very dry skin, difficulty losing weight. But, what prompted me to return to endo were these out of the blue heart palpitations. I even went to the ER and cardiologist who said they were harmless PVC's. Not convinced, I went to my Endo for blood test and got the following restults:
TSH 3.17
Free T4 1.0 (0.8 to 1.8)
Free T3 3.2 (2.3 to 4.2)
Now, to me, my results dont look that elavated (but what do I know?) But, since my husband and I are thinking of having a 2nd child, the endo felt strongly that TSH was too high--especially for having a heatlhy pregnancy. She perscribed 50 mcg Synthroid and I took my first dose today.
I am really nervous, as I have heard horror stories about people getting worse on Synthroid. I am at a healthy weight 156lbs and eat a strict Paleo diet and weightlift and do cardio. I will say, the last few years I have been slowly gaining weight and it has been almost impossible to lose it. But, other than that, no overt symptoms but PVC's.
Anyway, sorry to ramble, but do you guys think my above results were enough to warrent medication?
Just looking for input and perspective from differnt people. Thank you in advance!
I am 38 years old. and due to a strong familiy history of Hashimoto's (mother, aunts, and sister both diagnosed years ago) I get my thryroid tested by an Endocrinologist at least 1x a year. I have been doing this since 2010--since I was pregnant with my son at that time, she monitored me. My labs were always in the normal range TSH 1.5 pregannt. Then post partum in 2011, they went up to TSH 2.5. (No antibodies.) It was a "watch and wait" at that point.
Now, fast forward to 2014. I really dont have many symptoms except very dry skin, difficulty losing weight. But, what prompted me to return to endo were these out of the blue heart palpitations. I even went to the ER and cardiologist who said they were harmless PVC's. Not convinced, I went to my Endo for blood test and got the following restults:
TSH 3.17
Free T4 1.0 (0.8 to 1.8)
Free T3 3.2 (2.3 to 4.2)
Now, to me, my results dont look that elavated (but what do I know?) But, since my husband and I are thinking of having a 2nd child, the endo felt strongly that TSH was too high--especially for having a heatlhy pregnancy. She perscribed 50 mcg Synthroid and I took my first dose today.
I am really nervous, as I have heard horror stories about people getting worse on Synthroid. I am at a healthy weight 156lbs and eat a strict Paleo diet and weightlift and do cardio. I will say, the last few years I have been slowly gaining weight and it has been almost impossible to lose it. But, other than that, no overt symptoms but PVC's.
Anyway, sorry to ramble, but do you guys think my above results were enough to warrent medication?
Just looking for input and perspective from differnt people. Thank you in advance!
It's true that hypo is treated the same whether the cause is Hashi's or not. However, I think there's merit in knowing if you have an autoimmune disease (or two), and knowing you have Hashi's certainly gives you a better idea of what to expect as the disease progresses.
T4 alone works well for many people. But, it's a very individual thing.
My last U/S proved that my thyroid is dead, so my hypo is more than mild, and I take T4 alone.
People who don't convert well often have to add some T3 (Cytomel and generics) to their meds to bring up their FT3. Some people find that desiccated is the only thing that works for them.
Most doctors start patients on T4. If T4 works for you, it is arguably the easiest, cheapest and least subject to supply issues of the meds. It only has to be taken once a day. Once any meds with T3 are introduced, most people split into two half doses.
You'll probably fins a lot of sites demonizing T4 only therapy. People have their biases and tend to think that what worked for them will work for everyone. We all have to find what works best for us.
T4 alone works well for many people. But, it's a very individual thing.
My last U/S proved that my thyroid is dead, so my hypo is more than mild, and I take T4 alone.
People who don't convert well often have to add some T3 (Cytomel and generics) to their meds to bring up their FT3. Some people find that desiccated is the only thing that works for them.
Most doctors start patients on T4. If T4 works for you, it is arguably the easiest, cheapest and least subject to supply issues of the meds. It only has to be taken once a day. Once any meds with T3 are introduced, most people split into two half doses.
You'll probably fins a lot of sites demonizing T4 only therapy. People have their biases and tend to think that what worked for them will work for everyone. We all have to find what works best for us.
I do plan to have the antibodies test again. I have no idea why my endo didn't do it with this recent blood test. And when I questioned her, she said it still didn't change her mind about starting me on meds.
Does synthroid alone work well for most people with mild hypo?
Does synthroid alone work well for most people with mild hypo?
Oh, you're talking to the original minimalist when it comes to meds, supplements, etc. LOL However, I was very close to narcoleptic when hypo, so it wasn't too hard to convince me that this was an exception.
Do you plan to retest antibodies? Am I correct that your antibody test was in 2011?
Do you plan to retest antibodies? Am I correct that your antibody test was in 2011?
flyingfool--I tested negative for the antibodies.
I thought 50mcg was high too---but my endo said she is testing me in 6 weeks. Fingers crossed all goes well.
I thought 50mcg was high too---but my endo said she is testing me in 6 weeks. Fingers crossed all goes well.
I also agree that a starter dose makes some sense. I however think that starting out with 50 mcg is a bit high. Frequent starter doses are 25 to 50 mcg. But your numbers and symptoms are not that far out. So in my mind starting out at 25 mcg makes sense.
Some people have no issues starting out at 50 mcg. Other people need to start slower. So you may be one of those people who are fine. But if you start to feel side effects, let your Dr know and discuss lowering the dose or take the 50 mcg every other day or something.
Have you been tested for Hashimoto's? This owuld be TPOab or TGab tests. An elevated result in either or both of these would be positive for Hashi's. Treatment is the same whether you have it or not. But knowing if you have hashi's would be important so that you get tested more frequently so that the replacment thyroid can keep pace with the decreased efficiency of your thyroid glands output due to the Hashi's.
Some people have no issues starting out at 50 mcg. Other people need to start slower. So you may be one of those people who are fine. But if you start to feel side effects, let your Dr know and discuss lowering the dose or take the 50 mcg every other day or something.
Have you been tested for Hashimoto's? This owuld be TPOab or TGab tests. An elevated result in either or both of these would be positive for Hashi's. Treatment is the same whether you have it or not. But knowing if you have hashi's would be important so that you get tested more frequently so that the replacment thyroid can keep pace with the decreased efficiency of your thyroid glands output due to the Hashi's.
thanks so much for your response goolarra. Yes, its been a "watch & wait" due to my family history and I have Alopecia Areata--which as you might know is an auto-immune condition with high correlation of thryriod issues and other autoimmune disorders.
yes, the thoughts of becoming pregnany again is what pushed my ENdo to get me on synthroid. And I am certainly a minimalist when it comes to any kind of meds, but I agree---you dont mess with pregnancy.
To answer your question on symptoms...this is going to sound odd. Since the birth of my son in 2011, I started getting symptoms, extreme fatigue, weight gain (and extreme difficulty losing any weight even with a low carb, low glycemic, crossfit lifestyle). But then, when I went paleo (gluten, grain, dairy, refined sugar free etc) I have felt amazing! No more mind numbing fatigue, I have lost weight without any kind of effort. The only weird thing going on is the PVC's and recurrent sinus infections.
Anyway, thanks so much for your input!
yes, the thoughts of becoming pregnany again is what pushed my ENdo to get me on synthroid. And I am certainly a minimalist when it comes to any kind of meds, but I agree---you dont mess with pregnancy.
To answer your question on symptoms...this is going to sound odd. Since the birth of my son in 2011, I started getting symptoms, extreme fatigue, weight gain (and extreme difficulty losing any weight even with a low carb, low glycemic, crossfit lifestyle). But then, when I went paleo (gluten, grain, dairy, refined sugar free etc) I have felt amazing! No more mind numbing fatigue, I have lost weight without any kind of effort. The only weird thing going on is the PVC's and recurrent sinus infections.
Anyway, thanks so much for your input!
I do think your numbers warrant meds, especially considering that you plan to conceive in the near future.
Thyroid test ranges are very flawed for a number of reasons. Many of us find that FT4 has to be about 50% of range, based on symptom relief. FT3 often has to be upper half of range.
Your FT4 is only 20% of range. FT3 is at 47% of range. So, while "in normal range", they are in a very gray area of the range. Weight gain and inability to lose weight are hypo symptoms and PVCs, unexplained by a heart issue, can be a symptom as well. No fatigue and/or sleepiness, hair loss, depression, anxiety, constipation, etc.? You can google a more comprehensive list of thyroid symptoms.
I agree with your doctor about the pregnancy issue. Low maternal thyroid hormone levels can contribute to miscarriage and slowed fetal development. Pregnancy and childbirth can wreak havoc with normal thyroids, so you want everything as stable as possible before conceiving and to monitor closely throughout pregnancy.
Typically, when to start meds is somewhat a function of how you feel, how annoying your symptoms are to you. If they're mild and you prefer to stay off meds, I respect that. However, pregnancy adds another factor to that equation.
Thyroid test ranges are very flawed for a number of reasons. Many of us find that FT4 has to be about 50% of range, based on symptom relief. FT3 often has to be upper half of range.
Your FT4 is only 20% of range. FT3 is at 47% of range. So, while "in normal range", they are in a very gray area of the range. Weight gain and inability to lose weight are hypo symptoms and PVCs, unexplained by a heart issue, can be a symptom as well. No fatigue and/or sleepiness, hair loss, depression, anxiety, constipation, etc.? You can google a more comprehensive list of thyroid symptoms.
I agree with your doctor about the pregnancy issue. Low maternal thyroid hormone levels can contribute to miscarriage and slowed fetal development. Pregnancy and childbirth can wreak havoc with normal thyroids, so you want everything as stable as possible before conceiving and to monitor closely throughout pregnancy.
Typically, when to start meds is somewhat a function of how you feel, how annoying your symptoms are to you. If they're mild and you prefer to stay off meds, I respect that. However, pregnancy adds another factor to that equation.
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