I'm 28 and newly diagnosed with Hashimoto's via antibody testing after a journey of four years trying to figure out why my digestive system has gone haywire- gas, constipation, bloating, and loose stools and heartburn thrown in for good measure. Lately I've become quite sensitive to cold, have persistent muscle pain in my shoulder/neck, and have been dealing with bruxism. Blah. I'm really wanting to feel better as is everyone else on this forum! My TSH over the last month has ranged from 8.6 to 10 and my Free T4 looked ok at 1.05. My internist did not measure anything else, and I'm waiting to get in to see the endo (no openings til March). My internist put me on 75 mcg of levothyroxine generic three days ago. How long before symptoms should start to subside? Has anyone had good luck on levothyroxine? My mother has taken Synthroid namebrand for twenty years with mostly good luck. She was diagnosed as hypothyroid in her 40s but has never been tested for Hashimoto's, though I'm guessing she has it too since it's genetically inherited... Anyway. Sorry to ramble. Encouragement and suggestions welcome.
Everyone is different, I did not do well on Levo,my levels did not move much in 6 months, then when I went to Synthroid I did better, but some do well on Levo also, its just trial and error, Has or does your MD tested for Free T3 and Free T4? or is he/she a "TSH" nut? How your MD tests and treats makes a huge difference in your progress, if they base everything on TSH, then you are better off and can avoid much misery by locating another "Good" thyroid MD now, don't waste your time, money and the benefit of feeling good with the one you have. If you would like to post your thyroid levels and the ranges provided with each, then members can advise and comment. Best Wishes FTB4
Thanks for you response-- I'm not sure yet how my doctor feels about treatment regarding TSH/ FT3 and FT4 etc... I feel ok about her so far after our introductory visit, and I guess I'll have to re-assess at our next meeting depending on how my symptoms go and how receptive she is to my questions. This time she only requested a test for TSH and free T4. Not free T3. When I went in I said my mom had always sworn by name brand Synthroid, and she seemed open to changing me if I didn't react well to the generic, but definitely wanted me to try the generic first.
Fair enough, I guess, but you're right that if she isn't willing to be flexible and test for other things in the long run I should definitely switch. It's frustrating because right now I'm in Montana and am having a difficult time finding a doctor who I know is good (not to mention one who doesn't make me wait three months for an opening). I'm crossing my fingers for the endo in March.
I'd just like to add that 75 mcg is a bit high for a starting dose, especially if you are over 50, have been hypo for more than a few months or have a heart arrhythmia. It might be wise to ask your doctor if you could split that 75 in half and try that for a couple of weeks before going to the full 75.
It takes 4-6 weeks for your initial dose or any increase to reach its full potential in your blood. In that time, levels are building.
I've been on Synthroid, Levoxyl and generic at one time or another, and for me, there isn't one iota of difference among them. The major difference among them is the fillers (inactive ingredients) used by the different manufacturers. Some people are allergic or sensitive to them, but that can be an issue with both brand name and generic.
I can't tell you how important FT3 and FT4 are. Request those next time, ask for copies of all your lab results and keep your own history. This is invaluable. Jot down meds dosage and symptoms just prior to the draw on each lab report.
Don't just cross your fingers and wait until March to find out. I'd call the doctor's office and get answers to a couple of questions that will reveal whether you might be wasting your time waiting.
For perspective, 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. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."
So, in view of that definition of a good thyroid doctor, the questions I always ask are as follows. Is the doctor willing to 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? Then I ask if the doctor is willing to prescribe thyroid meds other than T4 only types? If either answer is no, or a hesitant answer, then I go on looking for a good thyroid doctor.
Thanks everyone! This whole thing is really scary, and I wish I could get in to see doctors right away instead of waiting as a first time patient. All the endos in Missoula have a 3 month wait time for newbies. I will call and ask around some more. My fear about the 75mcg is hair loss and potentially exacerbating heartburn or bruxism unless, as I'm hoping, they are connected to hypothyroidism and not a separate issue. I haven't lost much hair so far, but my mom said hers thinned out a bit ever since starting Synthroid 20 years ago. If it helps, in addition to my lab#s mentioned above, I'm 5'4" and 120 lbs, but I don't know if that makes a dose difference. All I have to go on other than that for how long I've been hypo are TSH tests from past screenings. One in 2005 when I felt pretty good was 2.8, and then in 2009 when my digestion was going crazy + terrible heartburn it was 4.8 and I was told that was normal.
Another random question-- does it matter if I take my birth control pills around the same time as the levothyroxine, maybe an hour or two difference between them? The nurse at my doctor's office said that it would be best to change my schedule and take my BC at night (which would be way harder for me to remember), but the pharmacist said not to worry. The pharmacist said if there was any impact on absorption it would be the same every day regardless and that they would just adjust the dose accordingly... I start my next pack tomorrow... what do you think I should do?
Initial dose is weight based to some extent. It's 1.7 mcg/kg/day. However, you indicate that you think you've been hypo for several years (and a 4.8 TSH in 2009 would support that). When our bodies are no longer used to having adequate levels of thyroid hormone, it's often best to start out a little low and work up to give everything time to rebalance. Synthroid's website suggests 12.5-25 mcg to start if any of the conditions I listed above apply.
People who continue to lose hair on Synthroid usually do that because they are undertreated. They are "in range" on labwork, but they are not high enough in the range. Hair loss is a symptom of hypo.
Heartburn should improve with meds...it's another hypo symptom. The bruxism? It's not a typical symptom, so you just may have to wait and see. I do that, too, so if you find anything out...
I'd go along with the nurse on the BC pills. It's best to separate all meds and supplements from thyroid meds by 3-4 hours. Taking two hormones at the same time? Shaky ground. The pharmacist is correct IF the impact is low. Estrogen can interact with thyroid hormones. I'd play it safe on that one. Can you take your BC pill at lunch or dinner?
Gimel, thank you for the doctor recommendations. Goolarra, thanks for the tip on pill timing and heartburn. The heartburn has been such a downer the last few years, and I really am hoping it goes the heck away after I find the right dosage and meds, so that I can stop taking prilosec. I'll let you know about the bruxism! I decided to take my birth control pills at noon and my thyroid meds at 8am-- the med website recommend 4 hours between thyroid and calcium, so I figured that was a safe bet.
Just for info I had very bad acid reflux during a period when I got back into being hypo, while my regular med (Armour Thyroid) was not available. During this time my Free T3 got too low in the range and heartburn resulted. And, by the way, I was taking 20 mg of Prilosec twice a day and still had the reflux problem. As soon as Armour was available again I got back on my regular dosage, got my Free T3 back into the upper part of its range and and in a very short time my reflux problem was gone.
Thanks Gimel-- it really makes me happy to hear that heartburn really can be associated with hypo, even though it's not on the standard lists of symptoms. My current internist (via the nurse) tells me that FT3 is an unnecessary test to monitor my treatment, soooo I'm really happy that I will be able to get in to see Dr. Corsi in a couple of months in case I don't convert T4 very well or in case anything else comes up that the standard recommendations from on high don't account for. It sounds like Corsi listens to patients' symptoms and tests for T3 and treats accordingly.
An under-active thyroid may disable the LES, allowing food and digestive acids to re-enter the esophagus from the stomach. In addition, hypothyroidism has been shown to delay gastric emptying, which allows more acid to flow upward into the esophagus.
Diagnosed with Hashimoto's several years ago. Presently on Levo at 88 mcgs. I too had bruxism, which has stopped completely. And the acid reflux gets worse before it gets better. Unfortunately. But the rest improves. Slowly. The acid reflux may get bad enough to go on Prevacid for awhile. You don't want to live with it because it will mess up your esophagus. I have to go in and get throat stretched about once a year. Diet change helps with this. Less carbs. No alcohol. NO caffeine. (sob) You may have to just watch what you're eating and drinking and see what makes it worse. Sometimes, for no known reason, you may just have a bout of acid reflux, and then mysteriously it goes away.
Wow! Thanks-- good info. I also just found this one: http://www.puristat.com/stomach/gastroparesis.aspx
which lists hypothyroidism as a direct cause of delayed gastric emptying and heartburn etc... I definitely stay off caffeine (haven't had any in three years now, AND I'm a writer!) and limit alcohol. It's nice to know I'm not alone in this.
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