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New to Thyroid Problem HELP

So I have had my Thyroid tested twice and here are the results:
1st:  01/05/12   TSH 13.200 Reference Range:  0.450-4.500 uIU/mL
2nd: 02/10/12 TSH 12.860 Reference Range:  0.450-4.500 uIU/mL

My Dr has scheduled me to start taking synthroid 100 mcg a day.
I am very nervous about taking medication and was wondering if this is normal or too high a dosage?
What side effects can I expect if any?  
Is there a natural approach to correct your Thyroid function?
Over the last 2 years I have lost 66LBS and I exercise now 3 days a week I think I am in pretty good health overall (now).

I am 32 yr male.

Please any input, advice, or suggestions you can offer are appreciated.
Thank you!
Best Answer
Avatar universal
Yes, I understand that you lost the weight on your own.  Weight gain and inability to lose weight are often symptoms of hypo, so it's a little surprising that you were able to do that while hypo.  It's inconsistent with your TSH, which bothers me.

FREE T3 and FREE T4 (not total T3 and T4) are the actual thyroid hormones.  They are much more important than TSH and should be what all meds decisions are based on.  TSH is very volatile, varying significantly even intraday.  Dosing meds based on TSH alone often leads to a rollercoaster of hypo/hyper (overmedicated) swings.

The lion's share of hypo is autoimmune thyroid disease (in the developed world), Hashimoto's thyroiditis.  It is a lifelong condition for which there is curtrently no cure, and those of us with Hashi's will be on meds for the rest of our lives.  There are other kinds of "temporary" thyroiditis, all relatively rare compared to Hashi's.  Antibody testing would confirm Hashi's.  Thyroid peroxidase antibodies (TPOab) and thyroglobulin antibodies (TGab) both have to be tested as some of us are positive for one, some the other and some both.  Antibody testing would provide you will a lot more information about your condition.

100 mcg is a pretty "normal" dose...we're all different and have different requirements...but 100 mcg is a very reasonable dose.  As a starting dose, it could be a little high.  You're under 50 and have no history of heart arrhythmia.  If you think you've been hypo for more than a few months, it can take your body a while to accustom to having thyroid meds available again.  It's often best to start out a bit lower and give your body time to adjust.  

As Christine pointed out above, Synthroid is a replacement hormone that your body ought to be amking on it's own.  It's not like taking other meds and there are few side effects.  Most side effects are due to fillers (inactive ingredients) in the tablets.

There is no natural way to correct this.  There are lots of theories out there about what helps and what doesn't, but the bottom line is the if your FT3 and/or FT4 are low and you're having hypo symptoms, you need to be on replacement hormones.  Being hypo can affect every cell in your body.

Anyway, if you're nervous about all this, get some more testing before you start your meds.  FT3, FT4, repeat TSH on the same draw, TPOab and TGab.  Those will give you a lot more information about what's going on.  You'd probably feel a lot more comfortable starting meds with more confirmation that they're necessary.

I should also mention that thyropid meds come in a couple of varieties, synthetic and desiccated porcine thyroid.  Some people consider the latter more "natural" than synthetics.  There's lots in the archives about the pros and cons of both.  Read both sides of the issue before you decide.
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Avatar universal
Agree with Goolarra.

you need Free T3 and Free T4 as soon as you can.  This will tell a lot about your Dr.  If he/she is unwilling to test for these, you can almost guarantee that he believes solely in TSH.  In which case you will never be treated optimally.

Unfortunately the vast majority of Dr's have this "immaculate TSH belief".  Thinking that it is the best thing since sliced bread.  But we all know home made bread you have to manually cut with a knife is better.

It is important to see the results of both the FT4 and FT3 levels with each dosage change.  This can determine early on if you have conversion problems etc and can also be used as a gauge to determine how big or small the next dosage increment will be as you'll have a basis to understand the resultant increase you'd likely have.

Some people are lucky and get a good Dr to start. But it is like winning the lottery.  Most people this is a significant struggle to find a good Dr.

A "good" Dr is one who will test you for at least both Frees AND will treat you clinically based upon your symptoms.  And not simply look at TSH or even the reference ranges.  and simply give you enough meds to get you on the bottom end of the reference range and call it "good enough".  Even though you still feel like crap.  The Dr's answer will be "your in the normal range".  Therefore you are normal.   Yeah right!

I do not tell you this to discourage you.  I tell you this so that you can prepare yourself.  And you get educated and become your own best advocate.
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Avatar universal
Any number of doctors can and do attempt to treat thyroid issues.  However, many of them are still not good thyroid doctors.  Endocrinology is the specialty that should deal with thyroid, but many endos just want to treat diabetes and really have no interest and not much expertise in thyroid.

I, personally, think it's very important to test FT3 and FT4 levels BEFORE going on meds.  Once on meds, your levels will be medicated levels, and you will have no baseline to evaluate what the meds have done.
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Avatar universal
Thank You very much for all this information, it is very helpful!  My Dr. specializes in internal medicine do you think he would be ideal for treating this issue?  So far he has just tested (as far as I know) the TSH levels on two occasions.  Would it be conceivable to think that once I begin taking the medicine and he wants to make changes that at that point he would test the individual T4 & T3's?  As always I am grateful for all the wisdom and advice shared on this site.  Thank You So MUCH!
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Avatar universal
The symptoms you list of memory problems, dry skin and even trouble sleeping are ALL consistent with Hypo. or Low Thyroid.

TSH is a screening tool at best. But with a TSH of 13 it is reliable at that high of number to clearly establish that you are VERY Hypo.

TSH can NOT be used to adjust your dosage of medicine.  And if your Dr is ONLY using TSH.  I would advise looking for another Dr ASAP.  Unless you are lucky, it is virtually impossible to adjust medication with TSH. You must have the Free T4 and free T3's tested.  These are actual Thyroid hormone, not a Pituitary hormone.  Research has shown that symptoms are correlated to FT3 (free T3) and are NOT correlated virtually at all with TSH.  And only remotely with FT4.

I also agree that 100 mcg is fairly common dose.  However most people seem to start out a bit lower and work up to that.  You may want to ask your Dr about splitting the dose and only taking half a pill every day for a week or so and then up to the full 100 mcg.  Some people can tolerate going straight to 100 mcg.

If you have been Hypo for a long time, your body may have a hard time initially adjusting to actually having hormone again.  Some people want to automatically blame an allergic reaction etc to the medicine when it is just the body's "shock" of having hormone.  On the other hand, some people do in fact have allergic reactions to the fillers and buffers in some pills.  So reactions if you have any need to be looked into.

There are not too many things you can do naturally at least that we know of today.

Foods to generally stay away from or limit would be the Cali-form type veggies. Cauliflower, broccoli, Brussels sprouts etc.

You may also if you have not already test for Vit D3, Vit B-12, magnesium, Selenium and iron.  It is quite common for people with low thyroid to also be low on some of these.  most of which all have effects of fatigue if low. or even low in range.  Some of them have a huge "normal" range. So if low you may want to supplement to raise them.

Brazil nuts or supplementing of Selenium can help in the conversion process of T4 hormone into the final usable T3 hormone.  But this I think while helping is no miracle cure and only  a help.

So far it seems looking to "all natural" solutions is kind of like looking to use something other than gasoline into your automobile when you're running on empty.  Sure you can put in water but  it won't help. And the only real cure is to put in the proper fuel.  Your body with Thyroid is the same way.  The only thing that really helps is to put in the proper Hormone. As the hormone is not found in foods.

If you want to take a "natural" medicine.  Then you may want to consider natural dissected Thyroid.  This is a manipulated medicine in pill form but it is made from pig Thyroid.  So it is natural in the sense that it comes from a natural source. However  pharmaceutical industry still processes it and puts it into pill form.  The advantage is that it has BOTH a T4 and a T3 component. While most synthetics are only pure T4 OR pure T3.

Do not feel bad about having to take medicine. It will be the only way to feel well again.
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Avatar universal
I'm not sure if he tested the FT3 or FT4 all the lab results that I see say TSH??  As far as the weight loss I have done that on my own by changing my eating habits and exercising regularly after my father was diagnosed with cancer it was a wake up call to me to change my health.  No history of heart arrhythmia that I know of I did a EKG and everything came back fine they said.  I have felt fatigued and fainted twice which caused all the tests in the first place (arg) have had trouble sleeping for as long as I can remember, dry skin, and trouble concentrating and remembering I am not sure if those are symptoms of my thyroid issue or not I guess a lot of it I just think is a part of life.  But I am very nervous about beginning any type of medication.  Someone told me that once you begin taking this you will be on it your whole life... to me that is scary.  Am I just overreacting?  Is there anything that can be done naturally to correct this?
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Avatar universal
Thank you for your advice that helps.
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Avatar universal
Your TSH is very indicative of hypothyroidism and the need for meds.  However, TSH is, at best, a screening tool.  Any number of factors, besides thyroid hormone levels, can affect TSH.  Meds decisions should always be based on FT3 and FT4 levels and symptoms.  Your doctor should be testing FT3 and FT4 every time he tests TSH.

Do you have hypo symptoms?  Weight loss is not typically a hypo symptom.  If you do have hypo symptoms, how long have you had them?  Any history of heart arrhythmia?
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Avatar universal
I've been taking levothyroxin (generic synthroid) for years...zero side effects. 100 mcg is kind of high for a starting dose but your TSH is really high so it seems reasonable. Your doctor will need to retest you in 6-8 weeks and may need to adjust your dosage. Once your dosage is established (and it can take a few adjustments...and must wait at least 6 weeks to test and adjust again) you will still need to be tested regularly (at least once a year) to make sure your dosage is correct.

Because Synthroid is replacing a hormone your body is supposed to be producing, it won't have side effects like other meds do. If you don't address your thyroid issue now, it can cause big problems later.
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