Just when I thought I might have an answer..,so I saw my new regular doc yesterday. He looked at my labs, agreed that there is an issue and said no problem to try cytomel. He said he didn't think I should reduce my synthroid and to stay at 175 mcg. You could tell he was not confident about that though. So, I pick up my rx today and see that he gave me 25 mcg daily. Uhhhhhh, that doesn't seem right. As it is i have tried a few days on 150 mcg of synthroid and actually slept at night. Then I decided I'd try the 175 and had a hard time sleeping. I know I should not be flip flopping probably. I have been feeling better anxiety wise tho. Not constantly shaking, no racing thoughts etc. Is it possible that now that I have calmed down that my body might readjust and start making t3 again or at least not making rt3? It seems like taking my b vitamins and stuff might be helping me feel better Not sure what to do now. I have an Endo appt on Jan 16. Maybe I should just try to stick it out on my synthroid until then. I just know from what I've read that the higher dose plus the cytomel is too much. Thoughts ?
"The research is out there. We can find it, why the heck can't they? " They don't look, because they're too busy relying on what they learned in med school.
Dr's know so little about thyroid that they don't venture far from the ranch. And the standard of care is T4 only medication to get TSH somewhere in the range. So they don't want to venture anywhere outside those bounds.
Frankly the body is so complex I don't have too big a problem with the average primary care physician not really understanding Thyroid. Probably 75% of the people if not more seem to get along fine with a simple T4 med and use of TSH only monitoring.
However for those remaining folks that don't fit into that circumstance, I do have a hard time not understanding the reluctance of a primary care Dr to refer you to another Dr who specializes in Thyroid. And I have absolutely no excuse or tolerance for an Endo who SHOULD know and understand Thyroid to do better. But many if not most don't seem to understand thyroid any better than the average general practitioner. That is unacceptable in my mind.
Many people here have a better understanding of thyroid than most Dr's and possibly most Endo's. How can this be in a day of technology for the Dr's to not understand this better. The research is out there. We can find it, why the heck can't they?
These guys were taught in med school that all their patients needed was T4. And logically, that should be true. Conversion of T4 to T3 happens mostly in the liver, but also at lesser sites throughout the body. It's a separate process...metabolic, not thyroid. So, they were taught that you just adjust T4 and T3 takes care of itself. Enter reality...
T3 is more volatile than T4. You really have to take it more than once a day to avoid the peaks and valleys in levels that can occur because it's so much faster-acting. So, it's a little harder to control. Add to that that T3 is about four times more powerful than T4, so a little bit goes a long way.
Nodules are very common with Hashi's. I have a bunch of them, and we just keep an eye on them. Thyroids are naturally nodule-y (i can make up words if I want to). I read an article a while back by a doctor who said that he could pick five healthy people out of a grocery line, and three of them would have nodules.
I don't think I mentioned the nodules on my thyroid either. There are 2, pretty small...small enough that we are just going to "keep and eye on them". Does that sound about right? I got so worked up with these numbers that I forgot. Really trying not to think about that part if the equation.
Wow, thanks for all that info guys! I really feel like I have a place to start and know what types of questions to ask. It makes a world of difference when you are not walking blindly into something. Saves a lot of time. You're right flyingfool, I am very fortunate to be living where I am now. My options would have been limited if this had happened a year ago.
Just out of pure curiosity, why are Drs so against Cytomel? What alternative is there?