Feeling so bad dr. says thyroid dosage ok

[Dawn1214]

If you could please give me some advice, I am a 45 yr old female. I have been on synthroid for 18 years since I had radiation therapy for hodgkins. I have been feeling really jittery and anxious lately. I have a constant feeling of a lump in my throat and heart palaptations. I had my gp run a thyroid test. He insists my levels are fine but I feel like I did years ago when my thyroid was hyper. My recent test was TSH 0.08  (.35-4.94) and t4 1.24  (.70-1.48). I called and had the receptionist give me these over the phone so I hope she read it correctly.

Are these levels acceptable or are there other tests that should be run. My gp keeps trying to put me on an antidepressant, he says I am depressed and that is why I am having these physical symptoms.

Thank you for your time.

[Dawn1214]

What are the symptoms of that? Does it make your thyroid go high and low? I guess I need to do some serious reading up on this stuff before I drive you crazy with questions

[Dnarose]

Hashi's is when you have the thyroid antibodies.

[Dawn1214]

What is Hashi's?

[Dnarose]

Some of your symptoms are hyper and some hypo. Do you have Hashi's? That could explain it.  You really only need to have the antibodies done to see if you have Hashis or not. If you never had it done, by all means get it tested.

TSH can be different depending upon time of daty it was tested as well. You always want to test asap upon waking. I usually test about 30 to 45 minutes afrer waking.

[Dawn1214]

I've had this lump feeling for about 4 months. could be anxiety related as I am not feeling good at all. I have the nervousness, fast heart rate, diarrhea, weight loss (although not eating as much), aches in my arm and leg muscles, itchy scalp, losing what seems like a lot of hair, my concentration level is way down and I feel so mean and agitated all the time. Are these all symptoms too?

My dr, is not on call this weekend, I think I will take 1/2 dose tomorrow and call him Monday morning to see if I can talk him into ordering the Free T3 and T4 tests for me. Do I need to have an Antibodies test too? He told me yesterday that my thyroid was fine but I know he only ran a TSH and T4 so he may give me a hard time and he will definitely think that I am being difficult. I just know something is going on. I thank you so much for answering my many questions.

[Dnarose]

Your free t3 may or may not be high.  Usually on Synthroid (T4)  the free t3 is either on the low side or is low in range depending on how well a converter you are. The Free t4 is more likely to be high on Synthroid.  If free T3 is on the low side, then perhaps adding T3 or switching to a T4/T3 medication may help.  What matters most in this is how you feel. If you feel good, things should be left alone. If you still have symptoms, then its time to figure out why. I've learned a lot since being diagnosed in 2000. I read as much as I could about hypothyroidism in order to get the best care I could.  In the process, I had to switch doctor many times, as treating this condition has to be a partnership with the doctor.  If a doctor only treats by TSH, most likely the patient will always have some symptoms.

About the feelng of a lump in your throat, that's usually a hypo symptom,  Symptoms of hyper would include; headaches, nervousness, fast heart rate, increased sweating, diarrhea,  and weight loss.

If you are really concerned about taking the full dose, just call your doctor's office. Usually a message can be got to him/her and they will call you up and tell you what to do.  If you are having any of the hyper symptoms I listed above, chances are your doctor will want you to decrease it or skip it for a while.

[Dawn1214]

I understand what you are saying but I am feeling so bad and if it is my thyroid med then I am scared to take a full dose and feel this way longer. Would it be ok to cut my dose in half for tomorrow and call my dr on monday for tests? Would being overmedicated make me feel like I have a lump in my throat even though i know i don't and would I feel like climbing the walls but haven't the energy or the concentration to do so?

[AR-10]

Your Free T4 can look fine and you can still have a high Free T3.

Cutting your dosage over the weekend is not a very good idea. What you need is an acurate picture of what your levels are, which requires all three tests being discussed run from the same blood draw.

If you stopped your meds for three or four days you may feel better at some point, but it will be on the way toward hypo and wouldn't last long. It's counter-productive unless you are so overmedicated that you need to stop them for a week or more.

It takes six week for a T4 med like Synthroid or Levoxyl to build up to full strength in your system. It takes six weeks to clear your system. It takes a week or two to feel a significant difference when starting or stopping the drug.

However, missing a dose or two can mess with things.

One thing to remember with thyroid issues is that the symptoms lag behind the hormone levels and they also linger after the levels are back in line.

Take your med consistantly, get retested, and get a copy of the tests. It sounds like you may be slightly overmedicated.

Dnarose has given you very good information to work with.

[Dawn1214]

I have a couple more questions. Would it be ok for me to cut my dosage down this weekend to see if it makes a difference and how long does my synthroid stay in my system?

[Dawn1214]

Dear Dnorose

I am on synthroid which is a T4 drug correct? So what your saying is that if dosage is too high then a free t3 test will be high because my t4 is making too much t3? If my T4 is within range would my T3 still be high? Would my symptoms be what I explained? I have had a really rough time for several months but have also had issues for several years. Back in 2001 my medication was raised when I was pregnant and never lowered. Is it normal for our body to require more med even after giving birth or should my med have been lowered back then? You seem really informed about all this and since I never really had a problem before I am a bit confused.

Thank you so much for your advice

[Dnarose]

You don't need to see an endocrinologist unless your case is complicated.  I found family doctors are easier to work with

Thyroid medications are either T4, T3, or T4 & T3.  Mot people take a T4 medication (Synthroid, Levoxyl) and the T4 converts to T3 in the body. T3 is the active hormone.  By having a free t4 and free t3 test you are finding how much of the T4 that is being converted to T3 can be free (available) to use by your body. The free t4 and free t3 are newer thyroid tests and usually you have to ask for them because most doctors will only do a TSH.

[Dawn1214]

This is my primary care, we don't have an Endocrinologist in my area. I appreciate the advice on the Free t4 and T3 tests what do these show?

[Dnarose]

Your TSH is a little on the hyper side, but your T4 is OK. If you aren't feeling well, ask for a free t4 and free t3 test. These tests show the amounts of T4 and T3 that is available (free)  They will provide a clearer picture.

[lindse4]

Was this your Primary Care Physician or an Endocrinologist? One consistant thing I have found is the Family docs do not understand the thyroid- ONLY an Endocrinologist has the ability to understand the results (which, from an amateur point of view, do not look normal). I would make an appt with an Endo and speak with them about it.