Synthroid Dosage

[marek1]

Hello. I would like to know if anyone can explain something.

I was prescribed 50mg Synthroid to take daily because of thyroid levels. I took a blood test a month after starting the medication to see the difference. I always felt tired and my weight keeps increasing despite being careful with what I eat and doing exercise several times a week.

I felt a little better but I received the test results today and my doctor explained I had to see an endocrine (sp?) specialist to review my situation. He said the medication I was taking was not enough.

My question is, what does this mean? Is 50mg Synthroid supposed to have taken care of it?

[Smilerdeb]

The thyroid affects every gland and organ in our bodies and I didnt know this until I was diagnosed with Graves Disease.
Its amazing how little is known about the thyroid with Doctors and the general public.
Its not until you are faced with your own thyroid issues that you realise just what the thyroid is and does.
Glad to hear you are feeling better...keep getting your levels checked every 4-6 weeks as you may need an increase/decrease in thyroid meds.

[mtkst13]

i'm glad you're feeling better!  isn't it amazing that such a little gland in your neck can effect so much?!

keep us posted and take care.

[marek1]

Update 2: So I spoke to the Endo today, and had the ultrasound. Apparently my thyroid is so small now from the radiation effects and it is not working anymore.

This is the first day taking 137mcg Levothyroxin and so far I have not felt the need to take a nap. I usually feel really tired/sleepy around 3pm and again around 7pm and sleep an hour accordingly...

Another thing I noticed is my vision is really clear (this might all be in my head...) but going outside and looking around at stuff appears a lot crisper than it did before.

[goolarra]

I'm glad you got in to see an endo so soon.  Don't forget gimel's suggestion above to get the actual numbers for all your tests...FT3, FT4 and TSH.  It's really worthwhile to keep track of all that for yourself and your own reference.

Thanks for updating us.

[marek1]

Update:

Saw the Endocrinologist today. She agreed with the above assertion.. said the thyroid was burned from the radiation.

She said "thyroid levels are over 100"; that was after 50mcg Synthroid daily for a month. She ordered an ultrasound and increased the dosage to 137mcg.

Thanks everyone for the help :)

[goolarra]

Forgot to add...yes, it is a lifelong problem.  Once you're hypo, you're hypo for good, except for a couple of rare kinds of temporary hypothyroidism.  Join the club!!!

[goolarra]

One thing implicated in thyroid problems is radiation to the neck.   See an endo...your thyroid problems seem more complicated than many.  Try to find one who specializes in thyroid or at least is a "generalist" and isn't only interested in diabetes.  Best of luck.

[marek1]

Thank you very much for the information and the tips. So this is a lifelong thing huh...

A little background I forgot to mention:
I am a 26 year old male. I went through surgery, radiation/chemotherapy 3 years ago for oral cancer (neck area is still pretty messed up) and I was fine for a while. I'm still doing follow-ups every few months. It was 2 years after the treatment (summer 08) that I started having thyroid problems. It wasn't until last month that I had any tests done. I'm supposed to see a specialist next week. Hopefully it can be sorted out.

Thanks again, gimel and goolarra for the help!

[goolarra]

No, 50mcg Synthroid was not supposed to take care of it.  Adjusting thyroid meds is a bit of an art form, and many doctors have no clue what to do if they can't look up your recommended dose on their computers and slap you on it and have your labs drop perfectly into line.  Sounds to me like your doctor knows his limitations and wants you to see an endocrinologist.  I'd recommend an endo also...this is a lifelong condition, and you want to work on a good relationship with a doctor.  I don't think he's sending you to an endo because of how you responded to the 50mcg (or because he thinks you're deathly ill).  I think he's doing it because HE doesn't understand thyroid and lnows it.

I agree with gimel concerning FT3 and FT4.

[gimel]

This is part of a post I just made to another member.  When I saw your response, I thought you might get some useful info from it, to keep in mind for your future appt.



What was the original reason for going on meds and how much are you taking?  Free T3 is the most important test, followed by free T4.  Free (unbound) T3 is the thyroid hormone that correlates best with hypo symptoms.  Suggest that you make sure they continue to test for the "Frees".   Are you also experiencing other symptoms?

The best you can hope for is a doctor that will listen to your symptoms, and test and adjust your free T3 and free T4 levels as required to keep you in the euthyroid state, which basically means free of either hypo or hyper symptoms.  Depending on the underlying cause for being hypo, some people require more free T3 and free T4 than others.  

P.S.  Trying to adjust meds by testing for TSH doesn't work.  TSH does not correlate well at all with hypo t symptoms.

[marek1]

Sorry, I don't have that information but I will provide it if and when I can get a hold of it. I was hoping for a general answer but I suspect it's a unique situation. I appreciate the quick response!

[gimel]

Please post your test results and reference ranges, so we can provide a better response.