Treating hypothyroid levels in elderly patient

[TamraW]

Hi, everyone.

I took my mom to yet another diabetes endo because her insurance won't cover my endo.

Mom is 75 and has a heart murmur from Rheumatic fever as a child. 13 years ago, she had a suspicious, but benign, nodule and one thyroid  lobe removed.  After I was diagnosed with Hashimoto's,  I had my mom get her antibodies tested this September.

For 13 years, her doc has only treated her TSH levels with Synthroid. She is tired, constipated, depressed, has GERD, pain in joints, cold and dry skin and frequent rashes.

Her endo today refuses to up her Synthroid (currently taking 125 mcg)  because she says her levels are perfect for an elderly woman. She believes pushing the TSH lower and frees higher puts my mom at risk for heart attack because of her age. She also said that positive antibodies mean nothing, and that antibodies come and go all the time. She said that next antibody test, my mom could have zero antibodies.  

These were her September results:
TGab - 211
TPOab - 167
TSH - 0.76
FT3 -  246 (range is 230-420)
FT4 -  1.1 (range is 0.9-1.7)

What do you think? I'm trying to convince my mom to go to my endo, a real thyroid doctor.

Thanks!
:) Tamra

[goolarra]

Well, as you know, her endo is full of b/s...antibodies fluctuate, but once you got 'em, you got 'em for life (unless thyroid is removed or "killed" off by RAI or by antibodies finishing their job).

Both your mother's labs and her symptoms are distinctly hypo.  At her age, I don't suppose I'd try to push her FT3 and FT4 up too high in the range or to push them up too quickly.  I guess you have to weigh the POSSIBILITY of higher levels causing a heart attack (which I would think is rare) against the FACT of feeling cr@ppy all the time due to hypothyroidism.  I don't deal well with the theoretical, so I'll almost always go for the sure thing.  Just keep in mind that baby steps in increases goes double for someone her age.

If you like your endo, get your mom to see him.  If he'll raise her dosage and it helps, it's obviously well worth the money.  If it doesn't, she can always go back to the guy who's paid for.

[TamraW]

My endo doesn't take insurance. He's an excellent thyroid doc. My husband offered to pay for my mom to see him, but she still refuses.

This endo was totally unconcerned about her antibodies and said they make no difference.

:) T.

[dawnangela]

Im with goolarra, baby steps with an increase at her age, it can cause problems as she already has heart problems, I think most doctors dont believe Antibodies cause symptoms, they say the symptoms we have are from hypo, not the antibodies...Me i just wouldn't know anymore :(

[ChitChatNine]

Hi - wish I could help  - but not enough knowledge.  Hope your mom gets better soon.

C~

[goolarra]

I agree basically about the antibodies...hypo is hypo, and it's all treated the same, antibodies or no antibodies.  However, that does not excuse the endo's **** and bull story about how they could be gone tomorrow.  Don't lie to me, doc, because I know better.

I don't know how you can convince your mom, except not taking "no" for an answer.  

If your mom already has heart problems (didn't know that), it's all the more important to see a thyroid doc who really knows what he's doing.

Have you tried arm twisting and drugs???!!!

[dawnangela]

Lol well if she is anything like my mum even "no" for an answer will not work:) That's a shame as it looks like the 3s and 4s are at the bottom end and an increase could help..But yes she would of course be better off seeing a thyroid specialist, maybe it can be pushed up slowly without causing harm to your mums heart by a specialist who knows..

[TamraW]

Thanks! My mom actually doesn't look or seem her age, but she gets so run down and constipated. Her frees are low, and I worry that her laxative fixation isn't good, either.

Anyway, I'm trying to convince her to go with me to my endo appt. tomorrow, just to see how a REAL thyroid doc should treat a patient.

:) Tamra