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Visit with new endo optimistic...
Hi gang!
Wellll...I had my first visit with a new endo today and it went well. He gave me the Hashi's "speech" (explained in detail the how's and why's of it) looked over my labs and told me my thyroid was enlarged and that he thought, based on all the hypothyroid symptoms I've had that I could benefit from meds..(Not anything close to what the last *@$#@ endo said!)
He feels more comfortable with starting me on low-dose synthroid (25 mcg) and check my levels in 5 weeks, or sooner if any issues developed. I asked about Armour, and he said it wasn't out of the picture, but if we could nail down a theraputic dose with the synthroid first, then base the Armour dose from that. He wants to get my TSH under 1.0 but no lower than .40 because this seems to be a "happy place" for Hashi's patients and if lower than .40 the hyperthyroid symptoms begin to show.
Hmmmm...Seems like I've heard this info somewhere before...Here maybe? LOL What do you all think? ~MM
Wellll...I had my first visit with a new endo today and it went well. He gave me the Hashi's "speech" (explained in detail the how's and why's of it) looked over my labs and told me my thyroid was enlarged and that he thought, based on all the hypothyroid symptoms I've had that I could benefit from meds..(Not anything close to what the last *@$#@ endo said!)
He feels more comfortable with starting me on low-dose synthroid (25 mcg) and check my levels in 5 weeks, or sooner if any issues developed. I asked about Armour, and he said it wasn't out of the picture, but if we could nail down a theraputic dose with the synthroid first, then base the Armour dose from that. He wants to get my TSH under 1.0 but no lower than .40 because this seems to be a "happy place" for Hashi's patients and if lower than .40 the hyperthyroid symptoms begin to show.
Hmmmm...Seems like I've heard this info somewhere before...Here maybe? LOL What do you all think? ~MM
COMMUNITY LEADER
I can relate to what your doctor said about the cramps, too. I do a lot of driving in both my job and personal life, which leaves me sitting in the same position for long periods. I have found that if I take a potassium supplement at bedtime a couple times/week, I don't have the cramps nearly so bad.
As to the TSH, I agree that it can be used as an indicator, but should not be used to diagnose a thyroid problem or dose medication, because it can swing wildly, even in the same day, so it could depend on the time of day the blood was drawn. I do hope he will place the most stock in your FT levels, when it comes time to change medication.
Since I've been on medication, I've never had a TSH between 0.4 - 1.0, so I've really no idea what I would feel like at those levels.
red - you might tell your friend to eat a baked potato with the skin on - has more potassium than a banana and probably won't produce such a drastic side effect.
As to the TSH, I agree that it can be used as an indicator, but should not be used to diagnose a thyroid problem or dose medication, because it can swing wildly, even in the same day, so it could depend on the time of day the blood was drawn. I do hope he will place the most stock in your FT levels, when it comes time to change medication.
Since I've been on medication, I've never had a TSH between 0.4 - 1.0, so I've really no idea what I would feel like at those levels.
red - you might tell your friend to eat a baked potato with the skin on - has more potassium than a banana and probably won't produce such a drastic side effect.
You're too funny! I can't say I've heard of bananas causing that sort of effect before...TMI! (Too much Information!!!)
Yes, I'm hoping this Dr will be okay. I was doubtful when I saw he was a bit older, but there is a lot to be said for experience! More than anything, I appreciate the fact that he actually listens and considers more than one approach to managing a problem...-And the fact he acknowledges Hashi's as it's own "species". Well, we'll see if the meds improve anything...He didn't sound very optimistic about ways to bring the antibodies down though...I'm still working on that one! I hope you are doing well and don't let your friend trap you under a blanket after he eats a banana! (My husband does that to me after eating beans and then laughs like a maniac. Boys. Puh.) LOL ~Melinda
Yes, I'm hoping this Dr will be okay. I was doubtful when I saw he was a bit older, but there is a lot to be said for experience! More than anything, I appreciate the fact that he actually listens and considers more than one approach to managing a problem...-And the fact he acknowledges Hashi's as it's own "species". Well, we'll see if the meds improve anything...He didn't sound very optimistic about ways to bring the antibodies down though...I'm still working on that one! I hope you are doing well and don't let your friend trap you under a blanket after he eats a banana! (My husband does that to me after eating beans and then laughs like a maniac. Boys. Puh.) LOL ~Melinda
I'd have to agree with your new doc. I feel lousy and too hyper under 1.0 TSH. But mainstream docs fail to understand the Hashi treatment plan.
Yes, everyone goes on about the TSH being irrelevant but it is a good guide to see where your levels are heading. TSH lags weeks behind a Free T4 so when I get tested and my Free T4 is up high and my TSH high also I know I am in trouble! I know that in a month I will be going to hypo land! Regardless how good my Free T4 is! So for me I use it as a predictor of what my medication is doing. I go hyper very easily so am wary of any doctors telling me to drop or increase my dose based on my TSH alone.
On the cramping, he sounds like a smart guy! It is highly likely those things are happening. I have a friend who gets horrible cramps, to the point he screams and writhes in agony. Had all his levels checked, all good. He flies internationally from Australia regularly. He even had an ambulance come to the plane when he landed in Singapore recently The doctor said a similar thing to him ( I was with him at the time) drink more water, get up more often (even for those sitting at a computer for more than a few hours), eat a banana (if you can tolerate them) which has all the essential vitamins and minerals except one of the B group, flex the foot often. My friend has had far less cramps since!!! (Mind you bananas make him pass gas you don't want to know about! LOL!)
Cheers
Yes, everyone goes on about the TSH being irrelevant but it is a good guide to see where your levels are heading. TSH lags weeks behind a Free T4 so when I get tested and my Free T4 is up high and my TSH high also I know I am in trouble! I know that in a month I will be going to hypo land! Regardless how good my Free T4 is! So for me I use it as a predictor of what my medication is doing. I go hyper very easily so am wary of any doctors telling me to drop or increase my dose based on my TSH alone.
On the cramping, he sounds like a smart guy! It is highly likely those things are happening. I have a friend who gets horrible cramps, to the point he screams and writhes in agony. Had all his levels checked, all good. He flies internationally from Australia regularly. He even had an ambulance come to the plane when he landed in Singapore recently The doctor said a similar thing to him ( I was with him at the time) drink more water, get up more often (even for those sitting at a computer for more than a few hours), eat a banana (if you can tolerate them) which has all the essential vitamins and minerals except one of the B group, flex the foot often. My friend has had far less cramps since!!! (Mind you bananas make him pass gas you don't want to know about! LOL!)
Cheers
Hi Barb!
Yes, he's going to keep an eye on the "frees" as well -I sort of understated what he said. His actual words were "once the TSH levels out, usually in the .40-1.0 range, Hashi's patients feel better." (I got the impression he thought I wouldn't be familiar with the significance of the "frees".) I think his impression changed when I started asking specific questions about the levels though. :)
His theory about the leg cramps revolves around blood flow/impedance and cellular potassium shifts. He thinks that at night or while sitting on a surface that impairs blood flow to the legs, the circulation is slowed and lactic acid (product of metabolism) builds up in the distal tissues. This creates a potassium shift (less available potassium at the cellular level) which slows nerve signals that would normally stimulate blood vessels to respond to increase blood flow to the leg muscles. Without enough blood/oxygen, the legs muscles spasm. Low vitamin B-12 and D makes the blood vessel response worse which adds to the cramping threshold.
His solution is simple. Maintain vitamin D levels, have better hydration, and take a potassium supplement and a quality B-complex (he suggested B-100) vitamin 3 or more times/week. The blood flow issue is also worse when the person has diabetic issues or renal problems. What do you think? ~MM
Yes, he's going to keep an eye on the "frees" as well -I sort of understated what he said. His actual words were "once the TSH levels out, usually in the .40-1.0 range, Hashi's patients feel better." (I got the impression he thought I wouldn't be familiar with the significance of the "frees".) I think his impression changed when I started asking specific questions about the levels though. :)
His theory about the leg cramps revolves around blood flow/impedance and cellular potassium shifts. He thinks that at night or while sitting on a surface that impairs blood flow to the legs, the circulation is slowed and lactic acid (product of metabolism) builds up in the distal tissues. This creates a potassium shift (less available potassium at the cellular level) which slows nerve signals that would normally stimulate blood vessels to respond to increase blood flow to the leg muscles. Without enough blood/oxygen, the legs muscles spasm. Low vitamin B-12 and D makes the blood vessel response worse which adds to the cramping threshold.
His solution is simple. Maintain vitamin D levels, have better hydration, and take a potassium supplement and a quality B-complex (he suggested B-100) vitamin 3 or more times/week. The blood flow issue is also worse when the person has diabetic issues or renal problems. What do you think? ~MM
COMMUNITY LEADER
I'm really happy to hear that your appt went well. I do hope the doctor is looking at labs, other than TSH, as well, though?? Remember - low TSH isn't what causes the hyper symptoms; it's high FT3. My TSH runs at < 0.01 all the time, but I'm not hyper, so be careful on that.
Yes, it's very common for those of us with Hashi's to have low vitamin B12; pernicious anemia is another autoimmune, and once we have one autoimmune, the chances of another (or more) are much greater.
I'm happy to hear that he started you on a low dose of synthroid; that should help things go much more smoothly.
I would be interested in hearing what he had to say about the night-time leg cramps......
Yes, it's very common for those of us with Hashi's to have low vitamin B12; pernicious anemia is another autoimmune, and once we have one autoimmune, the chances of another (or more) are much greater.
I'm happy to hear that he started you on a low dose of synthroid; that should help things go much more smoothly.
I would be interested in hearing what he had to say about the night-time leg cramps......
Hi!
In November my TSH was 2.89 and mid-January it was 1.58. -Just this drop from taking supplements that contained thyroid tissue (very weak thyroid hormones) and changing to an "anti-inflammatory" diet corresponded with a decrease in some pretty bad hypothyroid symptoms.
I'm already having a bit more faith in this endo than the last one as this one explained everything, listened to my concerns, and did not blow me off when I asked about alternative/preventative possibilities. (Not like the last one who looked at my labs and gave me the "you're fine" rubber stamp and shoved me out the door.) He even laid out a treatment plan, gave me advice on how to manage my weight and nutrition with Hashi's (did you know that Hashi's patients are susceptible to low vitamin B-12?) and explained why he thought night-time leg cramps are so prevalent. Yep. Definately an improvement over the last one! ~MM
In November my TSH was 2.89 and mid-January it was 1.58. -Just this drop from taking supplements that contained thyroid tissue (very weak thyroid hormones) and changing to an "anti-inflammatory" diet corresponded with a decrease in some pretty bad hypothyroid symptoms.
I'm already having a bit more faith in this endo than the last one as this one explained everything, listened to my concerns, and did not blow me off when I asked about alternative/preventative possibilities. (Not like the last one who looked at my labs and gave me the "you're fine" rubber stamp and shoved me out the door.) He even laid out a treatment plan, gave me advice on how to manage my weight and nutrition with Hashi's (did you know that Hashi's patients are susceptible to low vitamin B-12?) and explained why he thought night-time leg cramps are so prevalent. Yep. Definately an improvement over the last one! ~MM
Hi...
It's great to hear your appointment went well! It certainly helps when the doctor is decent!
When your doc says he wants your TSH between 0.4 and 1.0 just be careful in monitoring how your symptoms are going. If my TSH was in that range I'd feel majorly hyper!!!! Even though it may be the general "happy place" for hashi's you might be slightly different. But the doctor sounds good enough to know to go off labs AND also symptoms.
Good luck!! :)
It's great to hear your appointment went well! It certainly helps when the doctor is decent!
When your doc says he wants your TSH between 0.4 and 1.0 just be careful in monitoring how your symptoms are going. If my TSH was in that range I'd feel majorly hyper!!!! Even though it may be the general "happy place" for hashi's you might be slightly different. But the doctor sounds good enough to know to go off labs AND also symptoms.
Good luck!! :)
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