myxedema coma

[dpleiman]

Ok now i know i'm probably just allowing myself to get all worked up and need some words of encouragment and wisdom...

My GP today is switching me to synthroid from Levoxyl, to see if i can tolerate it better.. I want to start off slow because of the toxic feeling i had on starting a high dosage of Levoxyl however, she is concerned about myxedema coma because of my latest labs TSH 102 FT4 .17 FT3 1.98  and wants me to start off ASAP with the 88mcg..

My delimma.. I'm scared to keep at the lower dosage for too long due to my levels and possibility of myxedema coma. I'm scared to jump into the synthroid full force for fear of cardiac issues and toxic symptoms...

Which should be considered more potentially dangerous at this point?

Thanks for your help...

[dpleiman]

I was diagnosed with Hashimotos almost 3 years ago and been up and down and all around with levels and dosages of levoxyl... This recent episode is due to my doc yanking me off my meds because he thought he had a good reason for it i guess, but 3 weeks after yanking my meds this was the outcome, NOW i'm just trying to get back on meds to get my levels back to somewhat normal range but i'm having side effects from the high dosages..

I've had EKG's and they all come back fine other than some benign PVC's that scare the **** out of me when i have them. Doc's say my heart is fine so i guess i'm gonna make the jump to 88mcg and keep with it regardless of my symptoms and hope that they go away soon....

[dpleiman]

I started the full 88mcg dosage of senthroid today.. Let's pray it doesn't effect me like the levoxyl, i'm not too hopeful and expect hyper symptoms but i'm going to stick with it as long as i can and see if the symptoms subside just so i can get my levels out of the danger zone.

[stella5349]

No I don't think you are worrying to much. In fact I think you are pursueing this quite well.

If the range on your lab sheet is 2.3-4.2 and you are at a 1.98 - taking into consideration that you have a TSH of 102 ( whew .. that's high)  you should have reason for concern.

Personally I don't feel you are sufferering under any hyper symptoms. I think due the free T3 level - that is your major reason for what you are feeling.

The active hormone T3 is key to look at - comparing the ratios of the converted FT4 level.

You may benefit with the .88 Synthroid - asking for a very small T3 Cytomel dosage to take along side of that. Maybe start 5mcg.

Midpoint of active T3 could make things better for you.

Have you done any cardio tests - to make sure there are no issues there too? I would think checking that out as soon as you can would be best.

I ususally don't look much at the TSH as the tell all - it seems your doctor is though - and with a TSH that high - you should look at that. Something is blocking the pitutiary to tell the thyroid to pump crrect hormone levels. Whether the meds are not enough - or if you have an issue with the pititiary.

Either way, with that high of a TSH you are not getting enough hormone in to correct the balance in your symptom.

Your going to have to move slow - in my opinion and not expect to have a quick fix here. Your body is very slow and needs to have small changes done to except the right things and get better.

[dpleiman]

My reference range for Free T3 is 2.3 - 4.2 so even that is below normal at 1.98.... I don't understand how my endo could let this get so far out of control.. And it only took 3 weeks ughh..

Do you think my Free T3 will be ok while my Free T4 takes the time to convert? I worry too much ha..

[goolarra]

I understand that your doctor wants your levels up ASAP.  However, she is completely ignoring the symptoms you have gotten from the medication.  She obviously hasn't a clue how miserable you can feel when you are overmedicated, your starting dose is too high, or your increases are too rapid.

What would I do if I were you?  I think I'd try taking the 88 mcg of Synthroid.  It could be the fillers in Levoxyl that were causing your problems and the switch in brand names might make all the difference in the world for you.  However, if your hyper symptoms persist on the Synthroid, I'd also be on the phone to my doctor immediately.  If I couldn't contact her right away, I'd have no problem breaking those 88s in half and seeing how it goes on 44 mcg.

Taking ANY amount of Synthroid at this point is going to start raising your FT4 levels.  Your FT3 is still in reference range according to my labs range (1.8-4.2 - you should check your lab report to make sure yours is the same).  T3 is about four times more powerful than T4.  It's the active form of the thyroid hormones.

I'd also try to increase fairly aggressively in terms of time, but in very small increments.  For instance, try moving to 50 after 10 days to two weeks (no sooner, even if you do feel fine) if you have no hyper symptoms, then to 62.5 after the same time period, then to 68.5, 75, 88.  These are all doses you can get by splitting and/or combining available doses.  If you have hyper symptoms, you might have to linger at a lower dose for a bit longer until they subside

Once again, I'm no doctor, but I have been where you are now, and I was miserable and just longed to be hypo again.

Keep us posted..  

[laura1967]

I think your dr is doing the right thing at starting with 88mcg. As long as you keep getting increased, you should do well. Just like with Armour patients, they get increased every 2-4 weeks so they don't get overstimulated in most cases.
You should be fine.  :)