Hypo - Am I doing the right thing?

[ampky]

My doc is using the old TSH Range of .27-5.2. My TSH is 4.77 (T4 is 5.27 and T3 not checked. I have many of the hypo symptoms (fatigue, heavy limbs, slowness and just all-around feeling awful) and my doc dismises it saying these are from a stroke  hd five years ago.
Because my doc is doing nothing, I am self-medicating taking 3 grains of Nature-throid per day. Am I medicating correctly? When is an approximate time to see some results?

Thanks!

[ampky]

Your help is appreciated goolarra!!

[goolarra]

Make sure they test both TPOab (thyroid peroxidase antibody) and TGab (thyroglobulin antibody).  Some of us with Hashi's are just TPOab positive, a very small percentage just TGab positive, and some both.  Getting both is the only way to rule out Hashi's.

If you live in a fairly large market and have a choice among endos, you might try interviewing them a bit over the phone before making an appointment (probably through a nurse).  One good question is which tests they customarily order for their thyroid patients (FT3, FT4 and TSH are the minimum).  You can also ask which meds they are open to using (T4-only, synthetic T3/T4 combinations, dessicated [like NT]).  And you can ask if they have experience in dealing with thyroid issues with other patients who have some of the same other health concerns as you have.  I have a heart arrhythmia, so I asked if the doctor had treated other patients in similar circumstances...turns out he had and is now treating my arrhythmia along with my thyroid...very convenient.

Best of luck...keep at it...you WILL get the treatment you need.  Learn all you can about your condition.  It helps tremendously in dealing with the medical community.    

[ampky]

I'll try calling an endo Mon for an appt.  I've never had antibody testing, so I'll ask for that as well.

Thanks SO much!

[goolarra]

Yes, that is too fast to increase.  Thyroid meds take patience, patience and more patience.  If you try to hurry them, you are apt to go hyper...which is more dangerous than being hypo, and speaking from experience from being overmedicated and hyper, even less pleasant than hypo.  I'll take hypo any day...it's uncomfortable, but hyper is scary.

The T4 portion of the NT is going to take a little while to work out of your system so that your labs once again reflect your true thyroid function.  However, after only three weeks on NT, most of it will probably be gone within another three weeks if you d/c now.  T3 is very fast-acting and is neutralized by your body within a few hours if not used by your cells.  Labs continue to reflect a medicated state for a few days, however.

I can't answer your question about where your labs might be after 3-4 weeks on 3 gr NT. First, because we don't know what your FT3 or FT4 were before starting meds.  Second, we all react very differently to meds.  You and I could have the exact same labs, and I might feel just fine on one dose, and you might need twice as much (or half as much) to be symptom-free.  This is why it takes so much patience.  None of us can predict ahead of time just where we're going to end up.

You don't have a lot of time invested in the NT yet (only 3 weeks).  If I were you, I'd d/c now and make an appointment with a new doctor.  You need to start out with a complete set of labs (FT3, FT4 and TSH) and move very slowly and carefully.  Have you ever had antibody testing (TPOab and TGab) to see if you have Hashi's?

[ampky]

I have worked-up to 3 grains in about three weeks (I know...too soon, but just want to alleviate symptoms.) Also, I'm F, 39.
I'm now scared to go to another doc for fear the thyroid meds have lowered my TSH (and potential other tests) and the results will then show I'm not hypo.
Would taking up to 3 grains in 3-4 weeks bring the reults to a normal range?

Thanks for everyone's help!!

[Barb135]

I totally agree with everything goolarra said.  

Please find a doctor who will treat you in such a way as to alleviate your symptoms, without aggravating your other issues.  

[goolarra]

Your TSH is high as the range recommended by AACE is currently 0.3-3.0, and many would argue that the top end of that range should be even lower.  Total T4 is considered an obsolete test, and yours is a TT4, so it's of limited use although you can see that it's quite close to the bottom of the range...way too low.  Also, FT3 is the test that correlates best with symptoms, and it was not included.  I do think that you need to be on thyroid meds.

However, I really have to caution you about self-medicating.  Dosing of thyroid meds is an art, and it's really difficult for us to medicate ourselves properly, especially before we know how we feel when both hypo and hyper.  

How long have you been on the three grains?  You have to start out very gradually on thyroid meds (especially if you are over 50 or have been hypo for more than a few months or have cardio-vascular problems) and work up to higher doses as your body gets used to having the hormones present again.

I realize your frustration that your doctor wouldn't treat you, but I strongly urge you to find another doctor who will do proper testing and prescribe meds that are appropriate both to treat your thyroid and with respect to other health issues that may be present.  NatureThroid has a very high T3 content, and T3 is often not appropriate and seldom prescribed for people with cardio-vascular issues.  T3 can raise your HR and BP and stress your body.  I really don't think it's safe for you to be taking this or any other thyroid meds without medical help.

I really urge you to find competent medical help and not do this on your own.  NT, with its high T3 content, also should not be taken by anyone, regardless of age or health,  until FT3 has been tested, and the need for the T3 verified.  Thyroid storm (excessively high levels of FT3) can result, and this can be a life-threatening condition.  I'm not trying to scare you, just want you to be very careful.  Thyroid meds are not something to play around with.

[ampky]

The range on the T4 is 5.13-14.06.  It doesn't say anything but T4, so I really don't know which test it is.  I am taking the Rx given to me by a little bird :-)

[goolarra]

What is the range on your T4?  And is it free T4 or total T4?  If it doesn't specifically say "free" or "FT4", then it's total.  Are you taking the brand name NatureThroid, which typically requires a prescription, or are you taking something else?

Sorry to ask so many questions, but it really helps to give an appropriate response.