Hello - I guess I'll start with a history of what has happened to me and hopefully the doctor can give me some insight.I am a 28 year old female and after a couple of months of fatigue and muscle soreness I was diagonsed as hypothyroid with a TSH of 18.96 towards the end of July. I am 5'4" and 110 lbs (although I was 120 at the time) and my initial dose of Synthroid was 100mcg. After the first week, I did start to notice a difference physically, I definitely felt better, but was having trouble sleeping and very anxious. I also lost my job at around the same time so that could also account for a lot of my anxiety. After four weeks my TSH was tested again, but this time it was .06 so my dose was reduced to 50mcg. After a week or two, I began to feel like my muscle soreness was returning but definitely not as bad as I was in the beginning. After another four weeks after the dose change, I was tested again and my TSH only rose to .08. That was last week. I am now on the lowest dose of Synthroid they make (I think) 25mcg. I don't know what to make of how I feel - I do have a lot of strength it seems with heavy things, but while whisking eggs the other day my arm felt sore - doesn't seem to make sense to me. My hair loss is also out of control. I don't have my first endo appt until the end of october so I was hoping someone could give me some insight/advice. My mother has also been hypothryoid since her mid forties. Thank you so much - I'm so confused and my husband and I are eager to start trying to conceive our first child but want this thyroid in order first.
The synthroid dose needs to be slowly adjusted and then TSH checked after 6-8 weeks -- it may be that your dose was lowered too significantly. The other possibility is that you don't need synthroid and that the elevated TSH over the summer was a transient situation (ie, recovering from thyroiditis) - if the TSH was repeated 4-6 weeks after the first abnormal test and was still high - likely you need the synthroid - or if antibodies positive - likely you need the synthroid.
With planning a pregnancy in the near future my advice would be to get the TSH around 1 with 50, 75 or 88mcg of synthroid and keep TSH constant until done with child-bearing -- after child-bearing, re-consider if the synthroid is really needed....
Thank you so much for answering. I've been doing so much reading on the internet which at times can give peace of mind and other times can scare. I have to be honest that I was hoping it would be a thyroiditis situation because that would mean that I could recover. I kind of thought it was unlikely given that my mother and her sister are also hypothyroid - but they were not diagnosed until their forties. Do my TSH numbers suggest an average case of hypothyroid? How rare is thyroiditis? Is it similiar to a viral or a bacterial infection of the thyroid that can eventually go away? I'm sorry for all of the questions but I am just so nervous about having a hypothyroid pregnancy that I feel like I'm grasping at anything. I kept telling my mom that if I had a couple of healthy children, I wouldn't care about being hypo and I wouldn't care how long it would take to regulate - I can deal with it. Its just at this stage in my life I am so scared. Thank you so much for your time Dr. Mark. If anyone else reading has heard of someone having thyroiditis and recovering can you please respond? Thanks so much.
Thyroiditis is fairly common - the TSH you mentioned could be either from true hypothyroid or the recovery from thyroiditis. We think thyoroiditis is an inflammation due to virus or another infection and 85% of people recover fully. The family history is important - so check antibodies. Most hypothyroid women have healthy babies if they are monitored properly.
Thanks so much Dr Mark for easing my mind. I'm just worried that the 25mcg dose might be too high again and then what will I do? I guess I will have my antibodies checked when I finally see an endo at the end of this month. You are providing such a wonderful service giving so many people peace of mind.
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