Unspecific Acquired Hypothyroidism

[Psalm 3:5]

Aug 06 Dx w/above: TSH 107.94 (no other thyroid functions tested). Started 150mg ?synthyroid (not sure)?, ANA Reflex neg. Meds included lithium.
6 wks later TSH 10.126(.350-5.50) FT4 2.7(1.0-3.9) T4 9.3(5.0-12.5) T3 28.6(22.5-37.0) (inc ?med? 175mg).
8 Dec: TSH 1.704, FT4 3.0, T4 9.7, T3 30.7, symptoms persists.
10 Jan 07: Put down by walk & never really recovered. Meds include lithium, protonix, nuerontin, lamictal, allegra-d, cymbalta, inderal, klonopin, zanaflex,?synthyroid?, provigil, vicuprofen, promethazine, atarax, iron & multivitamin (monthly Vit B shots @ this time).
25 Jan: TSH 4.962, Free T4 2.6, T4 8.5, T3 30.4. ANA reflex neg. 19 April: TSH 3.685 (no med chg).
8 May: TSH 9.586, FT4 2.2, T4 6.7, T3 33.2 (inc to 200mg levothroid).
25 May: passed out in store, taken ER, UTI.
28 June: per my request come off all meds (believe meds masking accurate picture of illness). TSH .19, Free T4 4.70, T4 12.60, T3 37.5 upon admission.
ER twice in July. Req referral to endo.
10 July: PCP dec to 188mg levothroid, 25mg cytomel added (my request), myxedema diagnosis, lyrica added (my request), mobic, hydrochlorothiazide, promethazine PRN, multi-vitamin cont, protonix, motrin, atarax PRN.
17 July: w/endo, cytomel revoked/no myxedema
19 July: diff endo, started Armour Thyroid 150 mg (my request)
8 Aug: Pharmacy chg to generic thyroid, endo ok'ed
22 Aug: Follow up with endo Rx armour, TSH <.03 (.03 - 3.04), FT4 1.00 (.7 - 1.85), "But you have more energy?"
28 Aug: I have an infection, eyes swollen, itching, temp drop, , pain in joints, fatigue, insomnia or non-restorative sleep, rapid pulse, hair loss, problems swallowing, hypersensitive to clothing/touch/smell, water is painful, wgt loss, thyroid med only since 22 Aug. 60mg 1 am/pm w/no food. Called PCP this AM, out of town, no appts next week. I am scared, suggestions and beter understanding of Dx would be appreciated.

[cheshire]

150 mg of Armour was a very high starting dose. The appropriate starting dose is 60mgs, rasing every 2 weeks by 30mgs until 180-300mgs or symptoms subside completely.

As you were not properly managed for so long it is likely you have adrenal disfunction (cortisol disregulation) and may not tolerate active T3 until you have treated it properly. Have you run 4-point cortisol saliva test? Do some online research on adrenal function and hypo so this does not turn into a dangerous situation.

[borninquisitive]

Perhaps the doctor didn't run antibodies because you were obviously hypothyroid. That said, it's good to run antibody tests. From what I understand, Hashimotos can "swing."

My thinking has always been, when it comes to medication...to start out on a low dose and slowly increase, if needed. I think you have to give the body a chance to acclimate to the new med, see how your body responds and then, move from there if need be.
From what I have heard from a number of patients- is that once they got their thyroid regulated...they were able to nix some other non thyroid medications (given due to unregulated thyroid).

I have also seen lithium mentioned in regards to the thyroid-though can not remember the connection. You may want to google it.

Best to you.

[Psalm 3:5]

1. Why are T4 and TSH both high? I really can not find any literature on that. (was my original first question, just too brain dead and scared to remember it)

2. The ANA reflex test does not include thyroid antibodies? and why wouldn't a Dr. request a thyroid antibody test?

3. Just what should a person be checked for?

All of the sudden I feel very ignorant. I have been down for almost four years now with my overall health. I was medicated to what I consider extremes before a rheumatologist decided to do blood work revealing high TSH. I am depressed because I have no life due to my poor health, not because I am depressed. This illness has become the worst nightmare of my life. The emotional cost to my family unbelievable. Just makes me frustrated to have to have waited three years for blood work, one year on incorrect dosing schedule. No one ever suggested I take thyroid meds seperate from others, I am the most medication compliant person in the world and I can not help but think that one person telling me to adjust med scheduling may have started improvement earlier.

Thank you all for your post, questions and comments. I would still be taking thyroid medication with my multi-vitamin and foods, laying in bed wondering if I was dying if it wasn't for people asking and answering questions. Praise God for my husband, he got on the internet and found some people for us to learn from.

I have called my endo and very humbly asked that he treat me as he would have treated me without my interference (ie synthroid). Also asked if for thyroid antibodies to be checked. I have not taken thyroid medication today, heart finally quit pounding around 10:30 this morning.

Wow, I am beat, I am grateful for all, God bless.

[Psalm 3:5]

Thank you for your time. I appreciate your outreach, it helps my health and heart. God bless you.

[Mark Lupo, M.D.]

Currently it may be too much armour.  You have an underative thyroid -- would test thyroid antibodies to see if this is hashimoto's.  It could also have been lithium induced.

You've had a lot of med changes in the last 2 months - may be tough to determine exactly what's the cause.

Cannot make specific recs, but would consider going back to straight T4 (ie synthroid, levoxyl, etc) then consider in future adding a lower dose of cytomel if desired....(ie, 5mcg 2x/day rather than 25mcg all at once).