Help! How much hypothyroid meds should I take?

[Mark6]

What proper medication should I take?
My blood tests don't show any problems with my thyroid but I have all the symptoms. I'm a 36 yr-old male. I went from 75kg to 90kg in a year and I exercise daily, as I always have. It's beyond explanation. I am a very happy person yet the past 6 months I feel so down every single day. I have no energy no matter how much sleep I get. My skin is dry. My constipation is almost unbearable. My concentration level is very low and my muscles get sore for no reason. I convinced a doctor here (I live in Taiwan now) to help me. He started me on Eltroxin at 25mcg per day for one month. Nothing changed. Now he increased it to 100mcg per day. Is this ok? I don't think he really knows what to do with me. Please help if anyone can with some advice. Thank you so much.
Mark

[Mark Lupo, M.D.]

100mcg is a reasonable starting replacement dose for a young healthy person -- it will be important to check thyroid levels in 6 weeks to make sure the dose is correct.  It may take 2-3 months (even on the right dose) to notice symptom improvement.

[BG52]

I try not to comment on questions to Dr. Lupo, but I have one though to interject.

If your TSH was 1.98 before you were put on 100mcg of Eltroxin, then that dosage is way too high and it will drive you to a hyper state quickly. Your TSH will drop sharply before the medication has six weeks to build up to full strength in your system.

The 25mcg dose MAY have helped if given more time. I'm not sure you should be taking Eltroxin at all.

Your health will suffer if you continue taking 100mcg.

[Super_sally888]

I'm sorry, I didn't read your first post properly.  

Your symptoms could possibly be thyroid (though unlikely given your blood tests - though do find out about the antibodies...)....

have you looked at other things like celiac / gluten intollerance.  In some people it can cause constipation and a wide range of symptoms.

The weight gain makes me think you could look closer at your diet and if there are any foods you are sensitive.  Get your blood sugar checked.

Have you considered sleep apnoea? If you have a partner ask her if you snore a lot, of if she's ever noticed anything when you sleep.

Hope you feel better soon.

Sally

[GravesLady]

It might help Dr. Lupo if you would list your levels with Labs reference range.  

Doses are individual based upon TSH level.  If your level didn't show need for thyroid medication in the first place, can causes complications or make existing ones worse.  Thyroid medication is not a cure-all for all our ails. Plus there are many other health conditions that share thyroid symptoms which makes it difficult to distinguish between thyroid or other health conditions.  Test would need to rule out each health condition before saying thyroid.
My doctor put me through various test before ruling Graves' disease as the sole cause of my symptom.

Search health conditions that share your symptoms and have each checked out through their proper test.  Also, you might get better results if you treat each symptom  separately and from thyroid, where possible.  I did that with a few of my issues and got results.

Good Luck!

[Smilerdeb]

I totally agree with you Mark in regards to comment made by another member in this posting to Dr. Lupo..........

This is not a way to win friends, but, I can not feel empathy for you when myself and other like me or worse, suffer with real thyroid issues where levels and test do show thyroid.  I wish I could get my levels as good as yours. Accept you don't have a thyroid issue and move on, if you don't you are just going to make yourself sicker....or worse!

This member banned me from HER MSN site she has because I was a member of another Graves Support Group sending an email to me telling me to 'Swim with the sharks'.
Is that professional? Is that unjust?
I have no time whatsoever for anyone who decides that they want to PLAY Doctor here and have reported the certain member for her abuse.
I am glad you listened to Dr. Lupo as HE is the one who is the Doctor here...am I not right?

[Mark6]

Thank you very much for responding Dr. Lupo. Your opinion is invaluable in my case. That's the best and most honest advice I've received thus far and it gives me much more confidence in the doctor I do have now. I will follow your suggestions. If you don't hear from me again that will be great news... I'll be healthy!

Thanks again. You do a great service for desperate people.
Sincerely,
Mark

[Mark6]

I also wonder if Armour is a better option to try than Eltroxin because: it is natural (pig extract), some doctors like it more than Eltroxin, and Eltroxin is no guarantee to work for a sufferer of hypothyroidism. Hmmm.

[Mark6]

Thank you very much for your reply.

You may very well be right, I just don't know. I did discuss with my doctor about how some sufferers of hypothyroidism end up taking 200-250mcg per day. He stated that he figured 100mcg would be the highest level my body would ever need. I'm not sure where he got that conclusion from but that's what he said. He also told me, and I have read this, that it is ok to increase the dosage every month until you find the correct level for yourself, usually by 50mcg per month. (I am leaving on a 4-week vacation back to Canada next week so he thought 100mcg/day over 7 weeks would be fine until I can visit him again)

My doctor was wary of Eltroxin also because my TSH level is within range. But I have been so ill for so long-- and he agrees that I have full-blown symptoms of hypothyroidism-- so we thought this was the best option. He said it was Eltroxin or anti-depressants, and I know anti-depressants will only help my mood, so we went with Eltroxin.

The problem is the TSH level obviously. But if I just follow the "normal" TSH ranges set by hospitals, I will not receive any treatment. So how to know what dosage to try if your TSH test doesn't show that you have hypothyroidism? And if I don't have hypothyroidism, what other illness exhibits exactly the same symptoms?? And what can I take to cure it? No one has been able to answer this for me.

It may sound like I'm taking a gamle with my health, but after going from a perfectly fit and healthy young adult to having 6 months of my like taken away by serious illness, I'm willing to try some medication at this point. I have also read extensively on the effects of too much Eltroxin in one's system so I know what side-effects to look for. Laying off the dosage is said to reduce the bad side-effects within days if they do appear.

Not to sound crass BG52, but my health can't get any worse than what it is currently. I want my life back. I sincerely thank you and the others for commenting on my situation. It's great to know there are still others out there that care about the well-being of total strangers. :)  

  

[Mark6]

Thank you Sally for your concern and for responding.

Neither doctor I've seen has mentioned thyroid antibodies. Maybe they don't even know about it. I've never heard of celiac/gluten intollerance. I'll investigate that also.

Yes, I have had extensive tests for diabetes. I found out over 6 years ago that I have "pre" diabetes. The females on my mom's side have extreme diabetes so I've had mine checked regularly for years. I have had to watch my diet carefully and eat smaller amounts regularly. This gives more credence to the fact that my weight gain is coming from something that's not natural. I've been eating very healthy for many years, if not forever. I was in better shape than anyone I know at my age. And my entire immediate family of 6 is very thin and healthy. I don't smoke and my stress at work teaching kids is minimal because I like it and it's been the same job I've had the past 10 years. Nothing has changed in my life besides my health..

Also, I had been 75-77 kgs since I was in my early 20s-- over 15 years ago! And I've been eating the same for the past 10 years in this country. To jump 15kgs in 16 months is crazy AND no matter how much I exercise now (sometimes twice a day: swim, yoga, pilates, bike, etc.) or what I eat, I remain at 90 kgs. It hasn't budged for 6 months, I've tried. Something is seriously wrong with me.

As for sleep, I sleep fine but I don't like getting up. In part because I feel so miserable and I don't want to go through the day and in part because I still feel tired no matter what sleep I had. I don't have a partner now but my previous one never mentioned anything about snoring and she was a light sleeper. I was actually very very relieved and elated to get away from that relationship so it makes even less sense whatsoever that I feel so unhappy now. What a mystery this all is.

Thanks for your suggestions Sally. I won't give up. Life is too special.

[Super_sally888]

Hi,

Your thyroid test results look excellent and don't indicate a thyroid problem.  Just going on them you shouldn't need thyroid medication.  However, have you been tested for thyroid antibodies?  If you haven't this should be done, becuase very high levels of thyroid antibodies needs monitoring and could mean early thyroid disease.

There are other things that can cause symptoms similar to thyroid. Have you been checked for things like diabetes?  Do you have problems with sleeping / snoring?  

Do you smoke?  How much sleep do you get a night?  Is your weight normal?  How is your exercise levels? Are you under a lot of stress at work?  What exactly are the symptoms you have been having?

If you can answer these questions maybe there'll be more to go on and give you a response to.

Our bodies are very complex and though it is easy to blame thyroid, it may be something else entirely, or nothing specific.

Please feel free to respond.

Sally

[Mark6]

Thank you for your concern. I will follow your suggestions and look into them.

You may be correct. However, my first doctor said my thyroid looked very big but she couldn't give me the meds because the blood tests didn't show anything. She told me to see a new doctor. I hadn't even heard of a thyroid problem until she had mentioned it. My present doctor is also confused. I've read articles from other doctors that said many patients do have hypothyroidism even though it doesn't show on their blood tests. Some doctors estimate it may be as high as 10% of hypothyroid sufferers that still show a normal TSH range. They say you can't rely on this TSH testing alone even though most doctors do. Body (thermal) temperature testing seems workable but they don't have that kind of test where I live here in Taiwan.

I also read another doctor's article that said patients with a TSH test around 2.0 exhibit all the symptoms of hypothyroidism and actually do have hypothyroidism. My TSH is 1.98. (The range is 0.27~4.20.)
Also, my "Free T4" is 1.43 (The range is 1.0~1.8)
I read that a T3 test is kind of useless and I should have been given a "Free T3 test". Anyways, they gave me the T3 test here and it is 121.00. (The range is 70~200.)

The last point is that all my hypothyroidism symptoms started at exactly the same time. How could that be possible if I didn't have this sickness? It seems overly coincidental to me. Anyways, I'm trying to find someone who shares my dilemma and how it should be approached in terms of medication. I've felt like hell for 6 months now so I have to try something.
Any comments would be very appreciated, thank you.