Hypothyroidsim after RAI

[climber09]

I was diagnosed with Graves in 12/03. I went on Methimazole after a small goiter was found. It seemed like that was bringing my labs down and I didn't feel any different besides gaining a little weight. I tapered off Methimazole after 6 months. 6 months later my labs spiked again. my TSH 0.0, FT4 0.68, FT3 15.7. I then had RAI in 06/05 and my intake was really high when he gave the pill it was in the 90%'s, so I only had to drink a little bit of that stuff. My doc said normal uptake is around 30%. in 09/05 he started me on 137mcg/day Synthroid as my doctor decreased my dosage my weight went up I started feeling horrible, I have bad headaches, I just don't feel good anymore. My last labs in 07/07 were TSH 11.8, FT4 0.7, FT3 4.0 which was on 60mg/day of Thyroid Armour. I am now on 90mg/day of Armour now. I still feel the symptoms of Hypothyroidism. Why is that? Why is it better to use a drug that has more T3 in it when my T4 is lower? Why do doctors base everything off of T4 and patients are so hyped on getting bio-identical hormones from pigs because it makes them feel better? Is it possible for a person who takes Armour to go into hyperthyroidism from taking too much? Is it harmful?  

[climber09]

Is there any suggestions to how I can get my TSH back into normal levels while keeping my T3 and T4 in normal levels? I only have 90mg pills so I usually take it right when I get up in the morning. Could my headaches be associated with the hypothyroidism? I never really had many headaches until I dropped from hyper to hypo. Too me it is kind of getting stressful because it has been 2 and a half years and I still am going back to the doctors every three months for labs. I don't even think I have had same amount a medication for more than three months at time because they keep adjusting it. Do you have any suggestions that I could pitch to my doctor? Do you think spreading my medication out throughout the day could help out. I have talked to a physiology teacher at my college who actually specialized in hormones and that is something she actually recommended, but I am trying to gather as much info so I can finally stop getting poked every three months it is getting quit tiring.

[Mark Lupo, M.D.]

It is possible to be hyper from too much of any medication.  The T4 will run in the low range on armour b/c the pig thyroid has more T3 than human thyroid (in relation to T4).  Armour is not for everyone.  Goal TSH is still around 1.0 - independent of medication you are on -- and armour may be taken in am and around 2-3pm, this may help smooth out the day.  So if 90mg is the dose -- you could take 45mg 2x/day or 60 am and 30 pm.  Treatment must be individualized and some of this is trial & error - so there is not one "better" treatment for hypothyroid.