Confused About Thyroid Medication

[kellil]

Hi - I was diagnosed with Hashimoto's in early August after having back and forth symptoms of hypo and hyper thyroidism.   My endo put me on .25 of Synthroid for 1 week, .then 50 of Synthroid for one week, then raised it to .75 until my return appointment in October.  One week after starting my .75 dosage, I started to experience tremors, heart palps, irregular heartbeat, increased appetite, weight loss of 5 lbs. in 2 weeks, increased loose bowel movements, muscle cramps anxiety, panic attacks while driving and dizziness.  I contacted my endo's office and after much pleading they agreed to test my levels.  They told me it would take 10 days for the results and to not contact them as they would let me know when the results were in.  Long story short, I contacted my GP and went to see her re: my symptoms.  She obtained the lab results (they were in after 4 days) and my TSH was 0.283 and my FT4 was 2.0.  (In August my TSH was 13 and my FT4 was .64.)  She said it was no wonder I was feeling that way, that I was overmedicated and told me I should stop taking my medication for 3 days and to then start up again with .25 of Synthroid.  I followed her advice but within 3 days of taking the .25 dose I was again having the same problems.  I contacted my GP again and she said I should quit taking it for 6 weeks until my body clears everything out and she will retest at that time.  I haven't taken any Synthroid for 11 days now and although my symptoms are better, I am still having severe tremors, loose stools, anxiety, muscle cramps, and I get really shaky if I don't eat every two hours.  The irregular heartbeat has improved dramatically though.  Could this still be the Synthroid left in my system that is causing these symptoms?  How long does it take for Synthroid to clear out of your system?  By the way, my endo's office contacted me after 10 days and told me my results were fine and to continue on my .75 dosage.  I am confused as to what he wanted my numbers to be?  I was used to the hypo symptoms but these hyper symptoms are throwing me for a loop.  Any input would be greatly appreciated.

[ShelleyN720]

OMGosh, your endo sounds like my first endo. I dropped her after the second visit because of the horrific symptoms I developed from the T4 only med (Levoxyl) that she prescribed. Within a few days I developed terrible neuropathy & parethesia (severe pins & needles ALL over my body that burned like bee stings) I also had such pressure in my head especially behind my ear drums that I thought my head would explode! BUT! She liked my first set of labs because my TSH has dropped. I tearfully told her I could not stand my body's reaction to the Levoxyl. She told me the pins & needles etc were NOT from the Levoxyl. That I needed to go to a neurologist. (what made me angry was that I'd read at the Levoxyl website that the side effects I was experiencing were listed!!) I knew when I left there that I'd not go back. She was aloof and did not care about me. I called my primary care physician and asked her to prescibe Armour thyroid. She did. Within 5 days ALL of the previous symptoms were gone! Amazing, huh? I have several nodules and had the largest one (1.4cm) biopsied in May with ultrasound guided FNA. It came back benign, but I will have another done next month. It was not the worst thing I've ever gone through, but I cannot say I look forward to it.
I also have a new endo. He is pleasant enough but very much like most endos I read about on these boards. He doesn't seem to get the connection between all of the miserable symptoms that result from hashis.
I know my own thyroid still produces hormones because sometimes I will feel a bit hyper for a few days at a time. I take 60mg of Armour a day which is not a high dose. However, there are days when I feel a bit "wired".
When you see him next week take a list of questions and ask them ALL! You have to become your own healthcare advocate. We cannot be victims of doctors who although they mean no harm, are also not helping us.
I think you also need to ask for blood tests to check your levels of D3. We need D3 for thyroid hormone to work properly. Also need to check B12 levels. Be sure to take calcium and magnesium supplements and Evening Primrose Oil.
My level of D3 back in April was 30 in a range of 20-80. That is on the low end of the range. My doctor (at the time) said NOTHING about increasing my Vitamin D. I'd asked for a copy of my labs and discovered it. I swear, if the labs are in range they don't care if its the very BOTTOM of the range, they do nothing until they see the numbers are "out" of the so-called range. Bizarre!
Good luck with this next appointment. Be strong!

[kellil]

Thank you so much for your comment.  It helps so much to know that other people understand what you are going through.

Strange story about my ultrasound. My endo did do an ultrasound (I was in the hospital at the time) and told me that my thyroid looked fairly "clean."  (That was the term he used.)  One week later, while at a follow-up visit with my GP, she mentioned that she got the report from my thyroid ultrasound and asked if my endo had indicated what he was going to do about the nodules?  I was surprised to say the least!  I told her he never mentioned anything about nodules to me or my husband.  She called his office and they said they were going to do an ultrasound in October and needle biopsy if necessary.  I am confused as to why he didn't mention the nodules to me.  And if I do have nodules, they very well could be contributing to my symptoms.  

I am wondering if I am seeing the right endo. He (or his nurse) was not helpful in the least bit when I called them about the over-medication symptoms I was experiencing.  And the nodule thing bothers me too. Why didn't he mention it to me and explain what it was?  I'm confused!

I was told many times over the past two years that there was nothing wrong with me.  Also was told that I needed to be on reflux meds, anti-anxiety meds, etc.  It took two ER visits and a hospital stay before I was diagnosed and now I realize that was just the start of the journey.  It has been a long summer.  I kept thinking that I would feel so much better once they knew what was wrong and started me on medication.  Boy was I wrong.  This is a roller coaster ride!  

Do you think the Synthroid that I was taking 11 days ago is still affecting me?  My husband said it has a really long half life (7-10 days.)  I read that it takes weeks for your levels to drop.  I wish my endo would have increased my dose more slowly.  That doesn't make sense to me either. I have a lot of questions for him at my appointment next week.

Thanks again for your words of knowledge and encouragement!  They help alot!

[ShelleyN720]

I understand what you are going through. Maybe you are in the early stages of Hashimotos Thyroiditis which is when you can go for weeks & months slightly hyper, then weeks & months slightly hypo. A TSH of 13 definitely is a sign of your pituitary gland sending out stimulating hormone.
Did your endo also do an ultrasound to see if you have nodules? I have read that nodules tend to be a symptom of hashis and at times will secrete hormones indescriminately caused fluctuations in hormone levels - I too went from hyper to hypo to hyper to hypo long before I ever knew it was auto-immune thyroid disease. I can recall the various periods in my life over the last five years when these swings were going on. I went to the doctors a lot. They just gave me anti-depressants, or stomach meds, or anti-anxiety meds even though my complaints were dry skin, insomnia, ear infections, low body temperature, body aches & pains, heart palpitations, anxiety attacks....WHY do doctors not put the puzzle pieces together?
I swear they do not diagnose symptoms as a whole, but rather pick one or two and then medicate. Its crazy!
I suffered for months, years going back many times asking for help figuring out what was wrong. FINALLY this past March a doctor decided to do some blood work and my TSH was elevated to 7.56. Then an anti-TPO provided the hashis diagnosis and an ultrasound provided the multi-nodular goiter.
If I'd have been diagnosed earlier I do believe some thyroid hormone "may" have been able to save me from the thyroid nodules.
Doesn't matter now. It happened. Now I deal with having thryoid disease and am grateful to the posters on this site.
I too believe you are over-medicated. Loose bowels are a definite sign of that being the case along with the heart palps & anxiety.
I'd stop the Synthroid and try to drink lots of liquids to flush it out my body. Your thyroid has been stimulated by the extra hormones and you may be hyper for awhile. I'd not take any meds until you have more blood work done - including the FreeT3 and FreeT4 in addition to the TSH.
I know how awful it is to be driving down the street in traffic feeling like the car is caving in on you or the other drivers are going to run into you. I had anxiety attacks when I was first on synthetic thryoid. I changed to natural dessicated and it worked much better for me.
BUT! for you right now, you need to stay off until you can get some blood work done!
God bless you. You are not alone!