Hypothyroidism

[Rwelsh]

I am a 51 year old male.  6 weeks ago my normal lad work came back and my tsh level was high. 10.7.  My pcp put my on synthroid, 25mcg. My tsh levels are now in the normal range, on the high side, she didn't give me the number.  My question is this, ever since being on the synthroid I have not felt well.  Headaches, loss of appetite, weight gain, 7 pounds in 6 weeks. I am very active and do mixed martial arts 4 times a week.  Is this normal or should I go see an endocrinologist??  I was also taken off my HCTZ due to elevated calcium levels.  My blood pressure went up to 150 over 90 and she put me on another blood pressure medice.

[goolarra]

You're very welcome, and best of luck.

I'm glad your friends mentioned parathyroid as a possible cause of your high calcium...good call.  I also agree that after an out-of-range TSH test, a full thyroid panel should be run...FT3, FT4 and TSH...before starting meds.  

[Rwelsh]

I have it drawn every three months. My sister is an RN, as well as several former co-workers.  They all said she should not have taken me off the HCTZ due to high calcium.  Said she should have tested the parathyroid and definitely not started synthroid after one TSH test.  I am making an appointment with an endocrinologist that specializes in thyroid conditions close to here.  Came highly recommended from a friend with hyperthyroidism.  Thanks so much for all the help!!

[goolarra]

I just PMed you the names of doctors in TN.  We can't post their names here, thus the PM.

You're right, treating by TSH is not the way to go, nor is using a range with an upper limit above 3.0.  Even 3.0 is too high for most people.

If your TSH isn't as low as your doctor would like, why didn't she increase your meds?  She seems to be contradicting herself.  When do you have blood drawn again?  

[Rwelsh]

Thank you for the help.  I just came from a follow-up.  The range from the lab is .450 to 4.50.  After being on 25 mcg synthroid for 6 weeks my TSH was at 3.6.  When I asked her if I should see an endocrinologist she said I didn't need to, the TSH was coming down and was within the normal range.  Not as low as she would like but within the range. From everything I have read here this is not the way to treat this.  I live in rural SW Virginia.  About an hour and a half from Knoxville Tn and Kingsport/Johnson City Tn. Any recommendations on Dr's would be highly appreciated.  My doctor thinks my symptoms are due to the elevated BP and advised me to go see my cardiologist. She is a friend, as my wife works in the office, but I think I will have to hurt her feelings a little bit.  Thanks so much.

[goolarra]

TSH is a pituitary hormone, subject to many influences other than thyroid hormone levels.  It's also very volatile and can change by as much as 70% just depending on the time of day the blood was drawn.  So, it's not adequate testing to base meds decisions on.  Your doctor should be ordering FREE T3 and FREE T4 as well and basing decisions on those and symptoms rather than TSH.  

Another problem with TSH is that most labs use a range that has an upper limit of around 4.5-5.0.  Over 10 years ago, AACE recommended that the range for TSH be changed to 0.3-3.0.  Labs have been very slow to adopt that change.  So, if your doctor is telling you that you're on the high side of the "normal" range, you are probably over the 3.0 recommended by AACE.  Furthermore, most people feel better considerably below 3.0.  

Your doctor is also ignoring your symptoms, which clearly indicate you need a meds adjustment.  So, yes, I would find another doctor.  Although endocrinology is the specialty that deals with thyroid, not all endos are good thyroid doctors.  Some only want to deal with diabetes.  So, I would strongly suggest that you try to get a referral from a person you trust and/or interview doctors over the phone before making an appointment.  One of our members keeps a list of doctors recommended by forum members.  If you tell me your approximate location (city and state), I can see if we have anyone in your area.  

Too low a dose of thyroid meds can almost be worse than no meds at all.  Don't live with your symptoms.    

[Rwelsh]

Yes, she tested only TSH. After the follow up labwork, 6 weeks later, she called and said my TSH were in the normal range, but on the high side.  She said to continue on the same dose of synthroid. I never had the other symptoms, other than tiredness, before I started taking the synthroid. This was the first time my TSH level was high.  Thank you

[goolarra]

Is your doctor testing only TSH and adjusting your meds based on that alone?  It's a really good idea to get a copy of all thyroid labs and keep your own history.    

If you have FT3 and FT4 results, please post those as well with reference ranges.

You have hypo symptoms, so it's clear to me that you are under medicated.