I need HELP!

[jennm333]

I have been taking Levoxyl for 5 or so yrs now.  My dosage has been up and down.  I am on .137mg now and just recently been put on Cytomel 5mcg twice daily.  I had to basically have a breakdown infront of my endocrinologist to have him let me try this.  My endocrinologist had only taken my TSH for years.  Until recently, after having so many ups and downs (BAD MOOD SWINGS) and panic attacks, I saw an chiropractor neurologist and he told me that I needed a full thyroid blood work up and could not believe that my specialist had not done so.  After getting the results were as follows: Thyroid Peroxidase (TPO) Ab 203 (very high), TSH 1.12, T4 8.6, T3 35, FreeThyroxine 3.0,T3 84, Vit D 20.7.   Other than putting me on Vit D my endocrinologist (who had never run these tests) tells me that my thyroid is dead and that Cytomel only helps 8% of his pts. I  told him thatwas never told that my thyroid was dead in the last 3 yrs I have seen him and he said he must not have made himself clear!! I don't know how he could have known this bc he NEVER ran any of these tests!  He said that my BMI is 21 and that all people have mood swings and that I need to get 30 min of time to myself a day.  The neuroligist said this was absolutely ridiculous and that I have had Hashimotos for yrs and just wasn't diagnosed.  I am EXTREMELY UPSET and saddened that I was NOT told and that I could have tried to prevent this from going to Hahimotos.  I also was told by the neurologist that I should avoid gluten like the plague (something else my endocrinologist never told me)!  I guess I am so frustrated bc I don't know what I should be doing.  The endocrinologist said that he wants me to cutt my Levoxyl to 88 instead of 137 and then take (bc  of me) 5 mcg Cytomel 2x a day.   The neurologist said I should take 137 of Levoxyl and Cytomel 5mcg 2x day.   What do I do?  And is there anything else that I can do to feel more normal?  This is so frustrating!! HELP PLEASE!!

[busymom29154]

I was dx w/ Hashimoto's back in July and have only begun Levo meds on a very low dose.  My primary doc re-ran the blood panels and said all my levels are in the "normal" range, but I still feel rotten.  I just finished reading "The Thyroid Solution" by Ridha Arem, M.D. and it has highly enlightened me to this disease.  Although I don't agree with his idea that the TSH level is the all important thing to be looking at, the rest of his information was extremely informative and I intend on using it as ammo w/ my primary doc if he does not refer me to an endo or work w/ me as far as alleviating my symptoms and not just my thyroid levels.  I would suggest this book to anyone who has thyroid problems as it is an easy read and has a host of very good information.  Good Luck!

[gimel]

In my biased opinion I would ditch both of them and find a good thyroid doctor.  First of all, it is shameful, but not unusual,  that the Endo never tested anything other than TSH.  TSH is a pituitary hormone that is affected by so many variables it really doesn't work as a diagnostic.  At best it is an indicator, to be considered along with more important indicators, which are symptoms, and also the biologically active thyroid hormones, free T3 and free T4.  Note that these are not the same as total T3 and total T4.  FT3 is actually the most important because itis the most active and it has been shown to correlate best with hypo symptoms.  TSH does not correlate with hypo symptoms.

If you had been tested for the thyroid antibodies, TPO ab and TG ab earlier you would have known what was happening and what to expect.  With Hashi's your autoimmune system produces antibodies that attack the thyroid and continue until, over some time, the thyroid glands are destroyed.  There is some controversy about whether the attack can be minimized by going gluten free, as your other doctor suggested.  There is anecdotal evidence that this can help, but the mainstream medical community has not recognized or accepted this possibility.  I also have my doubts, because I am unable to follow the logic of why it is supposed to help.  I guess we'll all learn more about all that over the years ahead.

As for now, I would ask that you post your thyroid test results  again, along with the reference ranges shown for each.  Lab results vary, so each lab uses slightly different ranges.  It is important to know where the results fall within the range.  This will help in assessing the proposed dosage of your meds.  

In my opinion the best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever type of med is required to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not the absolute levels of the thyroid hormones.  I think that you really need to find a good thyroid doctor that will  treat you in this manner.  It doesn't have to be an Endo.

For now, let's start by looking at your test results and ranges.