Should I wait to be treated

[tiredfedup]

I am feeling completely exhausted and my doctors want to wait to treat me.  I will see an endo. on Thursday.  Should I push for treatment or should I wait?  After reading about people's experiences with Hashimotos and the difficulty on getting levels right with meds, I am unsure as to whether or not a person is better off waiting until they thyroid is not functioning.  Is it safer?  If it's not safer, then why do doctors prefer to wait?  Is it more dangerous to try small dosage of meds?  I am still so confused about this and would like to know more before my appointment on Thursday.  Help anyone????  Thank you so much!

Traci (Tiredandfedup and confused)

My levels are
TSH 2.92 (.27-4.2)
Free T4 1.0 (.9-1.8)
T3 108 (80-200)
Total T4 8.3 (4.6-12)
TPab 207 (0.0-35)

my antibodies went down slightly as my TSH went up.  Does that make sense?

[tiredfedup]

Thank you all so much for your input!  It helps to hear different opinions.  I will see what happens tomorrow.  I don't even know if I am feeling so wiped out b/c of the Hashimoto's or something else, but I am so exhausted.  I want to try med. at this point.  I will keep everyone posted.  This forum has be so helpful to me.  

Traci

[mtkst13]

well, all you can do at this point is go over your results, tell your symptoms, and say you'd like to try meds.  with your borderline levels, symptoms, and antibodies, this doc may try a low dose.  if not, see what the doc's gameplan is...when you should be retested, etc.  you definitely need follow-up.  i wish you had free t3 results...especially since your free t4 is low.  good luck and keep us posted.

[gimel]

I agree with goolarra.  Why wait until you are in hypo hell?  When you start out on meds, you will probably be started on a small initial dose and then wait for 6-8 weeks and retest,  then  an increase,  then wait, then more testing, etc.  It takes a while to ramp up to full dose and feel the full effects.  Why not get started on a small dose now and be further along in the treatment you will ultimately have to have anyway and hopefully avoid the worst of the symptoms?  JMHO

[goolarra]

It takes many years for the antibodies associated with Hashi's to destroy your thyroid to the point where it is not functioning at all.  You will be clinically hypo long before that happens, and your symptoms will increase and become worse.  Doctors prefer to wait because they are "treating the numbers".  Many have little interest in your symptoms as long as your labs are within "normal" range.

If you're feeling completely exhausted, you should probably consider pushing for treatment.  Your TSH is very close to the top of the range (0.3-3.0), and your FT4 is very near the bottom.  TT3 is also on the low side.  You will probably become  clinically hypo very shortly - then everyone will be happy to treat you!

I don't think you'll feel worse spending the next few months on a low dose of meds than you'll feel if you don't take meds and keep getting more hypo.  Save yourself the pain of descending into complete thyroid hell.  

Slight changes in antibodies are insignificant.  Basically, if you got 'em, you got 'em, and the actual number is less important.  Also, antibody level does not correlate with TSH at all.  If you get on meds, and your TSH goes down, the antibodies will still be the same, you'll just feel better.

Here's the question I think you have to ask yourself:  do I want to continue being exhausted and getting more hypo with more symptoms, or do I want to get on a low dose of meds with the possibility (some people have few problems regulating dose) of some difficulty in regulating dose?

If you had no symptoms, I'd be less likely to recommend treatment, but you do.

[mtkst13]

to be honest, i would wait to take meds and continue to get levels checked every six months.  right now you don't necessarily need meds and the doctors won't prescribe them.  

my opinion is that once you start taking the meds, it's hard to get regulated and your free t4 and free t3 start to do really strange things.  also, it's always better to have your own hormones vs synthetic if you don't need to take meds.  so since you're not clinically hypo, i'd wait but keep getting levels evaluated.

your levels are definitely borderline.  get checked in 6 months to see what's going on.  then go from there.  i know it's frustrating, but for now i think that's your best game plan.

make sure free t3, free t4, and tsh are drawn.