Thyroid Disorders Community
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Taking levothyroxine 75 mcg - still having serious symptoms...does it get better?

Do the symptoms ever get better? Is weight loss surgery an option for me?? Is it possible to have ADD and Hypothyroid?  35 year old female. Diagnosed with hypothyroid in 2007 by a bariatric doctor who was treating me for obesity.  TSH was over 8.  Started with 75 mcg of synthroid, went up to 100 mcg and felt great, losing weight all was good.  Lost my job and had to stop going to bariatric doctor (because they are self pay - insurance wont cover weight loss - $100/week is expensive w/ no job), then my PCP started treating me. Much to my pleading not to - He had my tsh level checked it was 2.9 and he reduced my synthroid to 75 mcg and changed from synthroid to levothyroxine.  Since this change, I have felt horrible, all the symptoms I had before i started treatment are back, joint pain, cold, constipation, dry hair, gained back all the weight I lost (60 pounds in less than 5 months). Now I have new symptoms, eye twitching, migrains, shortness of breath, excessive yawning, tired (cant even get through the day w/out a nap), boils on my privates (yes gross) and some serious ADD symptoms (had power turned off becuase i forgot to pay the bill, forget to do things people ask me, lost job because i cant focus long enough to complete a project, procrastination, worry, guilt, interrupt people who are talking, impulsive), depression, crying for no reason, mood swings, complete loss of sex drive.  My PCP put me on South Beach diet, and I gained 15 pounds in 3 weeks.  I work out at the gym 4-5 days a week for at least 1 and 1/2 hours (treadmill, elliptical, weights), Im up to 240 pounds, went to PCP he said I just want a magical pill to get rid of the weight - not so much - Ive never ever even mentioned or asked for any pills - I did a liquid diet for 8 months with no pills- and I have "dieted" since I was in 7th grade - Im 35.  I am going to an endocrinologist on the 20th of July, and Im hopeful she can help me - but at this point - I just want anyone to listen to me other than my husband who sees what i go through.  I am considering gastric bypass or banding as a last resort - I am desperate to feel good and after 10 years of being over 230 pounds, my body is taking a beating.  I went back on the liquid diet last month, and I lost 4 pounds in an entire month.  ANY HELP OR SUGGESTIONS WOULD BE GREATLY APPRECIATED!!!
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Avatar universal
A gastric bypass operation is a very serious step with many associated risks.  Before you go to that as a last resort, you need to try to get your PCP to understand that treating a hypo patient by testing and adjusting TSH levels is just wrong.  

Of course our weight is affected by our eating and exercise habits, but those of us that have fought the hypo wars know that when your thyroid isn't right and your metabolism is low, it's almost impossible to keep the weight off.  The key is to get thyroid hormones adjusted correctly and get the metabolism up to what it should normally be.  The experience of many members of this Forum has been that many times this does not happen because their doctor treats them based on TSH and never gets free T3 and free T4 up to a level to relieve hypo symptoms, including weight gain.

TSH is a pituitary hormone that signals the thyroid glands to increase/decrease thyroid hormone output.  But, since TSH is affected by so many variables, and fluctuates so much during the day, it does not correlate very well at all with hypo symptoms.  Since symptoms are what it is all about, I just don't understand why many doctors continue to use TSH as the diagnostic for thyroid problems and to determine medication.  There is even a huge controversy about which reference range to use for TSH.  The old range was .5-5.0.  Since 6 years ago, the AACE recommended a new range of .3-3.0.  The old range is still in widespread use.

Of much more importance to me than TSH, is free T3 and free T4, which are the biologically active thyroid hormones that regulate metabolism and many other body functions.  Free T3 is four times as potent as free T4 and it correlates best with hypo symptoms.  So in my opinion, the best way to treat a thyroid patient is by treating symptoms, by testing and adjusting free T3 and free T4 with meds as required to alleviate those symptoms.  

Note that the key to treatment is all about symptoms, not about treating your TSH level just to get it within some range that the doctor uses.  I suggest that you need to try and get your doctor to test you for the "frees", free T3 and free T4 ( not total T3 and T4),  and also for thyroid antibodies.  The antibodies testing would be to determine cause for your hypothyroidism.  This is important because, for symptoms relief,  people with autoimmune disease typically need to be medicated more to suppress their thyroid glands, by getting free T3 and free T4 to the upper part of their range.

While you go about trying to get to your doctor and discuss this with him and try and change his approach, I suggest that you also start looking for a good thyroid doctor because this might take some time and I'm not optimistic that your current PCP will be willing to reconsider your treatment regimen.  It's very important that you not waste any more time with doctors that don't know thyroid problems and that would not be willing to treat you based on your symptoms, by testing and adjusting free T3 and free T4, with meds as required to normalize your metabolism and alleviate your symptoms.

If you can't locate a good thyroid doctor through your personal contacts, you might try posting a new request,  asking members to send you a PM if they have a  recommendation for a good thyroid doctor in your area.
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