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Thyroid medication intolerance

I have Hashimoto and for the past five years I have struggled with taking thyroid medication. The least amount of Synthroid (1/4 of a 5 mg tablet)  sent me to the ER with chest pains. Subsequent tests were negative for heart issues. I was on Armour and did fine but when the drug was reformulated, I experienced toxic symptoms including high fevers. All these symptoms went away when I stopped the Armour.

I have been taking a compounded porcine for the past two years ( 15 mg and then raised to 30 mg). On this medication, and almost on a daily basis, I am also toxic. I experience all the symptoms of a hyperthyroid patient except for the fevers. Recently my levels are in the normal range and I am now experiencing jittery feelings, like jumping out of my skin. I know that it is related to the drug because I have stopped the drug, and I am totally normal, and I feel great. On the drug, my life is spent in the bathroom with constant bowel and urinary issues,unable to sleep, and constantly hungry.  Repeated tests for the bowel and urinary tract  issues have been negative.

Interestingly I don't have the tired issues that most thyroid patients unfortunately experience, before or after I was diagnosed. I feel healthy when I am off the drug and so ill when I am on the drug. I am too scared to get off the stuff. Then again, I am headed for a colostomy with the damage the drug is doing to my bowels. If I get off the drug I risk going into a coma. If I stay on it, I risk severe bowel issues. Not to mention that it is hard to function when one feels like jumping out of their skin.

I live in the Maryland, DC area. If anyone knows a practitioner who could help me out in the area, it will be deeply appreciated. My current medical doctor is totally clueless and useless. Thank you.
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Avatar universal
The doctor at the clinic that I went to yesterday, along with the staff were very patient and kind. I met with the doctor for about two hours and based on my physical exam, she feels that I am both hypo and hyper. She ordered  a battery of blood tests (8 vials) yesterday (complete thyroid, ferretin, and vitamin panel), and I will be doing the saliva test for the cortisol levels this weekend. She suggested I try a wheat and dairy free diet for my intestinal issues.

The doctor is not in favor at all of my taking the Thyro Gold medicine because she is not sure if it contains the raw gland. She also said that some of the side effects that I am experiencing such as being jittery and feeling like a drank lots of coffee comes from the T3 in the medicine.

She gave me a low dose prescription for the same synthetic drug that you are taking (13mcg). I am waiting for the pharmacy to get the drug and I will try it next week. She was debating to wait for the test results before she prescribed a medical protocol, but she thought I could give this a try. My hunch is that this drug is going to give me side effects, too. I have a feeling that the adrenals are not working properly and most likely contributing to the intolerance issue.

If anyone on this thread can explain to me how cortisol levels, vitamins, etc., impact the tolerance or processing of drugs in the body, I will appreciate your sage advice. I am hoping for a miracle! I get so down in the dumps because of the intolerance issue. I am envious of folks that can take medicine with absolutely no side effects.My simple thyroid problem is causing such havoc in my life. The nurse yesterday told me that the clinic is a last stop for  patients when they cannot get answers for their medical issues from conventional doctors.
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Avatar universal
The big question, which everyone, including Lowe, seems to be dancing around, is how much T3 and T4 are actually in the product.

This from the Thyro-Gold website:

"The product is protected by the 1994 Dietary Supplement Health and Education Act. As such, the FDA cannot regulate it as a drug—that is, as long as we walk an informational and terminological tightrope in informing the public and practitioners about the product. That tightrope walk is the reason you and others may sense some hedging in my communications about Thyro-Gold. I apologize for the seeming evasiveness, but it's a necessity to help keep the product available prescription-free to the public."

Since it's classified as a dietary supplement, and since any product with a measurable amount of T3 or T4 is available by prescription only (and classified by the FDA as a drug), I have my doubts about any T3 and T4 content.

However, for the sake of argument, let's say it does contain T3 and T4.  How much is the big question, and the other elephant in the living room is how consistent is the dosage from one batch to the next.

"Ms. Shonomon is a very reputable thyroid patient advocate."  Some of us find Mary Shomon more relutable than others do, and some of us find she advocates more for Mary than for thyroid patients.  

Good luck with your new doctors...  
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Avatar universal
Thank you for the good wishes.

I will keep you posted and let you know how my appointment  goes  with the integrative medical doctor.
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200220 tn?1361951554
I just posted my numbers from my last blood test on my other post.  I researched the doctor in Va. and that is a possibility for me at a future date as my finances right now are waiting for improvement.  I know that insurance doesn't always pay for the supplements or whatever they prescribe;  I hope you report how you made out with them.  I would love to go to a female doctor that listens and works with me.  I sometimes think that males doctors don't really know how we feel.  I have read this long post and it has a lot of info in it.  Please let me know how you like this practice.  I would like my daughter to go also.  She lives in Southern Maryland and suffers from severe headaches.  Thank and good luck
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Avatar universal
The product that I am taking is Thyro Gold formulated by the late Dr. Lowe. Mary Shonomon interviewed him several years ago and the interview is posted online and some parts of it are noted below (http://thyroid.about.com/od/hypothyroidismhashimotos/a/Optimal-Treatment-Hypothyroidism-John-Lowe.htm) . Ms. Shonomon is a very reputable thyroid patient advocate.

"Dr. Lowe: Thyro-Gold™ contains all the natural contents of the bovine thyroid gland. Many people believe there is such a thing as “thyroxine-free” desiccated thyroid. Presumably, the T4 has been selectively removed from these products, leaving only T3, T2, and T1.

Maybe there are “thyroxine-free” products with the T3, T2, and T1 left in. But if there is a technology for selectively removing T4, it’s being cleverly hidden from me and my colleagues, such as the biochemist who researches such issues with me.

As far as I know at this point, the term “thyroxine-free desiccated thyroid” actually refers to desiccated thyroid tissue from which all the iodinated compounds (T4, T3, T2, and T1) have been removed.

I say this based on carefully acquired evidence: we’ve systematically tested “thyroxine-free” thyroid tissue, and we found it to be metabolically inert. If the tissue we’ve tested is typical of all products labeled “thyroxine-free,” this means that people who use them to increase their body’s thyroid hormone regulation are likely to be very disappointed. We’ll notify readers if we find evidence that justifies a change in our current belief. But right now, our belief is this: dietary desiccated thyroid either contains the full array of thyroid or none at all."

As I mentioned in my previous posts, I became very ill on Synthorid. After I located a compounding pharmacy that had its own porcine brand, several medical doctors told me that it was not stable from one batch to the next and that I would never lower my numbers. I manged to lower my TSH from 15 to 3.491. On the Synthorid, it was always above the 5.0 range. Unfortunately, the dessicated porcine product has recently started to make me toxic.
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Avatar universal
It's almost impossible to know if the "bovine thyroid powder" has been stripped or not.  If it hasn't, it's still unregulated and could contain widely varying amounts of T4 and T3.  The package doesn't tell you how much T4 and T3 is in each tablet, does it?

Prescription desiccated would contain desiccated porcine thyroid.  It would contain both T3 and T4.  

You probably had to take progesterone because your pituitary wasn't producing enough FSH or LH.  Those are the hormones the pituitary sends out to stimulate your ovaries to produce reproductive hormones.  However, that was kind of the opposite problem you have now.  Your pituitary is putting out plenty of TSH, a little too much, really.  However, if you've had previous pituitary issues, that would certainly be on of the first places I looked.
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Avatar universal
Thank you...you are very knowledgeable. I appreciate the information that you are posting.

The OTC that I am taking has the following per capsule ( I am only taking 1/2 capsule per day):
150 mg of bovine thyroid powder
50 mg of L-Apsaric Acid
12.5 mg of Coleue Forskohlii (10%), 12.5 mg

The prescription compounded dessicated thyroid I was taking was 30 mg. I don't know if there was anything else in the capsule. Although the doctor increased the dosage from 15 mg to 30 mg in January 2013, I  often took less (sometimes 1/2 of the capsule because  of the side effects). Often I skipped a day and my level stayed as noted. The decision to increase the meds has always been made by my doctor based solely on my TSH.

I am not convinced that I need the medication because I become quickly toxic. As I have mentioned, I do not have hypo symptoms. In my younger days, I had problems with the pituitary gland not sending a signal to my body to produce progesterone and I had to take the hormone for many years (10 days each month). Since the same gland controls the thyroid gland, it may be a pituitary related problem. I am not sure my gland theory makes any sense.
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Avatar universal
Your TSH as you posted it above is 3.491 with a range of 0.4-4.0.  So, you are not below range but high in the range.  AACE recommended ten years ago or so that TSH range be changed to 0.3-3.0.  This is a much more reasonable TSH range, but as you can see, labs have been very slow to acknowledge the change.  Perhaps your doctor is one who uses the 0.3-3.0 range, as almost all of us on this forum do.  

As i said, TSH is not the test to base meds decisions on.

If you feel better off meds, perhaps you don't need them.  Perhaps you feel better on your OTC supplement because it's one of the ones that contains no thyroid hormones.  As I said, total T4 is not as useful ast FT4, but your total is at 48% of range.  That looks pretty good.  You're only taking 1/4 or 1/2 grain, correct?

If you don't have hypo symptoms, then you aren't hypo.  But, be aware that it takes thyroid meds (the T4 component) 4-6 weeks to go completely out of your system.  So it will be a while yet before that happens and you can draw any conclusions about whether or not hypo symptoms will appear.  
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Avatar universal
I imagine how often doctor and lab will test antibodies depends on the doctor/lab/country.  If you've never tested positive, it might be worth another shot.  Hashi's is the most prevalent cause of hypo in the developed world.

Insomnia is usually more of a hyper symptom, but a lot of hypos have a hard time staying asleep and getting a full night's sleep.
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Avatar universal
In response to your comment, "I can tell you.  "Normal" for one person is not "normal" for another.  For example, the FT4 range is usually something like 0.8-1.8.  That does not mean we will all feel well ANYWHERE in that range.  We all have our own personal range within the population range.  So, I may be happy at 0.8-1.0, but you may have to be at 1.3 to 1.5.  The range should be defined as the playing field in which a doctor can work, but all too often, once in range, he proclaims your thyroid "fine"."

I do agree with you that normal for one person may not be normal for another person. I repeatedly see on these posts and others that doctors tend to proclaim thyroid patients as having a healthy thyroid when their levels are in range. I have had a different experience. Although my TSH is slightly below the range, my PCP is on a mission to get it even lower and to keep increasing my dose of thyroid medicine. He is a superb pill pusher!

I keep telling him I am toxic and all he wants to do is increase the medication and send me to a mental health professional. He claims I have a mental health issue related to taking drugs. Then he proceeds to send me for tests for the toxic symptoms: colonoscopy (3 in six years)  for the IBS, urinary frequency (cystoscopy and bladder and kidney sonogram), racing heart (several cardiac tests), the list is endless and the tests have all been negative thus far.
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Avatar universal
My doctor could care less that I have toxic issues. He dismisses the intestinal problem as IBS, and everything else is anxiety related and I should go see a mental health professional. I mentioned previously that I stopped taking the porcine thyroid for four days and I felt great...no insomnia, IBS, and anxiety issues at all. I felt energetic and full of life. One hour after I took the compounded thyroid medicine, I was in the bathroom non-stop (both ways), up all night, and shaky. I stopped the medicine again, and I was fine. I was much healthier when I was in the hypo state six years ago then I am now.

I did experiment with an OTC thyroid supplement (bovine), taking half the dose the past two days. Thus far I have been fine...absolutely no side effects. The OTC I am using was formulated by a well know clinician in the field. At this point it may be too soon to know if the OTC will make me toxic or even keep my TSH in check. I will discuss the OTC with the integrative professionals next week.

Bottom line is that I do have Hashi which was confirmed by the antibody test and, therefore, I do have a thyroid condition. Maybe I will get lucky and find out I was misdiagnosed. The other bottom line is that I feel perfectly healthy off of thyroid drugs and ill when I take the medication.
Helpful - 0
4274823 tn?1388529098
You wrote, "Regardless, my medical doctor does not seem to care that I am toxic as long as I keep taking the medication. As my Mom would say, drugs fix one problem and then they cause another problem to surface."

I'm sorry to learn that your doctor is indifferent to your suffering. I agree with your Mom's statement. This is yet another reason to be hesitate when your doctor says I think you need to consider thyroid medication. I'm cautious because I don't wish to end up worse off.
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4274823 tn?1388529098
Thanks for your post. I did not test positive for antibodies in 2011. But that was quite some time ago so I thought it might be worth checking again. Do you know how often a doctor or lab is willing to test antibodies? I have read on this forum that Hashimoto's is a relatively common cause of hypothyroidism.

By the way I also have insomnia but luckily it's moderate. When my thyroid is at its worst I get restless legs. Thankfully this isn't the case at this time as I find this very uncomfortable. Have others experienced these symptoms too?
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Avatar universal
"I cannot understand and I cannot get an explanation from all the doctors that I have gone to, as to how my T3 and 4 values can be normal and my TSH is out of whack."

I can tell you.  "Normal" for one person is not "normal" for another.  For example, the FT4 range is usually something like 0.8-1.8.  That does not mean we will all feel well ANYWHERE in that range.  We all have our own personal range within the population range.  So, I may be happy at 0.8-1.0, but you may have to be at 1.3 to 1.5.  The range should be defined as the playing field in which a doctor can work, but all too often, once in range, he proclaims your thyroid "fine".  

Furthermore, TSH is a notoriously bad test when it comes to managing thyroid meds.  TSH is a pituitary hormone, so it can be influenced by any number of factors other than thyroid hormone levels.  Looking at TSH is a little like looking at your thermostat in your house.  You see that it's set at 80, so you stubbornly insist that the temp in your house is 80.  In a perfect world, it is, but what if the thermostat (pituitary) is broken or the heating system itself isn't functioning?  You have to look at another thermometer (FT3 and FT4 levels) in your house to see what it says.  If it says, it's 50, you might have a problem.  If you have your parka on (symptoms), it's a pretty sure thing that something is very wrong.

Another thing I want to emphasize is that FT3 and FT4 ranges are very flawed for a number of reasons.  Consequently, if your FT3 and/or FT4 levels are in the bottom half of the ranges, you probably should be classified as hypo, rather than "normal".

"By the way, here are two over the counter thyroid meds sold online that work just as well as the prescription brands with less side effects."

Some OTC meds have absolutely no T3 or T4 in them (the legally made ones).  By law, anything with a measurable T3 or T4 level is illegal without a script.  So much for legality, the "real' thing is also out there.  However, since it is being treated as a supplement, it is totally unregulated, and you have no idea what exactly you are taking.  In addition, if an OTC med does have T3 and T4 in it, it is subject to the exact same "side effects" as its prescription cousins.  It's a crap shoot...    
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Avatar universal
I don't know if you've already tested positive for antibodies or not.  If you have, further testing is redundant.  Once er have them, it's for life (unless the thyroid is removed and they go into remission).

Magnesium is water soluble, so you can try adding a little in on your own.  If you take magnesium as a laxative, take mag oxide.  If you're taking it to increase your blood levels, you want mag glycinate or mag citrate.  Mag oxide can actually lower your serum mag levels.

Your symptoms sound pretty severe.  I, too, only take meds when absolutely necessary, but putting up with those kind of symptoms gets old, and it's really not healthy for you to be hypo, either.  The problem is that the longer you are hypo and the more hypo you get, the odds increase that simply adding meds is not going to be a solution...i.e. you're more likely to develop adrenal fatigue and rack up a list of symptoms that might take years to recover from.  
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Avatar universal
The last endo I went to, did check my FT3 and 4 several times and these values were always within the normal range. However, at the time my TSH was not and it was at about 6. In my experience with the medical professionals, regardless if my T3 and 4 are normal, it is the TSH that guides them, and in my case I am told that I have to keep on taking the medicine. I cannot understand and I cannot get an explanation from all the doctors that I have gone to, as to how my T3 and 4 values can be normal and my TSH is out of whack.

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Avatar universal
I went through the magnesium test at the integrative medicine specialists that I consulted with several years ago, and it was low. I went through 12 weeks of of infusions, which did absolutely nothing for my aches and pains. This same group of specialists ordered the saliva tests for cortisol and my level was high in the evening. I never bothered to take the supplement for the cortisol level because my PCP thought it was not wise. I am going to ask this new group of integrative medicine specialists to retest my cortisol levels and then go on from there.

You can order most of these tests on your own, online, and then take the test results to your doctor.

By the way, here are two over the counter thyroid meds sold online that work just as well as the prescription brands with less side effects.
Helpful - 0
4274823 tn?1388529098
Hi, I just wish to clarify that the prescription drugs I stopped taking in 1993 weren't for my thyroid!

My thyroid was first identified as an issue in 2006.
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4274823 tn?1388529098
Thanks for your reply. I have been a squeaky wheel, but I suppose I have to get louder. Before my doctor would just test my TSH. I had to insist on a thyroid panel a couple of years ago. Recently he tested TSH, Free T4, and Free T3. I want to have the antibodies tested again. I also need to have my magnesium checked. I don't know if I can finally convince the doctor to test my adrenals. I went to a specialist once and he was old school and not helpful. And the naturopath made matters worse. So I'm not confident in conventional or alternative medicine. So I've just tried to manage on my own.
I will have to go see the physician some time in the near future to request further bloodwork before I can consider any course of treatment.  
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4274823 tn?1388529098
Thanks for your reply.

I often feel cold, my skin is dry, I sometimes get calf cramps in the middle of the night, I'm anxious/emotional/stressed, and I have occupational tendinitis. I don't feel as parched as I once did. I just tolerate the discomfort! My thyroid function seems to be like a yo-yo. Sometimes it isn't too bad and other times it is quite out of whack over several years. I really do believe there's more to it though and that's why I am leery about the doctor just wanting to prescribe thyroid medication and not investigate the big picture. I swear I likely have low cortisol. This could be partly why I have had tendinitis in my forearms for almost a year with 9 months of Physio. I was reading how those with thyroid problems are prone to musculoskeletal disorders. I am 45 and have been doing physical work for a long time and have hobbies that also involve my hands,wrists, arms. I could be entering perimenopause too.
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Avatar universal
"I have  been told repeatedly that we need the thyroid hormone to survive."

And we do.  However, you have to take into account just how bad your thyroid levels are.  You can live for decades (though probably not happily) with just slightly low levels.  Even with moderately low levels, it can take years to get to a crisis state.  People rarely die of hypothyroidism...it's a disease that moves slowly.

Every cell in your body needs thyroid hormone to function properly, so as levels decline you tend to keep adding more and more hypo symptoms to your list.  It's a miserable process...  
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Avatar universal
How do you get a doctor to test anything?  You have to become the squeaky wheel.  I don't know the stats on how many people with thyroid issues also have adrenal issues.  Perhaps the number is small enough that widespread adrenal testing before starting thyroid meds isn't warranted.  I don't know.  However, they should at least be aware that intolerance to low doses is a red flag that thyroid might not be the only issue.  
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Avatar universal
I am impressed that you have been able to stay healthy without the benefits of thyroid replacement. I have  been told repeatedly that we need the thyroid hormone to survive. I agree with you, it cannot be healthy for me to be in a constant state of toxicity. However, my PCP is not concerned at all by my toxic state. On the other hand, I am very concerned and I have reached the point where I need to get some real answers to my problem.

The naturopath that you went to should have known better then to give you  iodine supplements. I heard iodine eventually will destroy the thyroid gland. The folks that I am going to see next week are medical doctors who practice integrative medicine.

In reference to the adrenal glands, I read the work of the late Dr. Lowe (http://thyroid.about.com/od/hypothyroidismhashimotos/a/Optimal-Treatment-Hypothyroidism-John-Lowe.htm) and he addresses the issue that if the adrenal glands do not properly function, the patient is going to be intolerant to the least amount of thyroid medication (natural or synthetic). I even spoke to his wife who contacted me and she mentioned the adrenals and the cortisol issues, too. I think there is a connection between the adrenals and intolerance to meds. I was often given samples of Synthroid by various doctors when I started on my thyroid madness journey. The leaflet inside the sample boxes stated that adrenal issues should be ruled out before a patient is placed on thyroid hormone replacement. Unfortunately the PCP and the endos that I have seen refuse to test the adrenal gland. They dismiss the connection and label it as rubbish.
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4274823 tn?1388529098
More reason I am upset with the unprofessional naturopath who flooded my system with iodine when I said I had an underactive thyroid. I even filed a complaint with joke "Board of Directors of Drugless Therapy - Naturopathy" "in Canada but they didn't see anything wrong with the treatment.
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