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Total Thyroidectomy & Synthroid Dosage
I know it's different for everyone, but what is the average dose of synthroid for people who have has a thyroidectomy?
My doctor started me off on .175 and then I had an anxiety attack the other day (see journal) today he said my numbers were good, but reduced me to .137 and gave me some .150 samples as well. He said to start on the .137 and if I felt sluggish to take the .150's . How will I know the difference between general fatigue and not enough synthroid. Would the .175 have caused my anxiety attack?
help!
thanks!
My doctor started me off on .175 and then I had an anxiety attack the other day (see journal) today he said my numbers were good, but reduced me to .137 and gave me some .150 samples as well. He said to start on the .137 and if I felt sluggish to take the .150's . How will I know the difference between general fatigue and not enough synthroid. Would the .175 have caused my anxiety attack?
help!
thanks!
WOW!! I can't believe all this time and other times I've felt like this its been related to ferritin...since my previous thyroid tests have resulted on a normal range. I'm still waiting for the cardiologist to call me and explain my results...lets see how much she knows...last friday my obgyn called me twice. First he said all tests were normal (excluding the freet3) . So I asked if my symptoms could be realated to iron deficiency or ferritin levels...as u adviced me...and he said yes and asked me to start taking some over the counter Iron supplement and to go back to the clinic on monday to check these levels...then later that night he called and said he took a second look at the numbers and said one of the levels was slightly high...that's when he suggested to stop the synthroid over the weekend. So I didn't take the iron supplement thinking it was just my thyroid pill..I have learned a lot from all your researches...and thanks to u I will know how to choose the right doctor who could take care of my problem..I feel more confident about what to ask and ask and fight for when visiting a thyroid doctor....thank you for all your help..from the bottom of my heart many many thanks! I'm runnng to the pharmacy to look for some iron!
Ana =)
Ana =)
I think your ferritin level explains some of what is going on. You have very low Free T3 level, yet when you start on T4 med to raise your Thyroid hormone levels high enough to relieve symptoms, you seem to have that reaction.
Here is some info on the effect of ferritin.
"Low ferritin can cause negative reaction like palpitations, nervousness, and anxiety in someone starting thyroid hormone replacement. Someone described it like being shot out of a cannon. It is therefore imperative that ferritin not be at the bottom of the range before starting thyroid hormone medication."
Also, from another source.
"I frequent another board where the role of iron in the metabolism of thyroid hormone is discussed. Along with selenium, iodine, L-tyrosine, zinc and other vitamins/minerals/amino acids, iron plays an important role in the conversion of the less inactive T4 form of thyroid hormone to the more bio-active T3 form.
I've seen iron discussed a bit on this board but not so much about ferritin . I thought you might be interested in what I found. Ferritin levels often begin dropping before serum iron levels become critically low or before full-blown anemia becomes apparent.
Many hypothyroid patients find that having good ferritin levels improves their use of thyroid hormone (their own body's or supplemented). The range of 70-90 is quoted as optimal for hypothyroid patients. Someone on another board asked me if I knew of any research she could show her doctor to support this. He wanted her to stop supplementing iron when she raised her ferritin from 17 to 44.
Here's some of the research I found that suggests a minimal ferritin
range of 50-70 and an optimal range for hypothyroid treatment of 70-90. I have read that in Dr. Gillespie's book, "You're Not Crazy, It's Your Hormones", she advises a ferritin level of around 100. I haven't read her book, so I can't confirm the research basis for her recommendation, but the experience of many hypothyroid patient certainly bear her out.
Improving ferritin levels can be beneficial for both reducing or eliminating hair loss & unexplained fatigue. Both of those are also frequently associated with hypothyroidism."
Here is some further info.
FERRITIN test: Measures your levels of storage iron, which can be chronically low in hypothyroid patients. If your Ferritin result is less than 50, your levels are too low and can be causing problems…as well as leading you into anemia as you fall lower, which will give you symptoms similar to hypo, such as depression, achiness, fatigue. If you are in the 50′s, you are scooting by. Optimally, females shoot for 70-90 at the minimum; men tend to be above 100.
__________________________________
"The recommended way of taking iron to build up levels as fast as possible is to build up slowly over a week or two to let your digestion get used to the added iron and take the iron twice a day. You are aiming to ramp up to 150mg to 200mg of elemental iron a day which is 8 of these capsules a day. You need to build up to this dose over a week or two letting your digestion settle at each dose level before increasing. We have found that if you take several grams of vitamin C with each dose of iron that it both helps absorption and helps counter the constipation that iron can cause. These iron capsules are available from health food shops, and pharmacies"
From another source.
The goal of treatment is to raise ferritin levels to a value between 70 and 90 mg/dL and this is usually achieved with oral iron treatment. Raising ferritin levels to this range may be needed for patients with hypothyroidism to have an optimal response to thyroid hormone treatment. Ferrous Sulphate (325 mg orally, available over the counter) is usually the recommended treatment. Doctors usually recommend one pill a day for a ferritin level between 50 and 60 mg/dL, two pills a day for a ferritin between 30 and 50 mg/dL and three pills a day for a ferritin less than 30 mg/dL. Note: Other good iron supplements are ferrous fumerate and ferrous gluconate.
_____________________
After you start supplementing, keep in mind that you should be off all iron for at least 12 hours before any test to see what your body is hanging onto.
Here is some info on the effect of ferritin.
"Low ferritin can cause negative reaction like palpitations, nervousness, and anxiety in someone starting thyroid hormone replacement. Someone described it like being shot out of a cannon. It is therefore imperative that ferritin not be at the bottom of the range before starting thyroid hormone medication."
Also, from another source.
"I frequent another board where the role of iron in the metabolism of thyroid hormone is discussed. Along with selenium, iodine, L-tyrosine, zinc and other vitamins/minerals/amino acids, iron plays an important role in the conversion of the less inactive T4 form of thyroid hormone to the more bio-active T3 form.
I've seen iron discussed a bit on this board but not so much about ferritin . I thought you might be interested in what I found. Ferritin levels often begin dropping before serum iron levels become critically low or before full-blown anemia becomes apparent.
Many hypothyroid patients find that having good ferritin levels improves their use of thyroid hormone (their own body's or supplemented). The range of 70-90 is quoted as optimal for hypothyroid patients. Someone on another board asked me if I knew of any research she could show her doctor to support this. He wanted her to stop supplementing iron when she raised her ferritin from 17 to 44.
Here's some of the research I found that suggests a minimal ferritin
range of 50-70 and an optimal range for hypothyroid treatment of 70-90. I have read that in Dr. Gillespie's book, "You're Not Crazy, It's Your Hormones", she advises a ferritin level of around 100. I haven't read her book, so I can't confirm the research basis for her recommendation, but the experience of many hypothyroid patient certainly bear her out.
Improving ferritin levels can be beneficial for both reducing or eliminating hair loss & unexplained fatigue. Both of those are also frequently associated with hypothyroidism."
Here is some further info.
FERRITIN test: Measures your levels of storage iron, which can be chronically low in hypothyroid patients. If your Ferritin result is less than 50, your levels are too low and can be causing problems…as well as leading you into anemia as you fall lower, which will give you symptoms similar to hypo, such as depression, achiness, fatigue. If you are in the 50′s, you are scooting by. Optimally, females shoot for 70-90 at the minimum; men tend to be above 100.
__________________________________
"The recommended way of taking iron to build up levels as fast as possible is to build up slowly over a week or two to let your digestion get used to the added iron and take the iron twice a day. You are aiming to ramp up to 150mg to 200mg of elemental iron a day which is 8 of these capsules a day. You need to build up to this dose over a week or two letting your digestion settle at each dose level before increasing. We have found that if you take several grams of vitamin C with each dose of iron that it both helps absorption and helps counter the constipation that iron can cause. These iron capsules are available from health food shops, and pharmacies"
From another source.
The goal of treatment is to raise ferritin levels to a value between 70 and 90 mg/dL and this is usually achieved with oral iron treatment. Raising ferritin levels to this range may be needed for patients with hypothyroidism to have an optimal response to thyroid hormone treatment. Ferrous Sulphate (325 mg orally, available over the counter) is usually the recommended treatment. Doctors usually recommend one pill a day for a ferritin level between 50 and 60 mg/dL, two pills a day for a ferritin between 30 and 50 mg/dL and three pills a day for a ferritin less than 30 mg/dL. Note: Other good iron supplements are ferrous fumerate and ferrous gluconate.
_____________________
After you start supplementing, keep in mind that you should be off all iron for at least 12 hours before any test to see what your body is hanging onto.
FERR. 29 Ref. range 18-137ngl/mL
IRN. 127 Ref. range 37-170ug/dL
IBCT. 355.7 Ref. range 265.0-497.0
IRN. 127 Ref. range 37-170ug/dL
IBCT. 355.7 Ref. range 265.0-497.0
Your Free T3 result of 2 is even lower than I expected. No wonder you would have hypo symptoms from that.
So, the obvious question would be why do you seem to react to the T4 med? That question makes me wonder about your ferritin/iron levels. I know they were "normal', but would you please post the actual results and their ranges.
So, the obvious question would be why do you seem to react to the T4 med? That question makes me wonder about your ferritin/iron levels. I know they were "normal', but would you please post the actual results and their ranges.
Finally got the results
Ferritin and iron levels were normal
T3 FREE (V) 2. Pg/mL. Ref range 3-5 pg/mL
So it's low right?
Also the cardiologist ordered a comprehensive metabolic panel I dont know anything about this but according to the ref ranges some of my numbers are high like NA , CO2 , CL, GLUCOSE . The CREA came out low. From the lipid panel the HDL was on the borderline of being high. Also I wanted to mention that when I stopped the medication over the weekend I started feeling a lot better and after the last 2 nights when I took half of my pill I started having the high pulse symptoms again.
Ferritin and iron levels were normal
T3 FREE (V) 2. Pg/mL. Ref range 3-5 pg/mL
So it's low right?
Also the cardiologist ordered a comprehensive metabolic panel I dont know anything about this but according to the ref ranges some of my numbers are high like NA , CO2 , CL, GLUCOSE . The CREA came out low. From the lipid panel the HDL was on the borderline of being high. Also I wanted to mention that when I stopped the medication over the weekend I started feeling a lot better and after the last 2 nights when I took half of my pill I started having the high pulse symptoms again.
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