help for hypothyroidism

[kim9526]

In February 2008 my TSH level was 5.56.  I've been trying to convice my dr for years that i was hypothyroid but my TSH always was within the normal  range.  After doing research this time i approached my dr and explained that the range changed in 2002 and asked if she would let me try levothyroxine for my severe fatigue, irritability, depression, hair loss, dry skin, hypersleep (12-18 hrs day), severe cold intolerance, and heavy periods.  She said i could try 25 mcg of levothyroxie and recheck my levels in 4 weeks.  On 3/24/08 my TSH was 0.625, free t4 1.15, free t3 2.5.  My symptoms had almost totally resolved at that time.  I felt like a new person.  She called me after the results and said she was concerned about bone loss and that i should go to half the dose 12.5 mcg.  I explained to her that my symptoms were so much better and i had no symptoms of hyperthyroid (tachycardia, insomnia, diarrhea, hyperactivity etc).  I'm an ER nurse and very in tune with my body.  She agreed to let me stay on the 25 mcg but doesn't really feel comfortable with it.  Does this sound safe for me to do?  I'd even like to try a slightly higher dose than 25 mcg to see if i can get 100% relief of my symptoms (i still have no labido and moderate hair loss).  Are there different lab tests i should recommend for the next time?  When should i be retested.  I know the dr should go by symptoms and not lab results but i haven't convince my dr of this totally yet.  She's wanting me to forward any articles/info i find to her on this subject because she is willing to learn the new trends in diagnosing sub clinical hypothyroidism.  Thanks in advance for any help you can give.

[jd2]

hi!
i guess they classified me as sub-clinical, although i think i had a tsh of 6 (or it could've been 4 i cant remember), because i could only take 12.5mcg but felt really hypothyroid without it. after about a year on 12.5mcg im needing to increase now though. if you or your doc have any questions about what i've been through, please either post on here or message me, i'd be happy to help, but i dont know how much use i'd be, cos i guess to use someone as info they'd have to be part of a proper study?

[elvira333]

Although I can't suggest any tests for thyroid, I have had the same problem about bone loss concerns.  Whilst I am on thyroxine, my dr makes sure I get a DEXA scan every year or two, as I went for a scan for no particular reason a few years back and was found to be osteopoenic.   Not sure if this is due to genetic factors or thyroid problems, because I may have gone hyper before I went hypo and osteopororis is also common in our family.  As long as I have been on thyroxine over the years, I have not lost any more bone density during that time from careful monitoring and calcium supplementation.

So perhaps you could suggest to your dr that you get DEXA scans regularly enough to keep her feeling "comfortable".    I don't know where you are from but in Australia I have to pay $80-$100 every time with no rebate, but I just figure this is insurance against further bone loss, and without getting test even my dr would probably be hesitant to put me back on thyroxine.

[stella5349]

Your TSH is really close to hyperthyroid and you really don't want to go there. I'd give the 25mcg more time. You may adjust better as time goes by.

You are no longer classified as sub clinical - but if you want that information - you could start with

http://thyroid.about.com/od/heartdisease/a/subclinical.htm

http://thyroid.about.com/cs/hashimotos/a/subclinical.htm

http://adam.about.com/reports/000038_3.htm

The biggest concern for not treating hypothyroidism sub clinically is the cardiac problem that can develop.

There is controversy in the bone density thing and more  common than not - this is a concern in hyperthyroid patients more commonly.