tsh after 15mci rai

[Kristina538]

Hey everyone,  I had 15mci of RAI a year ago for a toxic nodule which was overproducing and making me hyper.  No other thyroid disease.   My thyroid has held well for the year (I was told there was a liklehood of going hypo within the first year... a small percentage later than the first year).   My TSH has held around 3.   Four weeks ago it hit 4.5 (low FT3 and lowish t4) and my recent test was 6.8 (FT3 and FT4 low end of normal).

I've talked my doctor into prescribing meds (and have been given 25 mcgm synthroid) because my hands are dry, I am having fluctuating periods of being very sleepy (then have good days) and am feeling flat and a little 'edgy'.

While I knew I would go hypo at some stage, I never thought to ask whether my whole thyroid would die off, or whether I would just need supplemented assistance of sythroid.   I was told not to take a test now for 6-8 weeks, and wonder whether the dose may be a little low, or how quickly my thyroid may crash.   I'm hoping I've managed to medicate before the symptoms worsen.   Any ideas would be appreciated, thanks.

[Kristina538]

Thanks so much for your comments; it really help :-).   I rang the chemist today and they said not to halve the tablet (I thought it would do something nasty to your throat if you halved it like some other meds), but then he said they couldn't guarantee the strength and then he totally backtracked and said to check with my Doc :-).

I went without eventually;  I guess 2 days worth was enough to put a bit of punch in my system, but THANKYOU so much for confirming that it's the 'strength' that they're concerned about with halving.   I agree, having the two halves of the same tab covers that one.  

I'm feeling more confident in strategising now (although I'm sure there'll be some ups and downs;  I'll try to stay consistent and build it up.

Thanks again so much!!

[Kristina538]

p,s, I'll pop into the Chemist and see if I can halve the synthroid... perhaps 12.5mcg - I really don't want to go without for a day.  Of course, now I'm feeling reasonable again!!    So strange to go from very sleepy to the opposite all in the same day.   Hyper was hard, but with sleeping pills, manageable, and with carbimazole easy (my tsh .01 and 4 weeks later 3.5 - my doctor says I'm sensitive to meds - but I was taking half then one on alternate days; and will probably do the same with the thyroxine... slowly, carefully, consistently and do whatever else it takes (just took a third of a sleeper)....  

It's strange that my T4 and T3 rose for Nov but TSH did too?  I have a non-toxic nodule to recheck in a month with the specialist;  maybe that's playing a part in it too.    My GP will do whatever I ask of him; he just isn't very good at researching himself (I get so sick of doing all the research and can miss things, but at least he's flexible when I'm determined with him!). Thanks.

[Kristina538]

Thanks for the valuable information.  I was expected to turn to hypo some time during the year, but thought my dr had a handle on it and got so busy at work I didn't check.  In Oct I felt tired, dry hands etc., so had my normal 6 weekly test (results as follows) - Dr said I didn't need meds:

Oct 26th:
Free T4 (10-20)   10
TSH (0.3 - 4.00)   4.5
Free T3 (3.00-6.5)  4.5

Nov 26th:  
Free T4 (10-20)   12
TSH (0.3 - 4.00)  6.8
Free T3  (3.00-6.5) 4.9

I demanded getting treatment last week;  I have had dry hands for some 2-3 months, but over the last month periods of extreme tiredness, then, over the last week, really really spacey, swallowing strange (seems like a lump in my throat), upset stomach and feeling shakey and nervous.

I started sinthroid two days ago, and actually felt a little better (stomach still a bit upset), but feel dehydrated, and have had an intermittant quite severe headache at the base of my neck.

The doctor said to go carefully and maybe take 1 tab every second day (I think I'll miss out tomorrow).   I was hyper for 2 years before having the RAI, so know what if feels like and will be careful.  My concern is more that I haven't caught it in time;  I am really struggling.

I feel the fluctuations so know what you mean, quite normal morning, then afternoon crap.  But for two days this week (before I started the synthroid), I really had the internal crazies.  I've got a big project on at work which doesn't help :-(.   Thank goodness only one day to go before the weekend; I may just go to the hosp tomorrow;  my GP just isn't up with the play.  Thanks G - any help gratefully received.

[goolarra]

If you have actual FT3 and FT4 results and reference ranges, please post them.

25 mcg is a pretty low dose, but it's always better to start out low and increase as needed and tolerated.  Otherwise, you might end up swinging from hypo to hyper, and that's no fun.

It takes 4-6 weeks for a dose to reach its full potential in your blood.  So, waiting 4-6 weeks to test is pretty standard, although your doctor is a bit on the high side of that.  I'd definitely go for the 6 weeks rather than the 8.  

Unfortunately, my guess is that no one can tell you at this point how fast or how far your thyroid is going to crash.  

As thyroid function declines, it's often quite tricky to maintain a proper meds dose.  The decline doesn't happen on a nice, smooth slope, but tends to go in fits and starts, can plateau and can take a sudden nose dive.  

If you post your FT3 and FT4, I can be more specific.