# Levothyroxine Question



## eacraz (Apr 18, 2012)

I went to the endo on 4/13 and was not to pleased with the experience. He seemed disinterested in my symptoms of Hashi's. I convinced him to do lab work for me. At that time, I have not found this board, so I didn't know what correct tests he should have done.

I had Ultrasound, TSH, FREE T4, & ANTI-TPO
TSH 4.330
FREE T4 1.03 ng/dl
ANTI-TPO >1000 IU/ML

He prescribed LEVOTHYROXINE & I haven't taken it yet. The reason being is that I have read that some people had felt worst taken the medicine. Also, in my findings that it really just mask the symptoms and doesn't really address the issue.

So, if anybody here has taken it & have good/bad experience, I would like to know. I am in the process trying to find another dr that understands Hashi's better.


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## joplin1975 (Jul 21, 2011)

First off, if you haven't had one yet, you reaaaaaaaaaaaaaally need an ultrasound of your thyroid.

Second, respectfully, I wouldn't take/not take your medications based on what you've read online. People have wildly different reactions to this medication, some good, some bad, some needing to look at other products out there, etc. But, if you don't start somewhere (and starting with a low dose of Levo is par for the course), you won't know where to go next.


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## eacraz (Apr 18, 2012)

Thanks for the response, Joplin!! I did have an ultrasound done. The result was that I have a mildly enlarged left lobe of the thyroid & bilateral heterogeneous echogenicity.

I am just slightly afraid that the endocrinologist didn't run all the necessary tests that were needed.

Have you heard the drug called ARMOUR?

Again, thanks for your reply!!


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## McKenna (Jun 23, 2010)

Do you have the lab range for the Free T4?



> Also, in my findings that it really just mask the symptoms and doesn't really address the issue.


If you are lacking thyroid hormone, then levothyroxine will supplement what you are not producing.

How was your Hashi's diagnosed? There are different reasons for a high TPO and Hashi's is one. Further testing, ultrasound and biopsy of any nodules (if you have any) would be the next steps. And as Joplin mentioned, starting levothyroxine is pretty standard.


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## joplin1975 (Jul 21, 2011)

Ok, good. So, no nodules? Very good.  He ran the basics, although I bet the bloodwork experts (which I am not) would love to see a free T3 and perhaps a TSI as well...but I'll have to let them speak up.

Yes, lots of people on this board are on Armour. It's considered a combination medication in that you get t3 and t4 in one pill whereas with Levo, you get t4 only. The dealio (in extraordinary layman's terms...I'm sure someone can do better) is that your thyroid shoots out t4 and as your body needs t3 (the active hormone), your liver processes the t4 and *poof* (can you tell I'm not a scientist?) turns it into t3.

Some people, for a variety of reasons, don't convert the t4 to t3 very well, ergo the need for combination drugs. However (and this is important), t3 is powerful stuff, so you don't want to go popping combo drugs unless 1) you know Levo isn't working for you (that is, that you don't convert) and 2) you add the free t3 test to the mix. I, personally, adore my synthroid, want to marry it and have its babies tongue0013...I'm also quite convinced, given how sensitive I have to medication changes, that I would likely stroke out if I ever tried a combo drug.

We'll need ranges with your labs to really understand them, but my suggestion would be to try the Levo for six weeks (you need at least six weeks, but possibly eight). See how you feel, get your blood work re-drawn at that time, and then re-assess.


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## McKenna (Jun 23, 2010)

> Have you heard the drug called ARMOUR?


Yes, many of us are on Armour.


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## eacraz (Apr 18, 2012)

joplin1975, you are funny. I like 'layman's terms', because it makes thing sound simple, when we know it isn't. heehee
The results from my 4/13 lab work is as follows:
ANTI-TPO-Ab >1000 IU/ml
FREE T4 1.03 ng/dl
TSH 4.33 uIU/ml


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## lainey (Aug 26, 2010)

I have been on Synthroid for over 6 years, and it "saved me in all the ways a woman can be saved" (because I was sinking like the Titanic).

There is a reason why T4 medications are the standard of care throughout the world--it is because they are consistent and reliable, and work for a vast majority of the patients that take them.

The endo ran the necessary tests to diagnose you--what others did you think should be run?

What starting dose was prescribed? With thyroid medications, most people do better on branded preparations, rather than generic--consistency and bioavailabilty are the reasons.

That said, you won't know if it will work for you unless you try it.


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## eacraz (Apr 18, 2012)

The prescription is for 25mg of Synthroid.

I thought that to truly tell if one has Hashi's is to run:
FREE T3 & TgAb along with the other tests he ran already for me. Again, I am all new to this and I apologize for my lack of knowledge. Hence, the reason why I am lurking around on the board. :ashamed0002:

I just want to make sure that I am doing everything I can and know my options. I know sometimes surfing the net for med info can be too much. 

But I truly appreciate all and any replies I get on my postings. :hugs:


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## lainey (Aug 26, 2010)

Actually, the more definitive test for Hashi's is a fine needle biopsy, where the cells of the thyroid are examined for the presence of Hurthle cells of a certain morphology.

This is rarely done, and the diagnosis is made via conjecture on the presence of antibodies.

Normal people can have thyroglobulin antibodies. They are primarily significant to those patients being treated for thyroid cancer, as their presence can interfere with the results of follow up testing. If your ultrasound is free of nodules, cancer is not of particular concern at this time.

The free T3 is not necessarily more revealing than the free T4 and TSH--some doctors will tell you that they only need the TSH to diagnose you with thyroid dysfunction, with the positive antibodies making it autoimmune in nature.


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