# How long before i feel better?



## Foggy (Mar 28, 2015)

I was diagnosed with papillary thyca in one lobe in'06 ar age 45. Had total thyroidectomy and rai. I had a clean scan in '07.I also have lupus -systemic dx '76. Had major lupus issues from '07-'14, but lupus doc checked my tsh, free t3 & t4, and I've held steady between 0-1 on 150mcg synthroid, and 10 cytomel. I've been doing a lot better, so finally made an apt w my endo. When i go, she does an ultra sound and all looks good, draws blood. Calls me the next day and tells me my tsh is 26!?!
While wrapping my foggy brain around that, i realized that this is why I've been so tired, sluggish and gained 5+ lbs, and why my legs felt like lead pipes when i was walking to the endos office.
I ordered my synthroid & cytomel by mail order late January because our insurance had suggested it. I assume that was the problem? My endo ordered 175mcg, which i got at my local pharmacy and started 3/17. She wants to see me in 6 weeks for blood work. I've been taking the new meds for 10 days, but almost think i feel more tired. Should i ask to get blood work sooner? Any other possible reasons for this result?


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

Well, then.....................................

It could be the Cytomel was inferior or genetic. That would not be a good thing. However, on the other hand, you may require Cytomel.

I am 72 and on 3 1/2 grains of Armour which is 31 mcgs. of T3 as well as the T4 (38 mcgs. per grain.) I am very very physically active so give that some thought.

Also, I have Lupus and my doctor and I find that by keeping the TSH suppressed we are also suppressing the Lupus antibodies (and other antibodies that I have.)

So...........................this was not all about me. It is just that I am the best example I can use for you.

Are you still on Cytomel as well as the Synthroid? Actually instead of raising the Synthroid your doc should be raising the Cytomel.

And we both know that because of the Thyca, it is essential that your

TSH be consistently suppressed.

Interesting info above.

Welcome to the board!


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## joplin1975 (Jul 21, 2011)

In addition to what Andros said, I think it's critical to get your free t4 and free t3 tested. Your TSH is clearly way to high and that could very well be inferior medication, but as you adjust those meds, you can't rely on TSH alone.


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## Foggy (Mar 28, 2015)

Thanks for your responses! .. I'm pretty sure my endo did free t3/4. She only mentioned the tsh .. i didn't hear much after she said 26, tho. I have a message into her about replacing my cytomel. 
After my tt in '06, my previous endo let my tsh hover between 60-30 for 8 months on generic meds - 300mcgs levothyroxine. Found my current endo, she switched me immediately to Synthroid and cytomel and my body absorbed it much better. My theory is that the stress of being so hypothyroid back in'06 is what kicked my lupus out of a 19yr quiet period/remission. So I'm a little more freaked by the high tsh, not so much abt thyca, but more on the lupus front. My rheumatology doc thinks I'm ok since I'm still on 2.5 of pred alternating days and 1 gram of CellCept am&pm 2gm total. It makes sense to my brain, but seems so counter-intuitive to me to sit here and just wait 4 more weeks before being tested. Trying to just breathe and relax as i wait - and not feel guilty for being such a tired slug ..


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## Octavia (Aug 1, 2011)

Wow - those are really high (300 mcg!!!???) doses of Synthroid/Levo. Do you take it on an empty stomach and wait 30-60 minutes to eat? I mean really, 300 mcg is unbelievably high, and the fact that your TSH was still high on that dose tells me it's definitely not being absorbed.


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## Foggy (Mar 28, 2015)

Yes, that was way back in 2007. My old endo just kept hiking up the dose, and after 8-9 months messing around on generic meds and a tsh of 30 on 300mcg i found another endo. She immediately switched me to Synthroid and Cytomel, and eventually i settled at 150 and 10. I vaguely remember being warned back then not to get thyroid meds by mail order - but forgot. Now I'm paying the price. I just hope I'm not developing some other issue preventing absorption. And I've always taken my meds first thing on an empty stomach, and wait at least 15-30 mins before my coffee .. solid food, usually 20-30 mins or even more after that.


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## jenny v (May 6, 2012)

I'm thinking you need to wait 30 minutes before coffee and 60 minutes before food because it sounds like you've got some absorption issues.


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## joplin1975 (Jul 21, 2011)

I think Jenny has some good thoughts. At a minimum, you can try waiting longer before the coffee and drinking an entire glass of water with the pill. If that doesn't help, you can at least rule out absorption issues. You're not taking any calcium or iron supplements/vitamins within four hours of taking the meds?

Were you buying online meds with or without a prescription? I think that matters regarding the quality of the meds.


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## Octavia (Aug 1, 2011)

When you talk about buying thyroid meds via mail order, what do you mean, exactly? Were they from a legit pharmacy, or just kind of an "under the table" deal?

I get my drugs via mail order pharmacy through my health insurance company. I think many health insurance companies are moving in that direction, if they haven't already switched. For example, my three most recent insurance companies would allow two months worth of drugs from my local pharmacy (such as Walgreens), but after that, I had to use my insurance company's mail order pharmacy and buy 90-day supplies for my long-term drugs. But these are legitimate pharmacies I'm talking about--Medco, Cigna, etc. I suspect you may be talking about not-so-legit drug suppliers, is that correct?

I agree with the ladies above about waiting at least 30-60 minutes for coffee/food after taking your thyroid drugs.


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## jenny v (May 6, 2012)

And keep in mind we're not judging you for where you get your meds! We just want to make sure we're clear on the source so we can offer the best advice.


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## Octavia (Aug 1, 2011)

jenny v said:


> And keep in mind we're not judging you for where you get your meds! We just want to make sure we're clear on the source so we can offer the best advice.


Agreed!!! If I sounded like I was being judgmental, that was not my intent at all. Not at all. I just wanted to understand the situation more clearly.


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## Foggy (Mar 28, 2015)

Lol .. no judgment taken .. yes got em thru my legit pharmacy mail order company, OptumRx. No supplements until after lunch. Will be more careful abt waiting for coffee.


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## Octavia (Aug 1, 2011)

Interesting. I used to get drugs through OptumRx. They're definitely legit, as you know!


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## Foggy (Mar 28, 2015)

The other thing, is that they were shipped during the really cold single digit weather we had back at the end of Jan, so i wonder if the extreme cold had something to do w it? Because I have not not changed my habits of taking 1st thing in the am for years


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## joplin1975 (Jul 21, 2011)

Uh, that's weird! I was under the impression that heat was more of a problem than cold. I do mail order and live in Upstate NY w/ cold temps...it hasn't been a problem. I wish I had more ideas!


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## Octavia (Aug 1, 2011)

Honestly, it makes me wonder if the pharmacist made a mistake with the dosage/pills. It's rare, but it happens. Can you double-check the number on the pills to make sure you got the right dosage?


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## Foggy (Mar 28, 2015)

They were the right color, light blue for 150mcg..and the only variable that changed was the mail order pharmacy .. unless it's a different manufacturer? I keep telling myself i think i feel a little better .. haven't convinced myself quite yet .. but getting closer ;-)


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## Kumo (Mar 3, 2015)

While taking Levo, my doctor told me to basically take it first thing in the morning (after you wake up), because levo basically works to "jumpstart" your metabolism (which is why you don't want to take it right before bed time). Wait about 60 minutes before drinking anything besides water and before you eat anything. I typically get a nauseous feeling about 40 minutes after I take my levo.


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## Foggy (Mar 28, 2015)

I thought the levothyroxine/synthroid was t4, and long acting, and leothironine/cytomel was t3 and short acting? I got my new cytomel today .. was a little easier to get up this morning, so maybe the new synthroid is starting to kick in ..


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## jenny v (May 6, 2012)

Foggy, you are correct. T4/Levo is longer acting and T3/Cytomel is faster acting.


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