# Starting Levothyroxine Tomorrow



## apandabear (Oct 2, 2012)

Hi everyone!

My doctor just diagnosed me (today) with hypothyroidism. My TSH is almost triple the level it was one year ago, and I'm pretty sure all that climbing was done in the last 4 months. Been run-down, absolutely exhausted, with a myriad of all the hypo symptoms. You know them, I won't bother repeating them all.

I was a little afraid that my doc wouldn't prescribe with a TSH of only 4.6 .. But after a consult today and discussion of my labs and my symptoms, she wrote me a prescription for 25mcg of Synthroid. I'm a generic-type of gal, so I'm going to try that for a while.

My insurance is crap right now, so I'm not getting the recommended ultrasound. Come Jan. 1st, I'm upgrading my insurance plan (if I don't get employer-sponsored plan of course) so I can actually handle this stuff.

I'm ... almost excited about this. I'll likely be on medication for the rest of my life, but I'm glad there is a reason for it, and an easy way to fix it.

I have a follow up lab draw in 6 weeks, and a face-to-face with the "Doc" (NP) a week or so after that. I'm going to make sure they pull a complete thyroid panel at that point.. I want to see what's going on with all these hormones!!

So my plan is... Wake up in the morning, take the levothyroxine. I don't normally eat breakfast, so that really doesn't affect my morning at all. I take a multi-vitamin and flaxseed oil caplet (my digestion has slowed to a crawl recently) around 1pm (after lunch). I take Yaz before I go to bed at night. Very recently I started taking a little Melatonin to help me get to sleep (racing thoughts and whatnot), and to mute my dreams (very vivid, sad or scary dreams recently. At one point in my life I would have welcomed that, but not now). Does anyone here take melatonin at night? I can't find anything that says I can't continue.

Been thinking of picking up some omeprazole, since I've been experiencing acid reflux when I lay down at night (4-6 hours after a meal!!). I'm worried the thyroid meds will make that worse. Anyone have experience there?

Thanks folks. Looking forward to feeling better... In a month or two. Hah.


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## CA-Lynn (Apr 29, 2010)

What an excellent attitude!


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## webster2 (May 19, 2011)

Attitude is everything! Cheers!


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## Lovlkn (Dec 20, 2009)

I'm going to answer some of your questions - in bold type below...



apandabear said:



> Hi everyone!
> 
> My doctor just diagnosed me (today) with hypothyroidism. My TSH is almost triple the level it was one year ago, and I'm pretty sure all that climbing was done in the last 4 months. Been run-down, absolutely exhausted, with a myriad of all the hypo symptoms. You know them, I won't bother repeating them all. *Excellent! You at least have a doctor who recognizes the symptoms - that's 1/2 the battle*
> 
> ...


*

Welcome - I would agree that your attitude is great considering how hypo you are :hugs: based on TSH alone.*


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## piggley (Sep 15, 2012)

helllo Apanda,
Have you thought about taking some Magnesium in the evening?
Hope you feel better soon..(nothing like a restless night to make the next day feel like crap.)


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## Adelaide (Jul 19, 2012)

I've been taking melatonin for a long long time. The truth is that it might not be good for any autoimmune conditions but I could not believe how much this stuff helped me sleep. Changed my life. That and synthroid are lifesavers for me. But on that note I can't say I'd recommend it because of the warnings on autoimmune conditions. Still... for me... it doesn't seem to have any effect on my thyroid that I know of... Unless my next labs come back bad. I live in dread of the doctor saying I can't take it anymore. I just have a weird sleep cycle which I've had all my life. My sleep time naturally always shifts to not being ready to sleep until 2:00 a.m. no matter how much sleep I didn't get the night before. Once I started melatonin, just like that! I could wake up bright and early like the rest of humanity.

So I guess I'd check with your doctor. I'm playing a dangerous game maybe. I don't know...


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## apandabear (Oct 2, 2012)

Thanks for the well-wishes folks! I don't really feel like I have a highly positive attitude.. But I guess it's largely related to having an answer. Over the last few months I've deteriorated into a shell of a person that doesn't want to do anything, doesn't want to go anywhere, takes hours to get out of bed, and can't keep relationships together. I was absolutely miserable. Now that I know there's a reason for it, a definitive cause, and I'm not just a lazy, miserable excuse of a person, I feel like there is hope. That maybe one day I'll have the desire to do something.

@Lovlkn
My NP tested "T4,Free(Direct)" along with TSH. This was just my yearly lab draw. FT4 seemed very normal, almost exactly midrange (1.25 ... range .82 - 1.77). T4 actually went UP a little from the year before, when my thyroid was normal and healthy, and I felt great (TSH was 1.6 / T4 was .99).
When we do a new lab draw next month, I'm going to request FT3 and antibodies in addition to the TSH and FT4. This lab draw will be absolutely free, so I am going to get what I can out of it!

There are usually at least 4 hours between waking up and eating lunch, so no worries there. What bothers me is not getting to drink my morning coffee right away!!

re: Melatonin ... I don't know why the melatonin mutes my dreams. For some people, yes it makes them more vivid. Not for me at this point in my life. Recently I lost my dog (hit by a car -- I saw the whole thing), and it haunts my dreams. But not since taking a little melatonin. My doc cleared me to take melatonin in the past, and didn't say anything about it recently. It helps me fall asleep faster, and really helps me stay asleep if I get the dose right (6mg to stay asleep). I wake up in the morning and actually feel like I got some sleep... I don't feel great, in fact I'm always exhausted, but I don't feel like I was awake most of the night rolling around. I feel like I slept for 8-10 hours and I'm still wiped. That's probably as good as it gets (without treating the thyroid).

@piggley ... I hadn't even heard of magnesium for heartburn.. I will have to give that a try. I'm much more comfortable taking vitamins as opposed to OTC meds. Thank you for the tip!! I will definitely pick some up. Would you recommend taking it right after a meal, an hour/couple hours after, or before bed?

@adelaide ... I did read the hint of melatonin being not-so-good for autoimmune conditions. That would be like Hashimotos? I haven't really tested for that yet. While it could be an issue, I'm not positive. The melatonin is actually working very well for me now. I don't intend to take it over prolonged periods of time, but it is really helping me while I reestablish my sleep schedule. Without the definitive proof that it's bad for me, or a doctor's directive to stop, I think I will continue to proceed with caution. Thank you for the information!

And it's officially Day 1! Do I feel any different? Of course not! I'm very much in-tune with my body though, so hopefully I'll start to feel something soon. Even if it's "I feel a little better, but still OFF" .. I'll be thrilled to say as much.

Thanks for the support everyone. What a journey this is.


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## DonnaK (Mar 22, 2011)

Hi there! Glad you are getting some help and hopefully will be feeling lots better soon. I just wanted to let you know my experience with levo and acid reflux. I have suffered with reflux for more than 10 years, but it was under control until I went on generic synthroid. I've been through four medication changes for the reflux and switched from generic to name brand synthroid and still have issues. Switching to name brand synthroid helped a little and the last medication change to protonics helped a little, but it's still there. So much so that I taste the acid in my throat 24/7 now. At my recent appt. with my gastro, he said that it should calm down once my TSH is in range as right now the enzymes are (something - I kinda missed how he explained it LOL).....but my TSH was at 10.04 at the time so maybe since yours is just slightly off it won't affect you the way it did myself. I personally felt it was the synthroid that made my reflux so bad, but I guess it could just be the high TSH right now. I am still in the process of getting my levels optimized.


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## apandabear (Oct 2, 2012)

I only recently (early 2012) experienced acid reflux. I had no idea what it was, but there were days I couldn't finish a meal. I was going to the doc anyway and discussed it with her.. lo and behold.. Acid Reflux. 2 weeks of omeprazole and I was fine for a couple months. Now it's back.. But at odd times of the day, and usually not near a meal. I've almost come to expect odd things from my body over these last few months though.

That is what concerned me about my acid reflux. I'd read several people say theirs got much worse once starting the synthroid. I'm on generic Levothyroxine.. Knock on wood, generics usually agree with me (I currently use a generic BCP).

I'm going to wait and see how the coming days and weeks go. Hopefully my digestive system rights itself.. But in the off chance it doesn't, I'll have to figure something out. But I will keep an eye out and make sure the reflux doesn't get worse.. Thanks for the info!!


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## Alw1977 (Aug 6, 2012)

I was diagnosed hypo 10 weeks ago. I started feeling better around week 4 of synthroid. As an FYI, many people believe that the name brand synthroid works better than the generic. There is such a small amount of hormone in those pills and I believe that synthroid brand name can have less variation in the actual amount of hormone than the generic. Or something like that.

My free T3 levels are still cruddy, but my TSH did improve in the first 8 weeks. I'd say I went from feeling about 15% of my normal self to about 40% normal. I had the same TSH as you when diagnosed. Still room for improvement. Your dose is very low, I have a feeling you'll need more to feel better (I started at 50 mcg, went to 75 mcg). This is a process and getting your meds right will take time. Synthroid may not be the magic pill for you, you may require T3 supplementation, but you won't know that for some time yet.

I just started supplementing Vit D and Ferritin as we learned both of those levels were too low for a person with hypothyroidism. You need more than the average person so you may want to have those levels checked at your next blood test.

Good luck!


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## Andros (Aug 26, 2009)

apandabear said:


> Thanks for the well-wishes folks! I don't really feel like I have a highly positive attitude.. But I guess it's largely related to having an answer. Over the last few months I've deteriorated into a shell of a person that doesn't want to do anything, doesn't want to go anywhere, takes hours to get out of bed, and can't keep relationships together. I was absolutely miserable. Now that I know there's a reason for it, a definitive cause, and I'm not just a lazy, miserable excuse of a person, I feel like there is hope. That maybe one day I'll have the desire to do something.
> 
> @Lovlkn
> My NP tested "T4,Free(Direct)" along with TSH. This was just my yearly lab draw. FT4 seemed very normal, almost exactly midrange (1.25 ... range .82 - 1.77). T4 actually went UP a little from the year before, when my thyroid was normal and healthy, and I felt great (TSH was 1.6 / T4 was .99).
> ...


{{{{apandabear}}}}; I am so so sorry for the loss of your dog.


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## apandabear (Oct 2, 2012)

Alw1977 said:


> My free T3 levels are still cruddy, but my TSH did improve in the first 8 weeks. I'd say I went from feeling about 15% of my normal self to about 40% normal. I had the same TSH as you when diagnosed. Still room for improvement. Your dose is very low, I have a feeling you'll need more to feel better (I started at 50 mcg, went to 75 mcg). This is a process and getting your meds right will take time. Synthroid may not be the magic pill for you, you may require T3 supplementation, but you won't know that for some time yet.
> 
> I just started supplementing Vit D and Ferritin as we learned both of those levels were too low for a person with hypothyroidism. You need more than the average person so you may want to have those levels checked at your next blood test.
> 
> Good luck!


Thanks for the well-wishes. We'll see about the FT3. I know it takes some time to figure out if you're a candidate for T3 supplementation. It's very possible that I'll need it, in my mind, since my FT4 was so ... normal.

I have the feeling the Synthroid dose won't be enough.. But I'm willing to gradually work my way up. My hypo set in over months. The last thing I want is to go hyper. As much as I hate the way I feel now, I have zero desire to go to the opposite end of the spectrum. I have a lab draw in 6.5 weeks. So as long as my doc keeps monitoring me this closely, I should progressively get better.

My Vitamin D is low. I was low last year.. Took the 50,000 for 12 weeks, and my levels only went up from 23.4 to 47.8 (range 30-100). I was supposed to take 1,000 per day to supplement. Of course I didn't, so I'm back to a startling 23.5 this year. Doing the 12 week regimen AGAIN, and after that, I swear, I will take the Vitamin D every day.

I historically had low iron, anemia-type issues. There were some days the Red Cross would stare at my blood drop, willing it to sink. It usually floated.. Or sunk to the middle of the vial and hung out. Iron was a huge deal. But according to my recent labs, I'm not nearly as anemic as I was...

Iron, Serum 121 (35-155 ug/dL)
Hemoglobin 13.4 (11.1-15.9 g/dL)
Hematocrit 39.6 (34.0-46.6 %)

I don't have a ferritin lab to look at.. But from what I understand, iron is carried IN the ferritin? So I could still have an iron problem?


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## apandabear (Oct 2, 2012)

Andros said:


> {{{{apandabear}}}}; I am so so sorry for the loss of your dog.


Thank you for your kindness. It was absolutely devastating. It feels so much more recent than 2 months ago..

The dreams that really bother me are the ones where she's alive.. She follows me. Deep down, I know she's gone, but in my dreams it's always so amazing and wonderful to have her back.

The memory of it, and the pain when I'm awake is just too much. It might be wrong to try to suppress it.. But when you add hypo on top of this, I could cry everyday still. I don't want to be so weepy anymore.


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## Alw1977 (Aug 6, 2012)

Panda -
Here's where I got my info about ferritin and why it's so important - in short, it aids in conversion from T4 to T3, which is what your body must do when you are on T4 only (like Synthroid): http://www.stopthethyroidmadness.com/ferritin/. Also, it explains how your other Iron levels can be normal but the ferritin still be low.

My doc pointed me to that site. He cautioned me that the author is very against treatment with T4 only. He admitted it's not the best course for all patients, but he has some that do well on it.

At any rate, I think you'd be wise to take an iron supplement - if you're female (and particularly are pre-menopause), you're probably low on iron anyway. There's a lot to learn about this condition, eh?


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## apandabear (Oct 2, 2012)

Alw1977 said:


> Panda -
> Here's where I got my info about ferritin and why it's so important - in short, it aids in conversion from T4 to T3, which is what your body must do when you are on T4 only (like Synthroid): http://www.stopthethyroidmadness.com/ferritin/. Also, it explains how your other Iron levels can be normal but the ferritin still be low.
> 
> My doc pointed me to that site. He cautioned me that the author is very against treatment with T4 only. He admitted it's not the best course for all patients, but he has some that do well on it.
> ...


Man. And I thought maintenance would be as easy as pinpointing the right thyroid med and the dosage.

I feel like I'm going to be taking mountains of vitamins along with it... Reading about the ferratin, they recommend taking iron, Vit C, and Folic Acid (or Vit B).

I'm already planning on daily Vit D once I'm done with the mega-dose Rx. Magnesium at night (heartburn, insomnia). I take a daily multi-vitamin, along with Flaxseed Oil (omega-3s and digestion aid).

I'm heading to CVS this afternoon.. Anything else I should pick up??

Finding the right time of day to take my vitamin cocktails will also be interesting.


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## Alw1977 (Aug 6, 2012)

Do you have a locally owned vitamin store near you? I went to one that I love and it's independent. They tend to carry higher-caliber vitamins (meaning more readily absorbable) and aren't any more pricey than CVS, from my experience.

At any rate, I got something called Mega Foods Blood Booster after speaking to the owner about my needs - it contains iron, Vit C, Folate and B12. So all your stuff in one! Highly recommended from all I've read online. Also good for iron is Floradix. I took it when pregnant. It's a drinkable liquid though, and I couldn't stand the stuff!


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## apandabear (Oct 2, 2012)

Alw1977 said:


> Do you have a locally owned vitamin store near you? I went to one that I love and it's independent. They tend to carry higher-caliber vitamins (meaning more readily absorbable) and aren't any more pricey than CVS, from my experience.
> 
> At any rate, I got something called Mega Foods Blood Booster after speaking to the owner about my needs - it contains iron, Vit C, Folate and B12. So all your stuff in one! Highly recommended from all I've read online. Also good for iron is Floradix. I took it when pregnant. It's a drinkable liquid though, and I couldn't stand the stuff!


Interesting. We don't have any independent shops around here. We have a Vitamin Shoppe and a GNC. Which is actually kind of ridiculous, since this is probably the most health-conscious part of the state. I will keep that in mind.

Thanks for the tip on the Blood Booster. I know what to look for now. Surely I can track that down!


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## Alw1977 (Aug 6, 2012)

Oh you're in Cary! I am UNC alumnus.

I bet Vitamin Shoppe carries it.


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## apandabear (Oct 2, 2012)

Almost at the 3 week mark.

I wish I could say I felt better. If anything, the last few weeks have been some of the worst. Holding on to hope that this will start working soon. I have a little less than a month to go before my next lab draw and consult.

A flight of stairs does me in. I'm holding with my current weight pattern (15lbs above my norm, and gaining 1-3lbs/month). Some mornings it takes all I have to get out of bed. Monday morning I actually took the morning off and went in at noon because I needed the sleep. Concentration is at an all time low. My skin is so dry, but my forehead is all pimply. Aches and pains and headaches. My moods are in the gutter. I'm horribly depressed and often think about death.

I know it gets better soon. It has to. I'm just so tired, and so, so close to getting out of it.

My boyfriend is getting really fed up with all of this. "I know you're the one who's sick, but it's really hard on me." I don't know how much longer he'll stick around, this disease has sucked most everything out of our relationship. And it's really hard to empathize with him right now. It's hard to care about much of anything either, but I know this is worth hanging on to.

Anyway, my apologies for the rant. These have been some low lows, and I'm feeling rather helpless!

Some good notes:

I met a coworker who had thyroid cancer. Docs removed his thyroid and let him go really hypo. Now he takes armour. It was nice to chat with him, and find someone I can talk to if I need to.

I managed to stop 99% of my reflux with magnesium supplements! 
And I looked at iron supplements and decided it was much to much to get into without consulting with my doc first. I don't feel comfortable taking 300% of my daily iron needs without talking to her.

Flaxseed oil seems to be the only thing that keeps my digestion going, and even that is not enough to make me regular. It's a step in the right direction anyway.


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## CA-Lynn (Apr 29, 2010)

I am so sorry about your dog. I understand that kind of loss and it is damned powerful.


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