# Can't seem to get rid of symptoms



## lbwell2 (May 7, 2013)

Hello,

I was diagnosed with Hyperthyroidism by my primary doctor in July of 2012. After three months of getting nowhere, I went to see an Endocrinologist. He said my thyroid had small nodules, and that I tested positive for Hashimoto's. I was switched from Thyroid 30 to Syntroid 75 last month because the Thyroid was causing me to be shaky and making my heart race. Now, I feel tired, depressed, and I'm suffering from muscle pain. The doctor said, "your numbers are good now, but since you are complaining, I'll increase your Synthroid to 88mcg. Do my numbers look good to all of you? I am so tired of feeling sick and tired. Has anyone really been cured completely of symptoms?

My labs are as follows
T4 FREE 2/18 0.8(.8-1.8) 4/3 1.1 (.8-1.8) 5/3 1.1 (.8-1.8)
T3 FREE 2/18 3.1 (2.3-4.2) 4/3 3.4 (2.3-4.2) 5/3 3.1 (2.3-4.2)
TSH 2/18 5.17 4/3 5.48 5/3 1.64


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## bigfoot (May 13, 2011)

Hmm... I'm guessing you actually meant "hypothyroidism"? For the folks who are indeed "hyperthyroid", they generally have a very low TSH (in the 0.0x range) and Free T4 and Free T3 numbers up and over the high end of the range.

Looking at your numbers, it seems they could stand to be improved a bit. Keep in mind, if your doc just raised you from 75 mcg to 88 mcg of Synthroid, that it can take 6-8 weeks for the medication to fully absorb. So your recent labs from 5/3/13, I'm guessing this was before the doc raised your dose to 88 mcg?

My apologies, but I'm going to cut and paste some general info that I just posted in another thread, rather than type it all out again. Some of this you may know, some you may not. Hopefully it helps a little.

hugs6

---Cut-and-Paste---

Hmm... what to expect? Everybody is going to respond differently. But I think a good rule of thumb is to keep in mind that the thyroid is the precise master thermostat for your body. Too little hormone, and your body slows everything down to conserve energy. Too much, and things speed way up. Here's a few tips:

* It takes 6-8 weeks for the thyroid hormone you will be taking (T4, aka, levothyroxine) to fully build up in your system. But, getting back to everyone responding differently, you might notice changes far sooner than that (days instead of weeks).

* Be consistent. Take it at the same time each day, ideally at least 1/2 hour before food, or 3-4 hours after food. Don't take it at the same time as calcium-containing supplements. Heck, ideally, take it all by itself anyway just to be safe and optimize absorption. You can take it first thing in the AM when you wake up, or even late at night right before bed (research shows it can be more effective this way).

* Keep track of changes. Maybe jot them down in a logbook somewhere. If you have a thermometer and are so inclined, you could take your temps at around 9am, 12 noon, and 3pm. Combine and average them out together for each day, and use this as a rough & fun guide to watch your progress. Same goes for taking your weight in the AM; before starting the day and having breakfast. If all this data isn't your thing, a note or two here and there is probably plenty.

* Watch what you eat. Drink lots of water. Avoid the calcium at the same time (ideally, hours away from taking your meds), as mentioned above. Be aware that the higher in fiber your diet, the more medication you might wind up needing. T4 is absorbed through the digestive system, so if you eat a lot of fiber that can speed things through, reducing effectiveness. Not that eating fiber is a bad thing! It all comes back to being consistent. Stay away from soy and big amounts of raw goitrogenic veggies (broccoli, cabbage, etc.). If you can avoid or eliminate gluten, all that much better. Same for junk food.

* Get regular labs, keep copies of them for reference. Your doc should be following up with you, and getting routine TSH, Free T4, and Free T3 labs every 6-8 weeks for a while, until they not only show you as stable, but you FEEL good & stable. A number on a piece of paper is only a guide. This stuff is part art, part science. Beware the docs who treat only by TSH. I know it's mentioned here a lot, but I'll repeat it: most feel good with a TSH around 1.0, and Free T3 and Free T4 in the upper 75% of the range. Gives you something to work towards.

* Keep an eye out for being over-medicated. If all of a sudden you are having five BMs for days on end, or your heart is racing while watching TV, chances are you are taking too much. Call your doc, they may want to run labs sooner, and it might be time to reduce your dosage a hair. FYI: you might have a little bit of anxiety while starting thyroid meds, but this should normally wear off.

* Verify your RX. All levothyroxine (T4) medications are not the same. The FDA allows for 10% +/- potency with the meds. So if this month you are taking brand-name Synthroid, then next month the pharmacy switches you to a generic, you might notice some changes. Ideally, have your doc write you a script for a brand-name drug and add a comment like, "dispense as written" or "no substitutions", or whatever phrase is used in your area. This all comes back to being consistent, too.

That's all I can think of right now. Really, taking this stuff is not a big deal. Most of us who are hanging around here are the vocal minority that have problems that a lot of folks don't. When things are going well, people aren't likely to seek out forums for questions and advice.


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## lbwell2 (May 7, 2013)

You're correct, I did mean hypothyroidism. I appreciate all of the great information you shared. My dose was just changed to 88mcg two days ago, so maybe this will be the dose that finally makes my symptoms go away. I asked for the test for gluten, and was told that it came back in the normal range. Should I cut it out anyway?


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## bigfoot (May 13, 2011)

Depends. Which test did they do for it? If they tested for straight Celiac disease, which is probably what they did, they could have missed a bad gluten sensitivity. (Ask me how I know, LOL.) There is a saliva test floating around out there that can check for gluten sensitivity (not Celiac), and probably a blood test by now, too.

There is no 'cure' for Hashi's. There is slowing/suppression of the antibody attacks by way of taking external thyroid hormone (or hopeful elimination via RAI/surgery). Docs like to interchange "hypothyroidism" and "Hashimoto's" as if they are one in the same. They are not. Hypothyroidism is, well, hypothyroidism, and Hashimoto's is an autoimmune attack that eventually, over time, usually results in Hypothyroidism. So the trick is to get at the root of the autoimmune attack and inflammation to help things out further.

Going gluten-free won't hurt. But you have to be diligent. They put freakin' gluten in _everything_. Taco sauce, shampoo, salad dressing, ice cream, you name it. Gluten can take days or weeks to fully get out of your system. It took me nearly a month to notice any changes, but when I did, it was like, "Wow!" It's not a cure-all, but it certainly could help a lot.

With thyroid medication, a little goes a long ways. That jump from 75 mcg to 88 mcg of Synthroid might not seem like much, but it is. Best to titrate low 'n' slow, to avoid any unwanted side-effects or overshooting your target. Let that increase soak in for a month or so, and see how you feel then.

:anim_32:


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## Andros (Aug 26, 2009)

lbwell2 said:


> You're correct, I did mean hypothyroidism. I appreciate all of the great information you shared. My dose was just changed to 88mcg two days ago, so maybe this will be the dose that finally makes my symptoms go away. I asked for the test for gluten, and was told that it came back in the normal range. Should I cut it out anyway?


Bigfoot is the bomb!

Yes; this may be the dose that does the trick for you. It looks like you are nearly there. Most of us feel best (not all of us) when FREE T3 is at about 75% of the range given by your lab and TSH @ 1.0 or a bit less.



Maybe waiting to go gluten-free would be a good idea because this way, you will have a better idea if it was the thryoid all along. What do you say?


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## bigfoot (May 13, 2011)

Shucks. Well, I chalk it all up to the great folks like you who give us the straight scoop!


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## lbwell2 (May 7, 2013)

The test for gluten was Gliadin Antibody (IGG, IGA), is that the test for Celiac? 
Results
IGA 5 (<20 units)
IGG 4 (<20 units)

I will hold off on going gluten free until I see how my labs look next month. I really don't have a lot of faith in my doctor, so I'm happy to have people here who can help guide me.


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## surge (Aug 15, 2012)

Here's a great site for explaining testing for celiacs and gluten sensitivity: http://www.theglutenfreebistro.com/...n-intolerance-testing-accurate-or-misleading/

I think your plan to not go GF until the tests next month are sound (and maybe ask for the serum test to be added...) and then try to go gf for 1 month - 6 weeks and see how you feel...


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