# Synthroid question



## hollywoodhaven (Apr 28, 2012)

Hi all!

My Synthroid dose has been increased incrementally from 25 mcg, then to 50 and then to 75 mcg. I have been on Synthroid for a total of about 4 months and have been on the 75 mcg dose for just about a month. I was diagnosed in mid-April with Graves with several calcifications on my thyroid and lymphnodes (they are both also enlarged.)

For the last couple of months I have been experiencing a tremendous amount of night time symptoms: night sweats, insomnia, agitation, and heart palpitations. Last night was the worst of all, I had a full out panic attack (my first one ever.)

During the day, I find that I am still exhausted and rundown. I have no energy. I am losing my hair at a rapid rate, I am extremely irritable, forgetful and very emotional. I just want to feel better.

My question is this: Am I experiencing general side effects of the Synthroid or am I potentially at a higher dose than I should be? Do I just need to be more patient in expecting to feel better (I am really, really trying, I promise!!)

I realize that this may sound whiny and inconsequential in the presence of all of you thyroid warriors but I appreciate any input!

Labs: (I hope these are the right ones.)

TSH: 5.13 mcIntUnit/mL [.27-4.20]
Free T4 1.24 ng/dL [0.93-1.70]
T3, Free 2.31 pg/ml [2.30-4.20]

Ab 5 intl units/mL [<=34]
Antibody 11 int units/mL [<=115]


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## webster2 (May 19, 2011)

hollywoodhaven said:


> Hi all!
> 
> My Synthroid dose has been increased incrementally from 25 mcg, then to 50 and then to 75 mcg. I have been on Synthroid for a total of about 4 months and have been on the 75 mcg dose for just about a month. I was diagnosed in mid-April with Graves with several calcifications on my thyroid and lymphnodes (they are both also enlarged.)
> 
> ...


Hey there! Don't ever feel that your posts may seem whiny or whatever. I think we are all her to help and learn about this thyroid journey.

I really don't have any answers but it looks like you were hypo, and now your symptoms seem like they may be hyper, but I am no expert. The night time business were the first symptoms that I had.

I wish you well!


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## Octavia (Aug 1, 2011)

I tend to agree with webster that your symptoms seem hyper...but your labs disagree. How recent are those labs?


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## hollywoodhaven (Apr 28, 2012)

Thanks for your responses, Webster and Octavia.

My initial labs were taken on 3/27 (the TSH of 5.13 from the CBC and differential was what started the ball in motion for the ultrasound and RAIU.)

The other data was collected on 4/05. My doctor is unconcerned by these results (Free T4, T3, Free and the Antibody.) She says that these are normal.

I also went back in on 6/20 and had a CBC panel drawn. My TSH level was 3.86 at this time. Since I was still feeling unwell (and had already begun exhibiting night sweats, etc.) my doctor felt that I was still quite hypo and raised my Synthroid dose from 50mcg to 75 mcg.


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## Andros (Aug 26, 2009)

hollywoodhaven said:


> Hi all!
> 
> My Synthroid dose has been increased incrementally from 25 mcg, then to 50 and then to 75 mcg. I have been on Synthroid for a total of about 4 months and have been on the 75 mcg dose for just about a month. I was diagnosed in mid-April with Graves with several calcifications on my thyroid and lymphnodes (they are both also enlarged.)
> 
> ...


Did you have RAI or surgical removal of your thyroid?

If not, I cannot imagine that you would be on Synthroid! Please clarify!


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## hollywoodhaven (Apr 28, 2012)

Andros,

My journey started in March of this year with those labs. I have not had any RAI or my thyroid removed. I was placed on Synthroid because of those initial labs (TSH 5.13) as well as the long list of hallmark hypo symptoms (that I had been experiencing for years) and because of the calcifications and nodules found on my lymphnodes and throughout my thyroid.

My RAIU indicated something else altogether which perplexed my doctor. It showed no calcifications or nodules on my thyroid and the entire thyroid lit up (the percentages, which I do not have on me, were high at all of the check points.) She then said that she thought that I had Graves and that since my TSH was still high and I was exhibiting hypo symptoms, she would continue Synthroid until it "flipped." My Synthroid dose was increased to 75 mcg when my TSH level did not drop as low as she would like it to (it was 3.86 on 6/20.)

She is not an endo and I have asked if/when I will be referred to one. She told me that she wants to "wait and see" until the 6 month mark (it's been 4) before she refers. Unfortunately, we have an HMO so I cannot go out and around her since she is my primary care physician. At this point, I obviously want a second opinion because what is going on simply isn't working!


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## CA-Lynn (Apr 29, 2010)

Are you in menopause?


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## hollywoodhaven (Apr 28, 2012)

No, I am 31 and had my first child five years ago. My periods are extremely regular with very consistent (and heavy) flows.


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## Andros (Aug 26, 2009)

hollywoodhaven said:


> Andros,
> 
> My journey started in March of this year with those labs. I have not had any RAI or my thyroid removed. I was placed on Synthroid because of those initial labs (TSH 5.13) as well as the long list of hallmark hypo symptoms (that I had been experiencing for years) and because of the calcifications and nodules found on my lymphnodes and throughout my thyroid.
> 
> ...


Antibodies will skew the TSH numbers and the FT3, FT4.

These tests are essential; especially the TSI and you probably have Trab and TBII. Because these are all stimulating, blocking and binding antibodies to the receptor sites thus skewing the numbers.

The RAIU did not lie.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

Also, it would be wise to consider getting a better doctor. The only thing that might flip is you. Your heart and other organs are at risk here.


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## Lovlkn (Dec 20, 2009)

Andros said:


> Antibodies will skew the TSH numbers and the FT3, FT4.
> 
> These tests are essential; especially the TSI and you probably have Trab and TBII. Because these are all stimulating, blocking and binding antibodies to the receptor sites thus skewing the numbers.
> 
> ...


I agree that you likely have both stimulating and suppressing antibodies at work.

Your body is adjusting to being on medication - hair loss is common with any movement of thyroid hormones.

What dose were you on when these labs were taken? How long have you been on the dose? What you might suggest to your doctor is a slower approach to increasing your Synthroid - if you are having anxiety that indicates too much replacement but your labs indicate you still being on the hypo side. Some people have anxiety while hypo .

How were you feeling on the 50mcg dose?


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## hollywoodhaven (Apr 28, 2012)

Andros said:


> Antibodies will skew the TSH numbers and the FT3, FT4.
> 
> These tests are essential; especially the TSI and you probably have Trab and TBII. Because these are all stimulating, blocking and binding antibodies to the receptor sites thus skewing the numbers.
> 
> ...


Thank you, Andros. I was unaware of most of this so it doesn't seem so perplexing anymore. According to the copies of the labs I have requested from where I have my blood drawn, my doctor has only requested a small fraction of the labs needed to paint the entire picture. I do not have results for TSI, TPO, TBII, Thyroglobulin Ab, or ANA.

And I agree. I need a doctor who is better equipped to diagnose and identify what is happening with my body and who can give me a clear course of action. I do not feel as though I am getting that at the moment and with your grave warnings about my vital organs being at risk, I am more worried than ever.

Thanks for the insight and your experience. I am grateful for the assistance and support that this forum offers.


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## hollywoodhaven (Apr 28, 2012)

Lovlkn said:


> I agree that you likely have both stimulating and suppressing antibodies at work.
> 
> Your body is adjusting to being on medication - hair loss is common with any movement of thyroid hormones.
> 
> ...


What dose were you on when these labs were taken?

When my TSH was first tested (3/27/12) and came back at a 5.13, I was not on any thyroid medication. (My CBC was drawn for an unrelated matter.) A few days later, I was tested for antibodies (4/05/12).

How long have you been on the dose?

4/18/12 - I began Synthroid 25 mcg after my thyroid sonogram results indicated several calcifications, nodules, and an enlarged thyroid and lymphnodes.

4/23 - 4/24/12 - RAIU

5/16/12 - Increase of Synthroid to 50 mcg

6/20/12 - TSH retested (3.86)

6/25/12 - Increase of Synthoid to 75 mcg

How were you feeling on the 50mcg dose?

Prior to being diagnosed with any sort of thyroid disorder, I was exhibiting several symptoms of hypothyroidism. I also have family history on my father's side (an aunt and my paternal grandmother.) I was experiencing

fatigue and loss of energy, 
brittle hair, itchy scalp, and hair loss 
thinning eyebrows.
dry skin
joint and muscle aches throughout my body
Cold all the time (and I live in sweltering Texas!)
lower body temperature
migraines
allergies
forgetful, brainfog like state
falling asleep at the drop of a hat, taking multiple naps during the day just to stay afloat, etc. 
diminished sex drive
depression and severe mood swings
IBS
numbness or tingling in the hands

These symptoms (plus others, these are the ones I remember and started keeping track of!) I had been experiencing for several years before diagnosis and continued somewhat unaltered through the 25mcg and 50 mcg doses. Around 50 mcg, I began to feel some of the less desirable effects that have now escalated to worrisome states:

a high resting heart rate, night sweats, severe insomnia, night terrors around the same time every night, heart palpitations, anxiety, irritability, dizziness, feeling faint, constriction in my chest, and finally, a full blown panic attack.

I am calling on Monday to request an appointment, updated labs (with a full thyroid and antibodies panel) and this time, I will insist on an endo referral. Am I missing anything?


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## joplin1975 (Jul 21, 2011)

I think that's a good place to start. While it won't be done immediately, I think you should also inquire about moving quickly towards a biopsy of those nodules, assuming they are large enough to biopsy.


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## Andros (Aug 26, 2009)

hollywoodhaven said:


> Thank you, Andros. I was unaware of most of this so it doesn't seem so perplexing anymore. According to the copies of the labs I have requested from where I have my blood drawn, my doctor has only requested a small fraction of the labs needed to paint the entire picture. I do not have results for TSI, TPO, TBII, Thyroglobulin Ab, or ANA.
> 
> And I agree. I need a doctor who is better equipped to diagnose and identify what is happening with my body and who can give me a clear course of action. I do not feel as though I am getting that at the moment and with your grave warnings about my vital organs being at risk, I am more worried than ever.
> 
> Thanks for the insight and your experience. I am grateful for the assistance and support that this forum offers.


Aaaaaaaaaaaaaaaaaaw; how nice of you to say! {{{{hollywoodhaven}}}} We are "grateful" that you are here.


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