# Ultrasound Results and D/C'd Synthroid



## Vaporizer (Sep 10, 2012)

Well that was fun(not). 14 days on 25mcg of Synthroid for a TSH of 8.885 made me Hyperthyroid. Each day i felt worse than the the previous day. I did have a couple of days last week that i felt better, but the side effects of the Synthroid were annoying. The last few days i was just salivating from nausea and jittery and anxious.

Last night i almost fell over in CVS while buying every anti nausea product they had, sea bands, ginger gum and Nauzene liquid. My heart was beating so fast at one point i almost went to the ER.

I finally fell asleep and went to see my Dr first thing this AM and she's DC'd the Synthroid for now. She said i could try 1/2 or 1/4 of that dose but we decided that i'd just go off it for a few weeks and deal with the fact that i'll go Hypo again. I'll redo bloods in 3 weeks and see her again after that and my Endo appt is for Nov 5. My US was totally NORMAL 

On the plus side i lost 10 pounds!!!!

I know i'll have to try Synthroid or another drug again but i'm just glad to be off it for now:winking0001:


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## Octavia (Aug 1, 2011)

That's unfortunate that you did not do well on the small dose of Synthroid. Did the doc discontinue based on labs that show you are hyper now, or just based on symptoms? I'm just curious.

I hope you start feeling better very quickly.


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## Vaporizer (Sep 10, 2012)

Just on symptoms cause i told her the only way i'd continue to take it is if she prescribed an anti-emetic, anti-diarrheal and some Xanex lol . I do not want to try the smaller dose, i just want to not feel sick for a few days. I have B'day Monday and i'd like to possibly enjoy it before i feel like crap again lol
I've been seeing her for about a year now and she said it's the most animated she's ever seen me.


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## joplin1975 (Jul 21, 2011)

Did she test for TSI?


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## Vaporizer (Sep 10, 2012)

I was already scheduled for repeat and more extensive testing in a few weeks . Thyroid Stimulating Hormone level, Thyroxine level free, Triiothyronine level free, Thyroglobulin antibody and Thyroid Peroxidase antibody. Along with the usual CBC, SMA, Hepatic function and lipid panels. Is the TSI in one of those?


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## Andros (Aug 26, 2009)

Vaporizer said:


> Well that was fun(not). 14 days on 25mcg of Synthroid for a TSH of 8.885 made me Hyperthyroid. Each day i felt worse than the the previous day. I did have a couple of days last week that i felt better, but the side effects of the Synthroid were annoying. The last few days i was just salivating from nausea and jittery and anxious.
> 
> Last night i almost fell over in CVS while buying every anti nausea product they had, sea bands, ginger gum and Nauzene liquid. My heart was beating so fast at one point i almost went to the ER.
> 
> ...


All this time, I have suspected you were hyper, not hypo. You would benefit greatly from getting the tests listed below.

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

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

TSH is not always a stand alone diagnostic tool when it comes to thyriod disease.

You started a new post so I don't really recall your history except for the nausea.


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## Andros (Aug 26, 2009)

Andros said:


> All this time, I have suspected you were hyper, not hypo. You would benefit greatly from getting the tests listed below.
> 
> 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.
> ...


Did you get your ultra-sound?


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## joplin1975 (Jul 21, 2011)

Nope, you should also get Thyroid Stimulating Immunoglobulin. I would be willing to bet that's why you couldn't tolerate synthroid (nor could I, until my thyroid was removed).


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## Vaporizer (Sep 10, 2012)

Andros said:


> All this time, I have suspected you were hyper, not hypo. You would benefit greatly from getting the tests listed below.
> 
> 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.
> ...


Hi Andros, before the Synthroid i was Hypo and my US was normal , no nodules etc. I'll tell my Primary to add those tests or maybe the Endo will add them.


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## Vaporizer (Sep 10, 2012)

joplin1975 said:


> Nope, you should also get Thyroid Stimulating Immunoglobulin. I would be willing to bet that's why you couldn't tolerate synthroid (nor could I, until my thyroid was removed).


My US from the other day was normal- no nodules etc. They remove non nodular thyroids?


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## Andros (Aug 26, 2009)

Vaporizer said:


> Hi Andros, before the Synthroid i was Hypo and my US was normal , no nodules etc. I'll tell my Primary to add those tests or maybe the Endo will add them.


I hope so; we all want to see you on the pathway to wellness!


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## joplin1975 (Jul 21, 2011)

Vaporizer said:


> My US from the other day was normal- no nodules etc. They remove non nodular thyroids?


I doubt it...but at least you'd have some part of the puzzle in terms of the why...


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## Vaporizer (Sep 10, 2012)

Thanks Andros, joplin1975 and everyone else. I'd like the puzzle solved too, just have to have more testing done.


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## Vaporizer (Sep 10, 2012)

So, i felt just as bad today as yesterday,nausea, diarrhea, anxiety etc. Went back to the hospital, my Dr is off today, but saw someone else. I lost another pound overnight- that's 11 lb. in 14 days. My BP was up to 152/92. I have pre-hypertension and have been on a low dose of 2.5 mg amlodipine and that normally keeps me in the normal range.

This Dr prescribed something for the nausea and Xanax- gave me Loperimide but i've been taking that, asked for something else, prescribed pepto tablets- pepto makes me nauseous and the tablets are cherry- hate anything cherry or berry-YUCK.

Because i told him i was Anxious- he referred me to Psych - told him this was ALL because i'm now Hyper! I've never had anxiety before.

SO, that's been my day lol. Can't wait for the synthroid to be out of my body(but it has a 1/2 life of 7-10 days!) really not looking forward to starting that again or some other drug again glow


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## bigfoot (May 13, 2011)

Oh man, does not sound like fun at all. This all sounds very familiar. I would also check for other contributing factors, too. The liver tests you mentioned are a good place to start, plus you might ask about gluten sensitivity and Celiac disease, Vitamin B-12, Vitamin D, Reverse T3, testosterone and/or estrogen, adrenal and cortisol 24-hour testing, any other underlying infections or bacteria, etc. When they run the TPO antibodies and Thyroglobulin antibodies (and hopefully the TSI, too), that should shed a little more light on things. Just know that very few doctors can interpret the TSI test and most confuse it with TSH (two totally different things).

Beware the doctors who see your cholesterol high and push statins, then see your high blood pressure and push antihypertensives, then you start peeing too much so you're given diabetes medication, then see you're anxious and push anxiety meds, then see you're depressed and push SSRIs, then see you have no energy and push something like Provigil, then wonder why you can't sleep and send you for a sleep study and hope you qualify for a CPAP. It is a vicious circle.

By now you probably already know that folks with thyroid problems can have high triglycerides, those with hyper phases of Hashi's (or Hyper/Graves or Thyrotoxicosis) can have nasty heart palps, anxiety, night sweats, and diarrhea, and those who are under-medicated or Hypo can wind up with zero energy and dry skin, along with hair falling out, anxiety and depression, and that things like gluten can cause your body to think it's under attack and ramp up the immune system.

Thankfully your thyroid ultrasound came back okay. But having a TSH of up over 8 is pretty unusual unless you just got over some massive illness. And since you can't tolerate Synthroid that could be a number of possibilities:

a) You have some sort of hyper component going on.
b) Your body just isn't used to the addition of external thyroid hormones and you need to go even slower with med increases.
c) Some sort of reaction to the fillers, coloring, etc. in Synthroid.

Something is going on here and I think you are well on your way to finding out. Hopefully your regular PCP and the endo can do a little research and figure out what is going on. Be sure to keep copies of all of your labs, too.

hugs4


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## Vaporizer (Sep 10, 2012)

Thanks Bigfoot, lots of useful info. I thinks it's standard at the hospital to refer someone to Psych if they have anxiety, i think the Dr was just covering his butt. I went and spoke to the nurse and she agreed that it was all due to the synthroid and to only make an appt if it does not go away.

I keep copies of everything and as long as i start to feel better i have repeat labs scheduled for 3 weeks, i'll ask about adding those tests. They pulled chems today to check lites etc. Don't have those results yet.


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## Vaporizer (Sep 10, 2012)

Hi, I went to the GP today to get my new lab results. Since i've been off the Synthroid for 28 days now, i've still had lingering problems, nausea, diarrhea, anxiety etc. These symptoms wax and wane throughout the day.

So my old labs were-TSH was 8.885 and my free t4 was 1.38.

My new labs are
TSH 4.793- Ref range (0.35-4.8)
Free T4 -1.34 Ref range (0.9-1.9)
Free T3-3.8 Ref range (2.3-4.2)
Thyroglob AB-<20.0 Ref range(<=40)
Thyroidperox Ab-<10.0 Ref range (<=35)

Got the printout of my US -The thyroid is normal in size. The right lobe is 4.3 cm in length, 0.9 cm in ap and 1.6 cm in transverse diameter. The left lobe is 3.4 cm in length, 1.1 cm in ap and 1.7 cm in transverse diameter. The Thyroid isthmus is 4mm in thickness. The thyroid parenchyma is homogeneously granular. There are no focal masses.

The Dr thinks my lingering symptoms are being caused by a drug i'm on for my lungs. He thinks it's Theophylline Toxicity.

I have an appt with the Endo on Nov 5 . I will ask about TSI and TRAB testing.

So my TSH is now in normal range(high) but i now know that my lethargy, breathing issue, weight gain over the past year, dry skin, and non existent libido are from my thyroid, not my Emphysema and age(just turned 58). We've just been blaming my lungs for everything. I did have more energy about 10 days into the synthroid 25mcg, but then all those other symptoms started and we blamed it on the synthroid, but who knows at this point.

SO, what do you all think? lol


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## Octavia (Aug 1, 2011)

I'm not sure I fully understand what you're saying/asking. Your doctor discontinued the Synthroid...you seem happy that your labs are in normal range...but you're saying that you now know your lingering symptoms are from thyroid...I guess I'm not connecting the dots. Is the plan to eventually get you back on a thyroid drug?

But is this the same doctor who prescribes the Theophyline? If so, what is he or she doing about the suspected toxicity? Or do you need to discuss that with a different doc?


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## Vaporizer (Sep 10, 2012)

Octavia said:


> I'm not sure I fully understand what you're saying/asking. Your doctor discontinued the Synthroid...you seem happy that your labs are in normal range...but you're saying that you now know your lingering symptoms are from thyroid...I guess I'm not connecting the dots. Is the plan to eventually get you back on a thyroid drug?
> 
> But is this the same doctor who prescribes the Theophyline? If so, what is he or she doing about the suspected toxicity? Or do you need to discuss that with a different doc?


Hi Octavia, i was wondering what you all think about my labs that were drawn last week.

My GP discontinued the synthroid based on my "hyper like " symptoms after a couple of weeks on Synthroid 25mcg. She thought i was going Hyper on that low dose. 
The Theophylline was prescribed by my Allergist a few months ago- NOT this Dr.

I did feel better after 10 days on Synthroid but then all the other symptoms started happening so that was D/C'd .

I'm hoping the endocrinologist has the answers and that i do try the synthroid again. I'm off the Theophylline as of today and hopefully i'll feel better- just hypo by the time i see her on Nov 5.


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## lainey (Aug 26, 2010)

So, all we ever talk about here is the importance of the frees, and how TSH does not matter.

Case in point:



> Free T4 -1.34 Ref range (0.9-1.9)
> Free T3-3.8 Ref range (2.3-4.2)


Your free T4 is at the 50% of the range, and the free T3 is at the 75% of the range. Disregarding TSH, those are considered nearly ideal for someone on thyroid replacement. Your free T4 was even higher in your original labs (1.38) so quite frankly, I am not that surprised that you felt hyper on a low dose of T4. Even though your TSH is high, your other numbers are quite high in the range--adding medication makes those only higher--ergo, hyper.

Now, it could quite simply be that you are one of those people who falls on the other end of the thyroid spectrum who just have a naturally higher TSH (the ranges are based on a curve, after all).

Or, these types of results are more common in someone with secondary hypothyroidism--you really should be screened for a pituitary problem.

In the meantime, it's probably a good idea to stay off of the T4 meds until your frees fall appropriately.


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## Vaporizer (Sep 10, 2012)

Hi lainey, thanks for your reply. I found bloods from 2010 and my TSH was 2.62 Ref range (0.40-4.50) and Free T4-1.2 Ref Range((0.8-1.8) So my TSH has increased.


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## lainey (Aug 26, 2010)

But with the TSH higher and out of range, the reasonable expectation is and should be that the Frees would be quite lower in the range--yours were not. The free T4 and T3 are the measure of the active hormones, so supplementing what you already have quite a lot of can present problems, as you have experienced.

You would not be the first person on this board with a such a TSH level, and frees in the upper portion of the ranges, that was unable to take T4 without experiencing hyper symptoms.

In secondary hypothyroidism, the problem is in the pituitary, which controls TSH secretion--being that it no longer responds properly to the thyroid hormone levels in the blood, i.e. T4 and T3.

If you are going to see an endo, this anomaly should be noted, especially in light of the onset of symptoms after taking levothyroxine.


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## Vaporizer (Sep 10, 2012)

Thanks lainey i appreciate the advice.


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## Octavia (Aug 1, 2011)

lainey said:


> But with the TSH higher and out of range, the reasonable expectation is and should be that the Frees would be quite lower in the range--yours were not. The free T4 and T3 are the measure of the active hormones, so supplementing what you already have quite a lot of can present problems, as you have experienced.
> 
> You would not be the first person on this board with a such a TSH level, and frees in the upper portion of the ranges, that was unable to take T4 without experiencing hyper symptoms.
> 
> ...


lainey, this make a lot of sense. Thanks for explaining it this way!


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## Andros (Aug 26, 2009)

lainey said:


> So, all we ever talk about here is the importance of the frees, and how TSH does not matter.
> 
> Case in point:
> 
> ...


I agree 100%; she's probably got TRAb messing around with the TSH receptor site to offset the TSI.


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## lainey (Aug 26, 2010)

Vaporizer--

Have you had an uptake scan? Just wondering, because it would give some clues as to how your thyroid is actually functioning.

It might not be a bad idea to continue to get blood work every 6-8 weeks or so to see if there is a pattern to it.

Because you know this information better--there are quite a few medications that influence TSH levels--steroids are one, so are sex hormones. Going on and off of these drugs can have an impact. You did say that you have emphysema--keep in mind that some of the medications for that could impact your TSH. Other illnesses as well can raise it--the body's natural response is to slow the metabolism when it is under stess--these can sometimes have a pretty dramatic impact on TSH.

I am just trying to brainstorm other issues that could impact your labs. Your TPO antibodies are not high, and while that does not preclude hypo, it still seems like your numbers need a little more investigation.


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## Vaporizer (Sep 10, 2012)

Thanks for all the advice. I do want to investigate all avenues. I have not had an uptake scan yet. Will talk to the endo about this also. The only steroid i take is in my Symbicort inhaler. I'm not on any other steroids or sex hormones. The only other drugs i take are Amlodipine 2.5 mg and Priloesc and Atrovent and Ventolin inhalers. I'm off the Theophylline . That's it.


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