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Q. I have had an ongoing argument with my family doctor about the correct dose of Synthroid. The endocrinologist who diagnosed my condition said my TSH should be in the normal range, but my family doctor is not concerned that this test is abnormally low (0.1 with a normal of .35 to 7.0). He just looks at the normal level for the T4.
I've heard that too much Synthroid could weaken bones. Doesn't a low TSH mean the dose is too high? The doctors seem to be rather evasive on the specifics of my case.
A. Adjusting the dose of thyroid medicine can be tricky, and the accepted levels on some blood tests have changed in the past several years. Your endocrinologist is correct that thyroid stimulating hormone (TSH) is often a more accurate measure of thyroid function than T4 tests. When the TSH test is as low as yours, it could mean that thyroid hormone levels are high. Too much thyroid can weaken bones and increase the risk of osteoporosis, so your concern is justified.
We are sending you our Guide to Thyroid Hormones with more information on the tests and how to interpret them. Many drugs, including oral contraceptives, Premarin, lithium, Tegretol and Dilantin, can affect thyroid test results, especially T4. Make sure the person interpreting your lab work is aware of every drug you take.
You and your doctor may need to work together to find the right dose of thyroid hormone. That is one that allows you to feel well while your lab test results are within an acceptable range.
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I am taking synthroid for low thyroid . It makes me so sleepy after 1-2 hours. Have you heard of this side effect from anyone else? I have to take it either before 5 am or after 7 am so I can be up before 9:00 am. I really sleep "deep" like it effects my brain. I am so groggy I don't want to get up. Have you heard of any people tell you this? My husband takes the generic form and it happens to him also. I am considering taking it at night.
Thank you
Diane S.
People's Pharmacy response: We have not heard this complaint much, but there is no reason not to take it at bedtime. Make sure you don't eat for about two hours before bed, so that the thyroid will be well absorbed.
My last TSH (1/17/12) was 100....It's usually about 57 for decades. My doctor doesn't understand why I'm not in "coma"....I have none of the symptoms that usually come with those kind of numbers.
MCM
Sounds like it is time to find a new Dr. My Dr and I have been working on the correct formula for my thyroid remedy for over ten years. Many years ago the tests didn't differentiate so my Dr had me take my temperature before getting out of bed in the morning and that is what we used as a guide.
What we wound up with is a combination of NatureThyroid, a natural product, and Cytomel.
Apparently my body was not converting one type of thyroid to the other as it is supposed to. T3 to T4 or vice versa, I can never remember which is which.
This combo keeps my body temp about 98 and the newer tests acknowledge that this is working. Also my energy level is good. (Until the FDA pulled the natural thyroids off the market and I crashed-big time. I wrote a nasty letter to the FDA. They backed down so I must not have been the only casualty.)
The moral of my story is that you have to have an open minded Dr who is willing to work with you.
Ask your endo or family doc to test your Free T4 and Free T3. I had a normal T4 and low TSH but I wasn't able to convert the T4 to T3. You may need to add a T3 med or add some selenium (start with a small dose, 25-100 mcg) to help the conversion. I'm using selenium and it's working nicely.
I have had problems with maintaining a normal TSH level for my thyroid in the past. However, a little over 2 years ago, my endocrinologist put me on a daily medication regimen of 25 MCG of Levothyroxine (Synthroid), which I take early each morning, and a dose of 5 MG of Methimazole (Tapazole) in late afternoon or evening.
I have my TSH levels tested about every 8 weeks, and my TSH levels have been excellent for over 2 years now. My last test a couple of weeks ago showed my TSH at 3.7.
Very very useful. my husband has had thyroid problems for over 40 years. Early very successful treatment was with Armour's natural Thyroid from animals. Then it became difficult to get and 2 years ago he had to switch to Synthoid . Very very difficult to get the right dose.
Over the 40 years that he has been tested, the tests, the methodology and the interpretations have been changed drastically. This leaves the patients and their doctors confused and often in conflict within the medical profession depending on their training and how many years they have practiced. Older physicians used to rely on a different set of tests and standards and depending on how they keep up they may rely on a different test that other physicians. I think there are 4 tests now used to determine thyroid function when we used to have one. And the older ones have been discontinued. I have almost no confidence in the newer tests and in the use of synthetic Thyroid. Bring back Armour. I have tried compound Pharmacists for powdered Thyroid in capsules and it DOESN'T WORK FOR ME.
Why would you not take it at night ? It doesn't make me sleepy but have been taking at night for 12 years
Armour is still available. It was back ordered, but Forest website says all doses are available. I take synthroid and cytomel at night and found no difference from taking it in the A.M., when I take my calcium, since there should be 4 hours between thyroid medication and calcium.
I m having low thyr. for years. I'm on RAW Thyroid now for >10 yrs: No problem! NATURAL SOURCES is maker of Raw THYROID .
Tami, have you tried NatureThyroid? It is a natural product just as Armour was. I too used to take Armour, but the NatureThyroid is doing great for me now.
I recently had a physical and routine lab tests. The thyroid tests measured my TSH at 16 but my T4 is in normal range. I understand my case would be considered "sub-clinical" and there is some debate over taking medication since I have no symptoms.
I am otherwise very healthy. I am very active, attend aerobics classes and my weight is normal. I take no medicine.
I'd be interested in hearing from others who have been at this crossroads.
Thanks.
I have had thyroid problems all my life. I started with extremely overactive thyroid and had it more or less killed with a radiation cocktail. Since that time in 1975 I have been on armour thyroid, thyrolar and now a combination of synthroid and something else to give me a balance of t3 and t4. My endocrinologist keeps wanting to have me cut back to a mid range or low level of input. I now have a doctor with the VA and they look at "how do you feel" theory which is the best results that I have had in years. I am glad that I went to the VA with my problems. The endocrinologist is a young lady who goes by the book and not how I feel so I no longer deal with her.
Very interesting. Obviously I need further discussions with my doctor. By the way, does anyone remember being tested for a "Basal Metabolism Rate?" Talk about guess work!.
Katie, you are going back a LOT of years when you talk about the Basal Metabolism Rate. I went through it and it really was a waste of time.
One can tell more with a thermometer under the tongue before getting out of bed in the morning. Before I started on natural thyroid medication my body temp was slightly under the bottom line, 96 degrees.
Yes, it took time to figure out what my body needed but it was really worth it. The secret of my success is having a Dr who has the patience and knowledge to guide me.
Another very interesting topic, and I'm requesting to receive follow-up comments.
I think my recent, best-ever TSH score may have to do with my own decision to take a spoonful of blackstrap molasses daily or at least several times a week. It has minerals in it that are scarce in the normal diet. I think it is also turning my hair a little darker.
Has anyone else had trouble with thinning hair while on Synthroid? The usual answer is "low thyroid causes hair loss" and that may be so, but Synthroid does not reverse that effect of low thyroid. It doesn't seem to help with constipation either. In fact, sometimes it would seem the only thing that Synthroid does do is to change the TSH score so that the doctor is happy. Doctor happy, Drug Company happy--two out of three is okay with them.
Those who are interested in thyroid diagnosis and treatments, as all of you are, may want to listen to our latest show on the subject. You can stream it from http://www.peoplespharmacy.com/2012/04/14/853-thyroid-controversies/
or go to iTunes to get a podcast download. We interviewed three different experts (one of them expert patient Mary Shomon) to get different perspectives on the controversies.
Terry