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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by wildcard on October 18, 2005, at 17:45:20
>The blood tests show that my thyroid is not working properly which is causing my main complaint-fatigue. What options do I have? I got the tests done at the health dept. and they have referred me to a doctor that can help w/ this. Same problem~NO INSURANCE. I have seen several OTC herbal supplements? Any input?
Posted by Phillipa on October 18, 2005, at 19:40:37
In reply to Hypothyroidism-What to do?, posted by wildcard on October 18, 2005, at 17:45:20
They will put you on synthroid or levothroxine. That's when all my problems began. When my thyroid quit. Mine is hashimotos throiditis caused by problems with my immune sytem. Most common kind I've heard. But it seemed that when I worked in psych most patients had low thyroid. I think there is definitely a link to depression, anxiety, etc. If your thyroid isn't working right even when on the meds. But a plus for you will be wt loss think you said you wanted to lose some. And the cardinal sign of low throid is tiredness. And it takes about 7 days to work. And when it does you will definitely feel better. Your meds you're on now may have to be adjusted. My low thyroid did the opposite and gave me high anxiety. But your symtoms are typical. Don't worry about it. It's simple to take the med daily. But it is a med you will need for the rest of your life. Fondly, Phillipa
Posted by holymama on October 18, 2005, at 19:50:48
In reply to Hypothyroidism-What to do?, posted by wildcard on October 18, 2005, at 17:45:20
Hi Wildcard,
I too have a hypothyroid, hashimoto's disease. I take synthroid for it. I used to see a naturopath and he recommended I take synthroid, he said as far as medications go, it is harmless and very effective.
Hope your fatigue eases when/if you start treatment! What a relief!
~Autumn~
Posted by Cairo on October 18, 2005, at 21:25:29
In reply to Hypothyroidism-What to do?, posted by wildcard on October 18, 2005, at 17:45:20
Are you worried about the cost of the medication or the endocrinologist? Generic levothyroxine will be available soon or you can have the doctor contact the drug company for "compassionate use" option.
""http://thyroid.about.com/od/thyroiddrugstreatments/a/generic.htm""
Once you're controlled on thyroid medication, meaning typically that your TSH is stabilized, you don't need to see the endo that often. But you're playing with fire if you don't see one and start on thyroid (if you need it) as heart disease and other sequelae from hypothyroidism may rear their ugly heads. You can't afford NOT to be checked.
A good family doctor or Internist can also diagnose and prescribe thyroid.
Cairo
> >The blood tests show that my thyroid is not working properly which is causing my main complaint-fatigue. What options do I have? I got the tests done at the health dept. and they have referred me to a doctor that can help w/ this. Same problem~NO INSURANCE. I have seen several OTC herbal supplements? Any input?
Posted by Phillipa on October 18, 2005, at 21:36:43
In reply to Re: Hypothyroidism-What to do?, posted by holymama on October 18, 2005, at 19:50:48
Hmmm seems to go along with my observation that people with psychiatric conditions have hypothroidism. Wonder if we took a poll what would turn up? Fondly, Phillipa
Posted by holymama on October 19, 2005, at 5:59:42
In reply to Re: Hypothyroidism-What to do? » wildcard, posted by Cairo on October 18, 2005, at 21:25:29
Just to add to Cairo's post,
I don't think the cost of synthroid is that much out of pocket. I want to say $20 a month.
Also, with my experience with seeing a PCP and an endochronologist for my thyroid problem -- My PCP can do bloodwork for me, and for a long time the tests were showing up fine -- I was withing normal range. But I was still having symptoms, and my bipolar issues were severe, so it was suggested I see a specialist. The specialist did bloodwork and showed me that -- yes, I was within 'normal' range, but when treating a patient with depression/bipolar, she wanted to see me within a very specific portion of that normal range, and at the time I was not there. So, my PCP didn't pick up on that -- he didn't get that specific. So, my point it, I found it beneficial to see a specialist.
Hope that helps.
Posted by wildcard on October 19, 2005, at 6:04:04
In reply to Re: Hypothyroidism-What to do?, posted by holymama on October 19, 2005, at 5:59:42
You are wonderful!! My levels are all borderline for normal to low or high so I was a bit confused as to why this general doc. would send me to an endocrinologist. At 27 though my cholesterol is way high along w/ those levels and I eat little to no fat??
Posted by holymama on October 19, 2005, at 12:48:09
In reply to Re: Hypothyroidism-What to do? » holymama, posted by wildcard on October 19, 2005, at 6:04:04
Posted by lynn971 on October 20, 2005, at 11:38:18
In reply to Hypothyroidism-What to do?, posted by wildcard on October 18, 2005, at 17:45:20
Wildcard, I am glad that you found your problem. I have a low thyroid too. Does your doctor have samples. Sometimes the med reps leave plenty of samples. That is what a friend that I work with does.
(((((Wildcard)))))
Posted by Cairo on October 20, 2005, at 21:32:24
In reply to Re: Hypothyroidism-What to do?, posted by lynn971 on October 20, 2005, at 11:38:18
I would also like to add that many attribute symptoms to hypothyroidism, but using thyroid medication and bringing your values up to "normal" may not improve the symptoms. I have taken Unithroid for years and my TSH, T3, T4 look great, in the "right" range, yet it does nothing for my fibromyalgia, depression and anxiety symptoms.
Yet, it's interesting that a trial of low dose Cymbalta (5mg) made some of my "thyroid-like" symptoms improve (weight gain, thinning hair, cold extremities, acne, postural dizziness, fatigue, thirst, etc). I feel this was due to revving up my HPA axis, which is generally sluggish. The only problem is that it didn't help my core symptoms and made my muscle tightness worse.
So I don't think it's an easy take thyroid and you'll be better or take T3 and you'll solve your problems. If you're helped by thyroid, then you had hypothyroidism and your symptoms were the result of that. But if it doesn't help, and I know plenty of people that it doesn't, then you have more going on.
BTW, you also need to have a thyroid scan and check for thyroid antibodies to rule out Hashimoto's as well as hyperthyroidism and other things. So whoever said a specialist would be better is correct, but for uncomplicated hypothyroidism, I still maintain a good general practitioner would do. The operative word is GOOD. My Internist was the one who picked up on the fact that my TSH was creeping up over 2 when it was still generally thought that a TSH under 5 is "normal".
Cairo
Posted by wildcard on October 20, 2005, at 21:45:05
In reply to Re: Hypothyroidism-What to do?, posted by Cairo on October 20, 2005, at 21:32:24
Thx Cairo! I actually got in w/ a specialist before a general prac. would accept my medicaid. I find your knowledge VERY helpful because everything I google about it is in medical terminology. I am 27 and found it odd that I always lose hair (if I didn't have so much, I'd be bald), stay cold, fatigue, and excessive thirst(drink mainly water). Knowledge is power so thank you again. I will take your info. w/ me. Take care.
Posted by thuso on October 26, 2005, at 16:48:12
In reply to Hypothyroidism-What to do?, posted by wildcard on October 18, 2005, at 17:45:20
>I don't think the cost of synthroid is that much out of pocket. I want to say $20 a month.
>This is correct. Every 30 day supply for me costs me just a little over $20. It's the Cytomel that costs me a buttload of money.
And I would also recommend seeing an endo if you can. I've had better luck and felt more comfortable when I saw a specialist. I've also found that most endo's understand that a patient should be between 1-2 to feel the best. Most GP's and internists still think normal is anything below 5.5! I'm one of those people where the lower I am, the better I feel.
I'm your age, so I know exactly how you feel and how much not feeling "right" can mess with you. I usually know that when my hair starts falling out in droves and/or I have to sleep 12-14 hours a day, it is time for another blood test. haha!
Posted by lorilu on October 28, 2005, at 2:58:10
In reply to Re: Hypothyroidism-What to do?, posted by Phillipa on October 18, 2005, at 21:36:43
> Hmmm seems to go along with my observation that people with psychiatric conditions have hypothroidism. Wonder if we took a poll what would turn up? Fondly, Phillipa
Hi, I just got diagnosed with hypothyroidism (Hashimoto's)last month and have "psychiatric conditions". This is the first week, after about a month of the thyroid med that I am not exhausted! I use to take 200-400mg of Provigil a day and could still go to bed by 9. Now I don't take it every day and LOOK it's one of those days, midnight, and I am awake!
Also, I can't take my psych meds with the thyroid med in the am and 2 weeks ago I forgot to take my Effexor for a few days. I figured that I might as well stop taking Effexor and I struggled through extreme brain zaps and flu like symptoms for a week. I am feeling better now and hoping the thyroid med will be a good replacement for the Effexor. I do have to say that my therapist said during the summer that I could wean off Effexor, I just hadn't got to my pdoc to get the ball rolling.
I still take Topamax, but down to 125mg, from 400 mg. I still need Topamax as a mood stabilizer, I could easily take 400 mg. if I didn't have kids or a job; but then I would be a zombie (a happy zombie though):`)
Finally, Yesterday I woke up and wanted to do the treadmill...I haven't wanted to exercise since 4th grade. It was 5:45 in the am (it had been so long I didn't know at first how to turn it on)!!!! I hate to sweat but now I seem to have more energy. I don't know if that is because I am off the Effexor or because I am now on thyroid replacement.
I always thought I would be a lifer on my cocktail of meds and now that I am diagnosed I am thinking this has been part of the blame. Maybe someday I can get off all my meds and then start taking the ADD meds my therapist really thinks should be the one I should be taking. No more meds until I get off 1-2 more.
Goodnight,
lorilu
Posted by Phillipa on October 28, 2005, at 18:02:03
In reply to Re: Hypothyroidism-What to do?, posted by lorilu on October 28, 2005, at 2:58:10
Lorilou, Maybe you were never depressed and that's he reason you can wean off your meds so quickly and easily. I know when my Hashimotos [anutoimmune most common] was dx'd and first treated. I didn't exhibit the typical symptoms at all. My anxiety just climbed the walls. Necessitating higher doses of xanax. But after about a week of synthroid I kindda woke up from a daze at work one evening and felt much better. Even though they say my thyroid is okay and levels are okay I have to question if something else is going on as my energy is low and I'm unable to work now racing thoughts unable to concentrate. Even on valium, now trileptal, luvox I'm a mess. Over whelmed by everything. There has to be an answer just haven't found it. Fondly, Phillipa
Posted by katekite1 on November 1, 2005, at 20:36:50
In reply to Re: Hypothyroidism-What to do? » lorilu, posted by Phillipa on October 28, 2005, at 18:02:03
You have to get your thyroid levels optimal for you, not just in the normal range. The normal range is found by taking the levels of a large sample of people, then taking the middle 95% of those. But within the range each person likely has an optimal level that is perfect for them!
Get a lab slip and then wait a few months for a day when you feel just great, get your levels checked on that day (TSH and either Free T4 and Free T3, OR TSH and total T4 and T3uptake with a calculated Free T index). Then later you will have a thyroid level you know you felt good at, if things get out whack.
To make this relevant to psycho-babble, if you are on thyroid meds and psych meds but not quite there yet, see about getting Cytomel (T3 supplement) from your psychiatrist. That is a augmentation strategy.
Lastly, most psych meds affect thyroid levels and any time you change psych meds it will affect your thyroid replacement dosing needs. For example one study found Paxil lowers thyroid hormone levels 11%, which is a huge amount really. Of course no one knows what that means to people, is it because levels were too high to start or what. But it does mean psych meds affect thyroid levels, may be something to consider.
Katekite1
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