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best drug fot high TSH level

I  have a TSH level of 12.610, but all other thyroid readings are normal.  What is the best drug to take for this that would just target the TSH level and leave everything else alone?
9 Responses
97953 tn?1440865392
MEDICAL PROFESSIONAL
Levothyroxine is the most appropriate and standard of care medicine to bring the TSH back to the normal range in this case of subclinical hypothyroidism.
393685 tn?1425812522
Respectively Dr. Lupo. Can I ask why Levothyroxine is the choice?
97953 tn?1440865392
MEDICAL PROFESSIONAL
It is the most researched and internationally recognized effective tretment for hypothyroidism. It is also more consistent and simpler than T4/T3 combos which have not been proven to be more beneficial and are best dosed twice daily.  So, for the majority of patients with hypothyroidism, levo alone works very consistently and reliably.
1013194 tn?1296459481
I had a very high TSH of 144..went on thyroxine..it has worked well for me..Dawn..
Avatar universal
Levothyroxine may be fine, all things being equal.  But if all things are NOT equal, if you have an allergic reaction to levothyroxine--which I think many do--adrenal issues, or tissue resistance to thyroid hormones, then, in my opinion, levothyroxine is probably worthless.  

I personally have 2 of the 3 situations above--not sure yet if I have thyroid resistance...need more lab work.  But this makes it a bit more of a conundrum for me, and others, I'm sure.  Beginning Synthroid 5 years ago, my TSH initially went down to between 3 & 4, where it stayed for about a year.  The doc was happy, but I never felt good--my Frees were not tested at that point in time.  

Then, after a few months my TSH went back up (became elevated) and has remained elevated for nearly three years; and my FT3 & FT4 both hit rock bottom where they've been through my last 3 labs.  

Synthroid was doing absolutely nothing for me, but every time the doctors attempted to raise the dosage I would have "intolerable" symptoms, and it would have to be lowered again--it was never possible to raise beyond 50 mcg--and staying at 50 was being sick every day.

Recently, I've had to make a new start, sans doctors.

I had read that some people do better when combining T3 and T4 meds.  Since I wasn't able to find Thyrolar or Cytomel without a prescription, but "could" find Naturethroid, I began trying combinations of Naturethroid and Synthroid, always decreasing the Synthroid a little.  (I was a little fearful of totally giving up "Synthroid, the Wonder Drug." )  

However, whenever I tried raising any of my combinations even a tiny amount, I began getting instantaneous symptoms.  By "instantaneous," I mean I would get symptoms    the very same day I would increase the meds!  

Since I was aware of how rapidly T3 works as opposed to T4 in the system, I naturally assumed that these horrendous symptoms were from the T3 in Naturethroid.....even though it was a tiny amount.

Since I record every detail of each day's symptoms, medications, temps, BP, pulse, diet, and supplements, I poured over everything a few days ago to see if I could find some sort of pattern.

What I found was that whenever I lowered the "Synthroid," these PROFOUND, symptoms either lessened or stopped.  When I say 'profound,' I mean ears ringing so badly I can hardly think, an almost total loss of voice, swollen, burning, itchy eyes, achiness through the shoulders, weak, WEAK legs, and one VERY strange and awful sensation of having had a nylon stocking pulled over my face, then it being used to hang me by the rafters.

THIS is what levothyroxine does to ME.

The first day in which I dropped Synthroid down to 6.25 (the lowest dose yet), as quickly as the symptoms above had come on, they ceased that quickly.  I've even been able to raise Naturethroid from 30 mg to 37.5 mg with no profound symptoms whatsoever.  

That's not to say I have NO symptoms.  I guess now I have what would be appropriately  be called "typical" hypothyroid symptoms, i.e., lethargy, dry skin, hair loss, easy weight gain, difficulty excercising, blah, blah, blah...yeah, a blah feeling for sure!  ;)  ...still not having any fun. :\

I was forced to find out the hard way, on my own, that levothyroxine is NOT the wonder drug my doctors all told me it would be.  Actually, it SEEMED to work for a while; but I think it eventually turns on you and either stops working altogether, or wreaks all manner of havoc--it appeared to do both to me.

So, I also ask, "respectively, as did Stella :  
Dr. Lupo, why is Levothyroxine the choice?  
(Rhetorical)




Avatar universal
It is the most researched and internationally recognized effective tretment for hypothyroidism. It is also more consistent and simpler than T4/T3 combos which have not been proven to be more beneficial and are best dosed twice daily.  So, for the majority of patients with hypothyroidism, levo alone works very consistently and reliably.
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I would like to add something else:  

How is it that Levothyroxine is more consistent than T4/T3 combo meds--what does that even mean?!  

And, siince when does being "simpler" dictate what, when, and how medications are prescribed for a given patient.  Don't tell me; I already know.  It's EXTREMELY important that it be made simpler FOR THE DOCTOR.....after all, they don't have all minute like we do.  

Most "true" hypothyroid patients are desperate to get well and are willing to do anything  doctors tell them to do.  The onus should not be put upon the hapless patient by insinuating, since they wouldn't be compliant anyhow, why bother to give them a superior treatment, something that might actually work.  

Also, the last time I checked the studies done on T3/T4 versus T4 alone, T4 alone as deemed by the people conducting the STUDY to be better, not by the test subjects, themselves.  Most of the test subjects "felt" better when T3 was added.  Surely this must mean something.    
Avatar universal
P.S.  While I realize the inconsistencies inherent in meds such as Naturethroid or Armour, this should not apply to Thyrolar.
Avatar universal
Just curious---this seems to be a RECURRING Pattern I see on ALL Endo Boards....

ie. Patients prescribed VERY WEAK doses of T-4---some complain for YEARS----usually find a new Doctor that gives them T-3 and MAGICALLY they feel just fine.

THANK GOD. I never had to go through that (however I have gone 9-years undiagnosed Thyroid problems---I even have copies of  Thyroid tests from back in 2000--when I first started complaining, and my Thyroid levels were over 6.0.

I realize the AACE did not upgrade Standards until (thik 2006) to the new ranges of 3.0-5.0

However, why is this a RECURRING theme on *ALL ENDO Boards"
1-A CONSISTENT illness---PRESENTATION Of Symptoms
doctor refuses T-3
2-Patient finds Doctor that will prescribe T-3, patient gets better?!?!

ALMOST 100% I've read, by the time someone gets T-3=--it is NIGHT AND DAY different how they feel.

*************
I mean this question with ALL DUE RESPECT Dr. Lupo (I'm not "challenging" you)---

But I'm really curious about this...it AMAZES ME to read this board--and other Endo boards...and people CRYING OUT in Pain....and INVARIABLY--they feel better on T-3, but very few Endo's will prescribe it (I do understand it's a difficult drug to get on a "right" dose---due to it's 1/2 life---however still---why will Endo's not try with a Patients??

The only assumption I can make is that Cytomel (King Pharmaceuticals Manufacturer)--does not have a "direct sales force"(Like LIpitor, etc.) King simply Wholesales out to McKesson, etc....who provides direct to Pharmacies.

I once had a Doctor tell me he'd never prescribe a Drug where he did not have a Rep call on him.. (I can see why---ie. he wants to know what he's prescribing).

However, I have *NEVER* felt so "normal" in my life (during 2008)--when I first started on Cytomel---AND--to say I faced ADVERSITY is an understatement (best friend took his own life, home burglarized, etc.).

My Cytomel Dose was an Adjunct for "Treatment Resistant Depression"---and worked PERFECT for me...

(My concern now--why I'm back on the boards---is that it's "Stopped working"---earlier this year......

Anyway, just had to RESPECTFULLY ask---why so many Endo's FLAT REFUSE to prescribe T-3?? Mine is prescribed by a Psychiatrist, however I'm regularly seeing an ENDO--and the Endo clearly said "Don't Stop taking it" (since it's helping my treatment resistant depression).

I know Most Endo's would be "HORRIFIED" by this, however in the Psychiatric Community, they are prescribing "HIGH DOSE" T-3 (100mcg and going up in 100mcg doses until a Therapeutic effect is reached).
http://www.psycheducation.org/thyroid/HighDose.htm
Avatar universal
A related discussion, reply to nancib was started.

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