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Further explanation of thyroid test and treatment

I saw my endocrinologist for the second time, today. My new TSH test shows the same thing my previous tests have shown--my TSH level is slightly low. However, my T3 and T4 levels are in range.

My doctor ordered tests for other things too. The new tests show that my cortisol levels are within range, my testosterone levels are within range but more on the low side, and that thyroid antibodies are present. Also, my thyroid ultrasound shows that I have a small nodule on my thyroid.

My doctor prescribe a low dose of Synthroid (50mg) to see how I respond, which I will have to take for several weeks. He said that if it helps my fatigue, mild depression, weakness, and other symptoms and corrects my TSH, I might want to continue taking it. The following are my concerns:

From my knowledge, once you start thyroid medication, you can't stop taking it. Is this true?  If I opt to stop taking it after several weeks, will this cause my thyroid to stop functioning?

Also, I really think I have Chronic Fatigue Syndrome, which I have read can go hand-in-hand with thyroid problems. Although many of the symptoms overlap, most of my symptoms seems to correspond with CFS.  Do you think it is wise to continue with thyroid treatment before ruling out CFS?

Your opinion or advice will be much appreciated.
Thank you


This discussion is related to Should I see an Endocrinologist?.
5 Responses
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213044 tn?1236527460
That depends.
You said your TSH is low, but it must be slightly high, or you would not be on medication.

50mcg of Synthroid is not a huge dose, but it is twice what would be considered a trial dose. 25mcg would be a trial dose if your numbers suggest you may or may not need medicating. Teetering on the edge of needing treatment, so to speak.

The doctor must feel you need replacement hormones. Whether or not the doctor is right is hard to say from my chair.

IF you take the meds for a few weeks and then stop, it should not affect thyroid function long term. You may get slightly ill from taking too much hormones, but it shouldn't affect the thyroid permanently if you stop the med.

If you take a low dose for six months or a year, your thyroid may get lazy and ramp down production. Stopping the med at that point may kick the thyroid back into full production, or it may not.

But I don't see that happening with a dose of 50mcg. Either you need it, or it will drive you hyper within six weeks and the doctor will discontinue it.

Just my I'm-not-a-doctor opinion.  
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Avatar universal
Hi Danny,

I actually have normal TSH levels AND normal T3and T4 levels...yet I have low thyroid function.  Tests alone will not necessarily determine a thyroid problem - your symptoms are a big determining factor here. As AR-10 said abovve, if it is not your thyroid, you will move fairly quickly into hyperthyroid symptoms, and you will know that your thyroid is not the issue.

I see a Naturopath for my thyroid issues.  When I first reviewed my symptomology and history with me, one of the things he sais to me was, "Well, you are a classic CFS case...but that doesn't do you any good unless you know what is causing it."  In other words, something  - undiagnosed - is causing the CFS. CFS is not a "be all / end all" diagnosis.  You have to find and treat the underlying issue.

Has your doctor also tested your B12 and Ferritin levels?  These are often low in hypothyroid cases.  Also, have you been taking your temperature, and have you had your blood pressure tested?  These are often low in hypothyroidism as well...just more clues to solving the puzzle.

Hang in there and listen to your body....you will figure it out!

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Avatar universal
Thanks for your response. My mistake, I meant to say my thyroid is slightly slow, so, yes, my TSH is slightly high. Sorry, I'm new to the whole thyroid thing. So I won't worry about any permanent dependence on the drug at this point. My doctor is looking at this as a trial run. I wonder if he put me on twice the usual trial dose, because of my body size. I'm 6'6 and 235 Ibs. One thing I didn't mention is that there is something else I would like to rule out before declaring my slow thyroid as the source of all my physical troubles. For the last 3-4 years, my apartment has had water and mold damage from a faulty air conditioner. I recently read that some molds can cause impaired thyroid function among other immunological diseases. However, I must admit that I've had some of the thyroid symptoms ( especially the fatigue) before I moved into the apartment, just not as severe. Anyways, I'm just taking things one step at a time.

Thanks again


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Avatar universal
Thanks for your help.

Are B12 and Ferritin levels a part of the standard lab tests, or do you have to request them? I've had several blood tests in the past months, and those things might have been tested. Unfortunately, I don't have many of the test results, but I think I can request them. I'll ask my doctor the next time I see. For now, I'm going to try to get into the habit of taking multivitamins. Believe me, I'm doing my research and trying to get to the bottom of my health issues. The only good thing that has come from learning about my impaired thyroid is that it has motivated me to find answers and to get better. There was a time not too long ago, (after years of doctors telling me there was nothing wrong with me or putting me on antidepressants and getting no where) when I just gave up and was resign feeling fatigued, depressed and miserable all the time. I don't accept that any more.

Any ways, thanks again
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Avatar universal
Hi Danny -

Sorry for the delay - I was traveling for work this week.

I totally understand what you are going through!  I have done more research than I ever imagined I would need or want to do in my lifetime.  You really do have to be your own advocate where your health is concerned.  The B12 and Ferritin tests are NOT standard - they are separate tests (eg not included in a CBC, etc).  I would ask your doctor if he/she did these tests, and if not, request them.
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