New here and could really use some help

[realtrade]

Hello, I am new here and could really use some advice to wrap my head around all of this. But first my labs so that whoever can answer my questions have something to go on.

First Lab 9/21 blood test
only results that were flagged are listed....all others were considered normal range

AST(SGOT) 65 H IU/L  range 0-40

Cholesterol, Total 220 H mg/dL    range 100-199

Triglycerides 436 H mg/dL    range 0-149

HDL Cholesterol 26L mg/dL    >39

TSH    20.64 uIU/mL       range 0.450- 4.500

Then My Primary asked I run additional test for TSH, Free T4 and T3 on 10/12

TSH 22.6 uIU/mL  range 0.450-4.500

T4, Free Direct   0.96 ng/dL range 0.82-1.77

T3 Free, serum   2.8 pg/mL    range 2.0-4.4

Thyroid Peroxidase (TPO) Ab  1958 H IU/mL    range 0-34

Antithyroglobulin Ab   11425 H IU/mL    range 0-40

Also had a ultrasound of my thyroid on 10/07 and the results were that I have 2  nodules both without calcification.
Dominant nodule measuring 1.5 cm on right and subtle nodule on left measuring 1.1 cm Both nodules were said to be solid and hypoechoic. And a small cyst measuring 2 mm.

So now that we have all that out of the way, I'd like to some question from people that have gone through this or are going through this.

My primary says I may have Hashimoto's. Didn't really discuss treatment since he said I have to go see an endo which I had an appointment with today. Didn't get a good vibe from him. He immediately put me on synthroid (haven't filled prescription yet...one of the questions I have) and wants me to do a FNA(fine needle aspirate). Didn't really answer any questions and sorta ushered me out saying I'll feel better once I'm on synthroid.

I have another appointment with another endo on 12/05. My first choice but didn't have availability till that day.

What questions should I go in there prepared to ask? I feel based on my interweb journeys about hashimoto and hypothyroidism that I would prefer to take Armour just because I'd prefer a natural approach to this. Never been on any medication in my life other that over the counter cold remedies and aspirin.

Would it be better for me to go ahead and wait to be put on armour or go ahead and take the synthroid and see how i feel till my appointment on 12/05 so for about a month and a few day?

I read taking adrenal support (im looking at dessicated adrenal from standard process) might be beneficial. Am also considering taking milk thistle to help with liver. And also thytrophin pmg also by standard process for the thryoid...according to reviews it helps support thyroid. Should I take these?

Why are my triglycerides so high? I don't eat alot of junk food....almost cut that down to 0.I drink occasionally and I do smoke 1-2 mini cigars a day.

I may have follow up questions, but those are the ones weighing on my mind now. Thanks

[flyingfool]

Also, some have reported that once you start taking Thyroid meds, the nodules are reduced.  

I forgot to mention that yes starting out at 137 mcg is a high starting dose. It is not terribly surprising for people to be at this rate or even higher.  But usually they start out or not much more than about 50 mcg.

And based upon your FT4 and Ft3 levels seems higher than I would expect you might need even as a final dose.  but everyone is different and I'm not a Doctor so what do I know???

[realtrade]

Thanks again Barb and Flyingfool. I started taking my synthroid yesterday. Not feeling that much different, I know it takes time for it to get working. But my left knee and left elbow joints are feeling weird. Hard to describe...not really painful but different, and it seems to take place about an hour after i take my 1 pill...and last the whole day, then no weird sensation this morning, then took my med again...and am feeling it again. Never really had joint issues since I'm only 30 fairly active.

As far as dosage is high....I didn't really argue because he didn't even want to talk about different medications or treatment possibilities, like I said earlier it wasn't my first choice of endo, but it was the one without having me wait for 1 1/2 months. He basically said in a hurried fashion that I'm giving you this dosage based on your weight. I am 5'9 and weigh 175lbs. I work out for about an 45 mins a day and watch what I eat. Endo said I'll be dropping weight like hot cakes once the meds fully kick in. I used to be 150lbs. I was expecting to get a clean bill of health when i went in for my checkup for 1st time in 11 yrs. I don't really feel sick, except for the feeling cold if my wife lowers the thermostat to below 77, i just thought i was a person who likes to be warm, and I thought me not losing weight even with diet and exercise was because I wasn't working out hard enough. Mild depression i also just chalked up to that's how I'm supposed to feel. I have been reading up on hashi's and hypo and found out irritability is also  one symptom and my wife pointed out that one right away. Kinda scared in the sense since I've been reading about this condition it seems that alot of people are struggling even after being on meds. When my primary first said I may have hashi , he told me that its no big deal and its easily treatable not curable...but a simple fix. Then why are so many people still struggling and is this what I have to look forward to? I am beginning to think i may have been better off not knowing.

[Barb135]

The main reason people still have trouble after getting on medications is because most doctors don't really know how to treat hypothyroidism/Hashi's.  Your endo starting you on such a high dosage is one example.

You haven't been on the medication long enough for it to really have an effect, but the fact that you feel worse, now, could be caused from the too high dosage, plus your body needs time to adjust to having hormones its been without; or you could be reacting to the binders/fillers in the medication.

Are you splitting the tablets or taking the whole thing?

[flyingfool]

My wife has been on increasing Levo medication for well over 10 years and her level now is only at 125mcg.  So a starting dosage of 137 seems odd to me.

At the VERY least I would do as Barb says and at least cut the pill in half and take it twice a day. Even half of that dosage is larger than most people start dosage.

Are you sure it is 137 mcg and not 37 mcg?

Clearly you are having some sort of reaction to the medication and you should call in to tell your Dr.  And also tell him that you've done some research and even go onto the medication website and see if they have recommended starting dosages etc.  If all your research says that the dosage your Dr started you out on is unusual.  You need to point that out. And also you may want to consider a different Dr if he was "hurried" and told you to take this dosage.

Sure Hashi's can be treated.  But as Barb135 said, the Dr has to know how to do it. And that is not as easy as it sounds to find such a Dr.

The more I read the more I'm starting to think that natural dissected Thyroid is the better route to go.  But some Dr.s absolutely refuse to prescribe the stuff.  They cite the inconsistency of dosages.  But when you study, you will find more recalls and more variation of synthetic thyroid meds than with natural Dissected. So the main claim by most Dr.s not to use natural thyroid is based on a totally false assumption!

[goolarra]

I agree that 137 mcg is a fairly high starting dose.  However, you are young, probably have not been hypo for very long since it was discovered on routine testing, so iif you have no other health problems (especially heart arrhythmia), you might be okay with it.  If it makes you nervous to start that high or you have a history of sensitivity to meds in general, you might want to ask your doctor about starting at half that (once a day), giving it a few weeks for your body to get used to having the hormones available again, then increasing as tolerated.

I don't know that it's fair to say that dessicated is the "better" route to go.  Some people do well on T4-only meds, some on synthetic T3/T4 combos, and some just seem to need dessicated.  Those people who will tell you that dessicated (or any other single approach) is the best way to go for everyone are the people whose writing is probably best avoided as biased.

Dessicated is no more inconsistent than any other thyroid meds.  Dessicated has a T4:T3 ratio of between 4 and 5:1.  Our thyroids, when functioning properly produce only about 20:1, so that's a lot of T3 in dessicated.  For some of us, that's a tremendous advantage, for others, it's too much.

Although dessicated is often referred to as "natural" thyroid, that might not be as true as it seems on first look.  T4 only meds keep the natural conversion process in place, and that's important since it encourages fluctuating levels due to bodily demands.  Of course, IF you don't convert well, then this becomes less of an issue.

The upshot of it all is "one hypo's heaven is another hypo's...".  What works for you might not work for me.  We all have to find what's best for us.

Regarding addressing your other tests that were out of line...I'd stabilize thyroid hormones before trying ANY of that.  You may find that little to none of it will be an issue once thyroid hormones are stabilized.  Work on that one first, then move on to any remaining problems one at a time.

Good luck with it all...I wouldn't cancel my appointment with the doctor behind Door #2...your first endo didn't sound very impressive.

[flyingfool]

Gloolarra makes excellent points!  That is why I like this forum.  I seem to learn something every time I visit.

Doesn't our natural Thyroid when working properly also produce T1's and T2's in addition to T4 and T3? Pure synthetics would not give you those T1 & T2's if your Thyroid is no longer working or working properly.  I have not yet researched what the T1 and T2 specific hormones do.  But if your body produces them, they must be needed for something.