Aa
Hypo or Hyper?
Hi.I am new to this forum and am hoping someone can help me. I recently (3months ago) had my second child. I developed hypothyroidism after my first child and was diagnosed when i had complaints of tiredness, foggy brain and low milk production. I was treated with extra thyrax medicaton during my pregnancy. 3 weeks post birth the GP checked my thyroid levels and lowered my dosage from 100mcg tto 75mcg, 3 weeks later they checked my levels and lowered my dose to 50 mcg..now 3 weeks later they checked my blood and my TSH is still at 0,03 and they want to lower my dose again.. But the problem is I felt fine on 50mcgm (is the same dosage i used prior to my pregnancy) but my milk production was decreasing..and now 2 days after taking 25mcgm I have muscle aches, tiredness, stomach ache.. I have the symptoms of low thyroid but my TSH is too low.. I hate that this is happening because i have had to put my 3 month old onto formula because i cant make enough milk (which i could in the beginning) and i have to start working full time next week and i feel horrible..I am a bit confused with everything, is this normal after a pregnancy and with lowering the dosages?
I have major breathing issues with my hypothyroid issues (yes my labs are perfect) *rolls eyes*. Anyway, i was googling away and found this and article on Air Hunger to Death: Breathing Problems of Hypothyroid Patients from Dr John C. Lowe....
"Doctor-Caused Lifelong Breathing Problem.
Yesterday I consulted long distance with a woman in her seventies who has had breathing troubles far worse than those of the young woman I mentioned above. In the early 1970s—before the Tyranny of the TSH[32] began—an endocrinologist treated her for hypothyroidism. Through trial-and-error, he found that her safe and effective dose of Armour Thyroid was 6 grains (360 mg).
She remained well on that dose until, years later, a second endocrinologist found her TSH level suppressed. The patient had no symptoms of overstimulation. Despite that, this endocrinologist insisted that she reduce her dose of Amour. She complied, lowering it to 4.5 grains (270 mg).
"Soon," she told me, "I simply was not functional. I was gasping for air and coughing so bad that I felt like I was damaging my lungs." To breathe, she had to sit upright on a sofa without leaning her head back to rest. This went on for eight weeks.
When her daughter, a nurse, phoned the endocrinologist, he denied that the patient’s breathing problem was related to her lower dose of Armour. He advised her to consult an ear, nose, and throat specialist. She saw a lung specialist instead, and he prescribed 40 mg of cortisone and an inhaler. The inhaler enabled her to get through her days. But even with the help of the inhaler, she couldn’t walk up a short flight of stairs without gasping for air. Her voice was so badly affected that she could no longer sing, which she had always enjoyed. "I could only croak," she said.
In March of 2004, she located the original endocrinologist who had put her on 6 grains of Armour in the early 1970s. Her put her back on that dose. "It took me the rest of the year to get off the cortisone and get well," she told me. "Before the second endocrinologist lowered my Armour dose, I’d never had any asthma or other breathing problems. Now I’m left with a lifelong breathing problem." She’s largely over the breathing problems that began on the lower dose, but she still has to use an inhaler one or two times each day.
I admire this woman’s strength of character in wresting control of her health away from her doctors. Some of them have recently tried to persuade her to lower her dose again. "They simply don’t listen when I tell them what happened to me on the lower dose. I feel that I’m up against a wall of idiocy," she said. "I don’t have too many years left to fool around with their book theories, and I’m not going to let them kill me." The tragic fact is, of course, that many doctors today would sacrifice her health and, indeed, even her life. Like most fanatics, to these doctors any price the patient might pay is worth achieving their obsessive goal—keeping the patient’s TSH "in range."
"Doctor-Caused Lifelong Breathing Problem.
Yesterday I consulted long distance with a woman in her seventies who has had breathing troubles far worse than those of the young woman I mentioned above. In the early 1970s—before the Tyranny of the TSH[32] began—an endocrinologist treated her for hypothyroidism. Through trial-and-error, he found that her safe and effective dose of Armour Thyroid was 6 grains (360 mg).
She remained well on that dose until, years later, a second endocrinologist found her TSH level suppressed. The patient had no symptoms of overstimulation. Despite that, this endocrinologist insisted that she reduce her dose of Amour. She complied, lowering it to 4.5 grains (270 mg).
"Soon," she told me, "I simply was not functional. I was gasping for air and coughing so bad that I felt like I was damaging my lungs." To breathe, she had to sit upright on a sofa without leaning her head back to rest. This went on for eight weeks.
When her daughter, a nurse, phoned the endocrinologist, he denied that the patient’s breathing problem was related to her lower dose of Armour. He advised her to consult an ear, nose, and throat specialist. She saw a lung specialist instead, and he prescribed 40 mg of cortisone and an inhaler. The inhaler enabled her to get through her days. But even with the help of the inhaler, she couldn’t walk up a short flight of stairs without gasping for air. Her voice was so badly affected that she could no longer sing, which she had always enjoyed. "I could only croak," she said.
In March of 2004, she located the original endocrinologist who had put her on 6 grains of Armour in the early 1970s. Her put her back on that dose. "It took me the rest of the year to get off the cortisone and get well," she told me. "Before the second endocrinologist lowered my Armour dose, I’d never had any asthma or other breathing problems. Now I’m left with a lifelong breathing problem." She’s largely over the breathing problems that began on the lower dose, but she still has to use an inhaler one or two times each day.
I admire this woman’s strength of character in wresting control of her health away from her doctors. Some of them have recently tried to persuade her to lower her dose again. "They simply don’t listen when I tell them what happened to me on the lower dose. I feel that I’m up against a wall of idiocy," she said. "I don’t have too many years left to fool around with their book theories, and I’m not going to let them kill me." The tragic fact is, of course, that many doctors today would sacrifice her health and, indeed, even her life. Like most fanatics, to these doctors any price the patient might pay is worth achieving their obsessive goal—keeping the patient’s TSH "in range."
We're all different, so another person's experience with meds after pregnancy isn't really relevant to what yours might be.
The biggest problem I see in your comments is that it looks like your doctor is adjusting meds based on TSH alone. He should also be testing FREE T3 and FREE T4. They are the actual thyroid hormones and much more important in treating hypo. TSH is a pituitary hormone and is an INdirect measure fo thyroid status. FT3 and FT4 are direct measures.
TSH can be influenced by any number of factors. Once on meds, many people's TSH is suppressed close to zero and never moves from there.
It takes 4-6 weeks for a dose change to reach its full potential in your blood. So, since your doctor has been ordering labs at 3 week intervals, he isn't even givng the previous decrease time to fully settle.
Has he tested FT3 and FT4? If you do have those, please post them with reference ranges that vary lab to lab and have to come from your own lab report.
The biggest problem I see in your comments is that it looks like your doctor is adjusting meds based on TSH alone. He should also be testing FREE T3 and FREE T4. They are the actual thyroid hormones and much more important in treating hypo. TSH is a pituitary hormone and is an INdirect measure fo thyroid status. FT3 and FT4 are direct measures.
TSH can be influenced by any number of factors. Once on meds, many people's TSH is suppressed close to zero and never moves from there.
It takes 4-6 weeks for a dose change to reach its full potential in your blood. So, since your doctor has been ordering labs at 3 week intervals, he isn't even givng the previous decrease time to fully settle.
Has he tested FT3 and FT4? If you do have those, please post them with reference ranges that vary lab to lab and have to come from your own lab report.
Unfortunately many doctors don't understand that frequently patients will have suppressed TSH levels when taking enough thyroid medication to raise Free T3 and Free T4 levels high enough to relieve symptoms.. This does not mean that you are hyper, unless you do have hyper symptoms, due to excessive levels of Free T3 and Free T4, which are the biologically active thyroid hormones. TSH is supposed to reflect levels of Free T3 and Free T4 but it cannot be shown to correlate well with either, much less with symptoms, which are the most important.
There are many sources that talk about the frequent need to suppress TSH in order to relieve symptoms. I think the best approach would to be request to be tested for Free T3 and Free T4 (not the same as Total T3 and T4), so that you can show the doctor that the active thyroid hormones are well within range, and that you need to increase, not decrease, your meds to relieve symptoms. In fact if they are only in the lower half of their ranges, that frequently causes hypo symptoms. Not sure how difficult it might be for you, but you should push hard enough to get those tests done for you. It would also be good to test for Vitamin A, D, B12, and ferritin because many hypo patients are deficient in those areas as well. For these tests, like with Free T3, just being in the low end of their ranges is not adequate either.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not just TSH. You can get some goo info from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance. The letter is then sent to the Primary Doctor, in order to help guide treatment. Please note this statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
There are many sources that talk about the frequent need to suppress TSH in order to relieve symptoms. I think the best approach would to be request to be tested for Free T3 and Free T4 (not the same as Total T3 and T4), so that you can show the doctor that the active thyroid hormones are well within range, and that you need to increase, not decrease, your meds to relieve symptoms. In fact if they are only in the lower half of their ranges, that frequently causes hypo symptoms. Not sure how difficult it might be for you, but you should push hard enough to get those tests done for you. It would also be good to test for Vitamin A, D, B12, and ferritin because many hypo patients are deficient in those areas as well. For these tests, like with Free T3, just being in the low end of their ranges is not adequate either.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not just TSH. You can get some goo info from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance. The letter is then sent to the Primary Doctor, in order to help guide treatment. Please note this statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
thanx for the info. my doc also checked mt T4 which was 19, so it indicates overactive thyroid. i dont really understand why i feel so hypo though.. is it important to testT3 as well? or does the TSH and T4 give a good indication of whats going on? With my first child i first went hyper then hypo so maybe thats why my dose is lower now..
I am speaking to my doc again 2mrw and i will ask if i canttake the 50mcgm a bit longer then get tested again..
I'm surprised he changed your doses after only three weeks (each time!!).
I know when I started on 25mcg - 4 weeks later my TSH had actually increased , despite me feeling quite a bit better - was told to continue on the same dose a bit longer and 3 weeks later it was 3.5. I've increased now slightly since my next 2.9 and 5.8 tests. I try my best to stay on one dose over a 5 week period (unless I'm starting to feel, over 3-4 days, hyper - which has happened once).
I'm glad you're asking if you can stay on the higher dose, even if only for 4 weeks until the next bloods, and ring for an appt if you're not improving. And yes, it's best to test FT3 and FT4 (not T3 or T4).
I know when I started on 25mcg - 4 weeks later my TSH had actually increased , despite me feeling quite a bit better - was told to continue on the same dose a bit longer and 3 weeks later it was 3.5. I've increased now slightly since my next 2.9 and 5.8 tests. I try my best to stay on one dose over a 5 week period (unless I'm starting to feel, over 3-4 days, hyper - which has happened once).
I'm glad you're asking if you can stay on the higher dose, even if only for 4 weeks until the next bloods, and ring for an appt if you're not improving. And yes, it's best to test FT3 and FT4 (not T3 or T4).
Was that a Free T4 test or total T4?
Yes it is very important to test Free T3. As I mentioned above Free T3 largely regulates metabolism and many other body functions. Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate. Patients taking T4 meds sometimes find that their body does not adequately convert T4 meds to T3, which can result in hypo symptoms, since the free T3 would be too low.
So be sure that you are tested for Free T3 and free T4 each time you go in for testing. I would also suggest that you test for Reverse T3, just to be sure of that. Since hypo patients frequently are deficient in other areas as well, it would be good to test for Vitamin A, D, B12, ferritin and a full iron test panel.
Yes it is very important to test Free T3. As I mentioned above Free T3 largely regulates metabolism and many other body functions. Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate. Patients taking T4 meds sometimes find that their body does not adequately convert T4 meds to T3, which can result in hypo symptoms, since the free T3 would be too low.
So be sure that you are tested for Free T3 and free T4 each time you go in for testing. I would also suggest that you test for Reverse T3, just to be sure of that. Since hypo patients frequently are deficient in other areas as well, it would be good to test for Vitamin A, D, B12, ferritin and a full iron test panel.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
