Hashimoto's

[babyiguama]

Hello, I am a 44yo female.  I have been diagnosed with Hashimoto's for 15 years (confirmed with FNA).  I do have a benign nodule on the right that on ultrasound is the same size as one of my other thyroid lobes- otherwise uneventful on ultrasound.

I am currently taking Synthroid 150mcg and Cytomel 5mcg.  I exercise 5 days/wk, keep track of steps/calorie intake…can not seem to budge weight.  In fact, I have gained another 10 pounds in the past month.  I feel terrible: tired, foggy, some hair loss, heavy, regular menstrual periods (but bleeding only 4 days)- all of my normal hypo symptoms but I have HOT FLASHES.  Also, I am a nurse- I work 12 hours shifts.  I have lots of retained fluid, especially in my legs and am up going to the bathroom all night.   I rarely sleep well.  Please help, I am feeling worse each month and gaining weight!

My labs this week:

TSH  0.45   L

FT4  0.8 bottom of the range

FT3 2.4 bottom of the range

TPO 650  

[Barb135]

Forgot to mention that the lab is using old ranges for TSH... new range (12 yrs old) is 0.3-3.0, recommended by ATA and AACE, so your TSH is not low... you still have room to go.  You can try using that on your doctor and see if it gets you anywhere.  

Also point out that "in range" isn't good enough for everyone.  Some of us have to be higher in the range.  Some doctors are "teachable", if you present facts.

[Barb135]

It seems that military personnel have a harder time getting good thyroid treatment as the tendency is for doctors to look more at the TSH  than anything else... If you're lucky, you might be able to take in some information and convince your doctor that's not the be all, end all, but regulations only give them so much leeway.

I'd agree with you about the frequent urination and blood sugar.  It's important to get that checked out, if you haven't already.  

I do find that drinking plenty of water is very important in preventing fluid retention - kind of like, if we get a little dehydrated our body seems to hold on to what's there, type thing.  

Another thing I discovered when I was really retaining fluid is that dandelion tea or dandelion capsules really helps get rid of it.  A couple of cups of dandelion tea/day or a few dandelion root capsules worked wonders when my lasix wouldn't do the trick - if the swelling is real bad, it might take a few days to get it completely down.  My doctor gave it his blessing, but be sure talk to yours... You can sweeten the tea with honey or stevia  that won't spike your blood sugar.  

Part of your current weight gain will be fluid, though you do need to figure a way to get your thyroid meds increased.  Is there any way you can see a civilian doctor?

[babyiguama]

Thanks for both of your comments/suggestions.  I have the same beliefs re: the TSH levels and FT's…unfortunately, we are military stationed overseas, and we have no endocrinologists here.  My FP doc does not understand  AT ALL, thinks I should lower my dose, and does not believe in using Cytomel.  Arghhh!

Thanks for the concern about my bladder :)  I actually go frequently- like to the point I question myself about my sugars.   This hospital is a totally different, better pace- you actually get to eat AND pee, lol.  The previous hospital I was at (for 22 years)- not.  I also  think you are right about the hot flashes.  Annoying.

I have not had my B12 checked, but D was actually well in range.  My doc in the US was into staying pretty up to date, I was lucky.  I feel like here, I am left to self adjusting, which I really do not want to do!  We move back in July, thank goodness.

What dose of Cytomel are others on?

[gimel]

Why is your doctor keeping your Free T3 and Free T4 on the bottom of the range?  The range is far too broad to be functional across the entire range, for most hypo patients.  Many members have said that symptom relief required Free T3 n the upper part of its range and Free T4 at the middle of its range, at minimum.  While many are reluctant to do so, your doctor is at least willing to prescribe both T4 and T3 med.  Now it is a matter of increasing your dosages to reach optimal levels.  

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.   I say this about TSH because frequently a hypo patient will have TSH levels suppressed below the range when taking adequate dosages of thyroid med.  From your info I suspect that your doctor has not increased your meds in order to keep your TSH within range.  That does not work.  You can get some good insight from this link written by a good thyroid doctor.  

http://hormonerestoration.com/Thyroid.html

Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin I suggest that you should get those tested as well and supplement as necessary.  D should be about 60, B12 in the upper end of its range, and ferritin for women should be about 60 minimum.

[Barb135]

Looks like you need an increase in both, your Synthroid and Cytomel to bring your FT levels up to decent levels, as, both, you're results and symptoms indicate that you're still very hypo.

TSH is a pituitary hormone, not a thyroid hormone and it neither causes, nor alleviates symptoms... once a person is on thyroid replacement hormones (particularly T3, such as cytomel), TSH is often low/suppressed. My own stays at < 0.01 - 0.01 all the time.  

I'd put the hot flashes down to peri-menopause, not thyroid.

Fluid retention is also a hypo symptom, but can happen if you don't drink enough fluid during the day.  Perhaps, since you're a nurse, you're not going to the bathroom during the day (holding it), so you're having to go more at night.  I've had that happen... If you might be doing that (unconsciously, of course), I strongly recommend that you not do that, as it cause serious bladder issues down the road - trust me, I'm there!!

Your elevated TPOab indicates Hashimoto's.