Should I wean myself off of my Thyroid Drug?

[Catslover]

I suffer from extreme fatigue, hair loss, weight gain, etc. I was referred to an endocrinologist. Readings were; TSH 3.25,  Free T4:  .82    So, she put me on 25 mg of Levothyroxine  -- (& then tried to put me on a diet drug, but I declined the diet drug). I was very ill/gastronomically & even more sickly/tired for a month from the Levo. After a month, my gut issues subsided, but my pulse rate dropped to mid 50's, and 46 at one time.   (I have been on Ziac blood pressure pills for years btw.) I felt worse than ever.

My doc retested me at 8 weeks: TSH: 1.22   Free T4:  1.17   Free T3:  3.32  , and  TPO AB Antibodies: .50  
I was then switched to Synthroid pills instead of generic, and my dose was doubled to 50 mg. I've been on that for nearly a month.   I had congestion for a week with sore throat, and issue a couple nights of not being able to deeply swallow/barely breath! Since then, my pulse has averaged 59 to 63, a bit better, toward normal, except for today it went to 92! Past conversations with my doc, she didn’t seem alarmed when my pulse dropped. And she suggested if Synthroid doesn’t work, to turn to diet drugs. She would never consider prescribing natural thyroid products, when I enquired.

I feel I'm worse off than when I began thyroid meds and my husband fears for my safety, as do I. I feel worse than ever, half dead. And now, I feel at least getting off thyroid meds, I'd just go back to my original issues of  deep fatigue hair & weight. And my heart would be safer. So - I'm wondering opinions about weaning or getting myself off the Synthroid. I'd appreciate any input.  

[gimel]

A suppressed TSH is nothing to be worried about.  It is not a sign of too much Synthroid, unless there are hyperthyroid symptoms, due to excessive levels of Free T4 and Free T3, which is not the case for you.  Many doctors do not recognize that the equilibrium that exists among the hypothalamus/pituitary/thyroid gland, which produces a continuous low flow of thyroid hormone, changes significantly when taking thyroid medication.   Taking thyroid med in a single dose daily upsets that equilibrium and for most people taking thyroid med adequate to relieve hypo symptoms, results in suppressed TSH levels.  There are several scientific studies that have shown this to be the case.  You can read about this in Rec. 10 on page 13 of the link I gave you above, which also includes footnotes for the appropriate references.  

[Catslover]

Thanks, Gimel. I just read that page you mentioned. Glad to know suppressed TSH isn't a big deal! I guess the increased heart rate/palpitations are my main concern from the increased T4. Can't wait to get this more balanced out with the new doc. (Thanks again for that doctor recommendation, btw.)

[Catslover]

Just posting an update here.  My blood pressure & pulse remained high and I get palipitations daily, so I saw an internist - who changed me to a different beta blocker ; doubled to 20 mg - of Propranolol. She ran (only) 2 tests - to hold me over until I see my new thyroid doc in 2 weeks. Results:

TSH: .59  (.45-5.33)
Free T4  1.0 (.58-1.64)

Btw, my endocrinologist was unconcerned about my heart, saying that blood pressure isn't affected by Synthroid, just heart rate is, and that 70-100 is normal. Yeah, right! My normal is in the 60's. Not waking up mornings at  70-82. She said I could stop taking Synthroid for two to several days to see if I felt better, that otherwise all was fine! I had already lowered my Synthroid for 5 days ahead of the surprise blood test which was done and contacting docs. (I stopped every other day, and did 25 mg on the others for 1 week.)

I just have to get by for 2 more weeks when I see my new doc who is integrative and works with natural meds, etc. Is the low TSH anything to be worried about? Is this a sign of too much Synthroid? All of this is confusing and actually scary, although I feel safer now with better b.pressure pills, my heart is still fluttery though slightly better only 1day on the new beta blocker. (Doc listened w/ stethoscope and said I was okay.)

[gimel]

Well, in conjunction with your symptoms, your original test result for FT4 was indicative of being hypothyroid.   Your TSH was not real high, and your TPO ab test was negative, so no indication of Hashi's there.  I am at a loss as to how your FT4 went up so much with only a 25 mcg dose of T4.  

Over the counter supplements will not solve your issues.  I think you need to see a good thyroid doctor and get all the tests recommended above.  I have names of a few doctors in the Chicago area, that have been recommended by other thyroid patients.  I am sending you a PM with info.  To access, just click on your name and then from your personal page, click on messages.  

[Catslover]

Thank you, Gimel, checking my message box now....

[gimel]

When the doctor first prescribed the 25 mcg of Levo, was it based on symptoms or the test results?

You mentioned a number of symptoms that are frequently related to being hypothyroid.  Your first test results unfortunately did not include Free T3, but your Free T4 at .82 was only 14% of a reference range which is too broad at the low end, to be functional for many people.  Many of us find that Free T4 needs to be at least mid-range, and Free T3 is best in the upper third of the range, or as needed to relieve symptoms.  Your more current test results showed FT4 at 56% of its range, and FT3 at 45% of its range.  I don't understand how a dose of only 25 mcg of T4 med would have that effect.  Since your TSH went down, your natural thyroid hormone production would also go down, and the net result is usually no significant change with that dosage.  

Based on what you have told me about this doctor and the response about natural thyroid products, I think you would be much better off finding a good thyroid doctor, and getting some additional testing done.  Also, could it be that your low pulse rate is due to too much blood pressure med?  That is another thing that concerns me.  Also I don't like her suggestion to take diet drugs.  

You can see the tests that should be done in Sugg. 4 on page 2 of the following paper.   Specificallly I think you need to re-test Free T4, Free T3, Reverse T3, cortisol and ferritin.  You already were tested for Vitamin D and B12.  D needs to be a bit higher.  B12 was adequate.  

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

If you will tell us your location, perhaps we can suggest a doctor that has been recommended by other thyroid patients.  

[Catslover]

I live in a Chicago, Illinois suburb. Thanks so much for your great guidance. I'll start taking more Vit. D right away.

Oh, when my blood pressure dipped my 2nd month on Levo, oddly, my blood pressure itself wasn't that low. Just my pulse was.

Would I be considered hypothyroid?   Also, with a .50 TPO/AB result, am I free from antibodies and not autoimmune?

I'm guessing that mere over-the-counter iodine or thyroid supplements won't be enough to solve my issues. Or would they? I'd love to handle this on my own, instead of w/docs, if I could. Because, thus far, I have more issues with meds than without; more fatigue, under eye bloating, and worst of all -heart rate issues.  :-/  

[Catslover]

Btw, my doc had my TSH and T4 results in hand (from my internist) before my appointment. And I told her about my extreme fatigue when I saw her. She readily prescribed the 25 mg of Levo. (Thanks for taking the time to read all of this.)

[gimel]

There is a lot we need to discuss, but first please post the reference ranges shown on the lab report for those results.  Also, did you take your thyroid med the morning of the blood draw for those tests?  What time was the blood draw?

[Catslover]

Hi Gimel. Thanks so much for helping me. I did not take my thyroid med the morning of the draw, until after my blood tests. Here are my ranges:

Thanks so much for helping me wade thru this.
TSH:  1.22       ( .45-5.33)
TS4 Free  1.17   ( .58-1.64)
T3 Free   3.32 (2.53-4.29)
TPO AB: .50  (.00-9.00)

[Catslover]

More test results:
Vitamin D:  46.5
Folate:    23.6
Vitamin B12:  841