can we talk thyroid and medication

[Flowing Brook]

I went to the dr. a while back because I was exhausted most of the time. He ran some blood tests. He told me that my thyroid was a little off and that could be causing my exhaustion. He put me on 150 mcg of levothyroxine. I went from being exhausted most of the time to being EXHAUSTED ALL Of the time.

It is not just a physical exhaustion but also a mental exhaustion. I think well I am too exhausted to do anything so maybe it is a good time to get some studying done. I study for a few minutes and have to quit because I am just too tired to even read. My body just feels tired it that makes sense. I have some kind of mental confusion going on lately.

I also either feel cold or like I am sitting next to a furnace. I also have psoriac arthritic if it makes any difference.

What is weird is there have been a few times this month that I felt ADD. I had more energy than I knew what to do with. I walked about 6 miles one day just because I was so jittery and had to do something.

 

I guess I am wondering is it normal to get even more tired at first after taking thyroid medicine? I have 2 refills left. I do not know if I should stick it out or go back to the dr. I am just wondering if anyone has any btdt.

[LG Gone Wild]

I suggest going to an endocrinologist if you aren't already.

[LaxMom]

Uh. That sounds more like you're bouncing between hypo and hyper. Did he check for thyroiditis?

 

I take Armour and have never been more exhausted than before I started taking it, nor have I overdosed myself and felt jittery. Eta: that's not true. I upped my dosage once and had a jitter issue, so I split the difference and it was fine.

[TrulySusan]

I also think you should see and endocrinologist. Also. when I went on thyroid medication for low thyroid, I had a dramatic improvement in my energy level within 2 days.

[LaxMom]

I also think you should see and endocrinologist. Also. when I went on thyroid medication for low thyroid, I had a dramatic improvement in my energy level within 2 days.

 

Me, too. And mental clarity. And I definitely think you should see an endocrinologist to look into this in more detail.

[Lawana]

I think it is likely you are on way too high of a dose. Did the doctor do any follow up? Blood work? If you put a tissue across your outstretched hand, dose it reveal a tremor?

[Flowing Brook]

I think it is likely you are on way too high of a dose. Did the doctor do any follow up? Blood work? If you put a tissue across your outstretched hand, dose it reveal a tremor?

 

 

The follow up will be after I finish my refills. I have three months left. I am not sure if I can stick it out. I keep thinking it will get better and take a while for the meds to kick in.

I put a tissue across my hand there was a little bit of a tremor. What does this mean?

[tabinfl]

Have you seen a rheumatologist lately to check on your PsA? Systemic inflammatory diseases can also cause these symptoms (fatigue, confusion) when they flare up. If you are taking medication for that, esp. steroids, that can cause the "hyper" side effects as well. Make sure all of your medications & lab result info goes to all of your doctors, so that they can (hopefully) work together -- or at least not undo each other's efforts -- to treat YOU, not just one or two of your symptoms.

[Lawana]

The tremor means the dose is most likely too high. You need to let the provider know you are having symptoms and need a reevaluation now! I don't know what your TSH was, but 150 mcg is a quite high dose for someone whose numbers were "a little off". As others have mentioned, an endocrinologist is a specialist who deals with thyroid issues, and it might be a good idea to see one.

 

Exhaustion is a symptom of too much levothyroxine, or an over active thyroid, as well as an under active one.

[Flowing Brook]

Have you seen a rheumatologist lately to check on your PsA? Systemic inflammatory diseases can also cause these symptoms (fatigue, confusion) when they flare up. If you are taking medication for that, esp. steroids, that can cause the "hyper" side effects as well. Make sure all of your medications & lab result info goes to all of your doctors, so that they can (hopefully) work together -- or at least not undo each other's efforts -- to treat YOU, not just one or two of your symptoms.

 

 

 

I do not take anything for my PsA as of right now it is just an aggravation. I mild pain and the psoriasis is only on my knees, hands and a small part on my scalp. Can the fatigue and confusion be bad if my psa is mild? Thanks

[JenneinCA]

 

 

The follow up will be after I finish my refills. I have three months left. I am not sure if I can stick it out. I keep thinking it will get better and take a while for the meds to kick in.

I put a tissue across my hand there was a little bit of a tremor. What does this mean?

 

 

Wait a second. How long have you been on this dose? My doc changed my thyroid medicine dose and I needed to redo the blood test after six weeks to check the dosage. He specifically did NOT give me more refills than that because he wanted to confirm the dose was correct.

 

If you have been on this dose for at least six weeks you need to get a new blood test and potentially a new prescription. I am totally loving the new higher dose of my meds I am finally warm! I expect to find out the new dose is fine, but I am getting it checked anyway.

 

 

[Flowing Brook]

Wait a second. How long have you been on this dose? My doc changed my thyroid medicine dose and I needed to redo the blood test after six weeks to check the dosage. He specifically did NOT give me more refills than that because he wanted to confirm the dose was correct.

 

If you have been on this dose for at least six weeks you need to get a new blood test and potentially a new prescription. I am totally loving the new higher dose of my meds I am finally warm! I expect to find out the new dose is fine, but I am getting it checked anyway.

 

 

I have been taking this right at a month. It is the first prescription I have ever taken in my life with the exception of antibiotics which has not been much.

[LMV]

I went to the dr. a while back because I was exhausted most of the time. He ran some blood tests. He told me that my thyroid was a little off and that could be causing my exhaustion. He put me on 150 mcg of levothyroxine. I went from being exhausted most of the time to being EXHAUSTED ALL Of the time.

It is not just a physical exhaustion but also a mental exhaustion. I think well I am too exhausted to do anything so maybe it is a good time to get some studying done. I study for a few minutes and have to quit because I am just too tired to even read. My body just feels tired it that makes sense. I have some kind of mental confusion going on lately.

I also either feel cold or like I am sitting next to a furnace. I also have psoriac arthritic if it makes any difference.

What is weird is there have been a few times this month that I felt ADD. I had more energy than I knew what to do with. I walked about 6 miles one day just because I was so jittery and had to do something.

 

I guess I am wondering is it normal to get even more tired at first after taking thyroid medicine? I have 2 refills left. I do not know if I should stick it out or go back to the dr. I am just wondering if anyone has any btdt.

 

How long have you been on the Levothyroxine? Has your doctor repeated your TSH, Free T4 since you have started the medicine? 150mcg is a reasonably high dose which doesn't mean it isn't necessarily appropriate (although often if doses like that will be needed physicians like to start with lower doses and work up to the higher dose as it induces less myocardial strain). Based on what you're reporting symptom wise it sounds like your thyroid replacement may be too high and you would benefit from a dose reduction. It is also possible that this represents some kind of thyroiditis. Sometimes thyroiditis (especially post partum) can be transient so thyroid replacement dosing may need to be adjusted carefully and even stopped in some cases. With Hashiomoto's Thyroiditis (did your doctor check antibody studies at original diagnosis? do you have a goiter?) patients generally end up with hypothyroidism but they can have transient hyperthyroidism due to thyroid hormone release from the damaged thyroid follicles.

 

I do not offer any of this as medical advice because I believe that medical advice should only come from physicians you have some kind of patient relationship with. However, I hope this will give you a place to start with your doctor. I would call them on Monday and arrange a follow up appointment. Good Luck!

[LMV]

 

 

I have been taking this right at a month. It is the first prescription I have ever taken in my life with the exception of antibiotics which has not been much.

 

With this information I would still give your doctor a call and schedule an earlier follow up appointment. Repeating lab work after 4 weeks on therapy is reasonable and enough time to have the medication achieved a steady state.

[Flowing Brook]

How long have you been on the Levothyroxine? Has your doctor repeated your TSH, Free T4 since you have started the medicine? 150mcg is a reasonably high dose which doesn't mean it isn't necessarily appropriate (although often if doses like that will be needed physicians like to start with lower doses and work up to the higher dose as it induces less myocardial strain). Based on what you're reporting symptom wise it sounds like your thyroid replacement may be too high and you would benefit from a dose reduction. It is also possible that this represents some kind of thyroiditis. Sometimes thyroiditis (especially post partum) can be transient so thyroid replacement dosing may need to be adjusted carefully and even stopped in some cases. With Hashiomoto's Thyroiditis (did your doctor check antibody studies at original diagnosis? do you have a goiter?) patients generally end up with hypothyroidism but they can have transient hyperthyroidism due to thyroid hormone release from the damaged thyroid follicles.

 

I do not offer any of this as medical advice because I believe that medical advice should only come from physicians you have some kind of patient relationship with. However, I hope this will give you a place to start with your doctor. I would call them on Monday and arrange a follow up appointment. Good Luck!

 

 

LMV thanks for the suggestions. As a midwife I understand that you can't give medical advice.

I have been taking this for right at a month. It is the first time I have ever taken thyroid medication. Or any medicine besides antibiotics.

How would my dr check for hashiomoto's? He did say PsA attacks the thyroid and pancreas.

I have been eating a lot of sugar lately would that have this kind of effect? Tia

[tabinfl]

I do not take anything for my PsA as of right now it is just an aggravation. I mild pain and the psoriasis is only on my knees, hands and a small part on my scalp. Can the fatigue and confusion be bad if my psa is mild? Thanks

 

 

It's possible to have mild symptoms on the outside, and more going on "invisibly". There are some specific, specialized tests for this family of diseases, not generally included in what a GP/family doc would do. They can uncover disease activity that doesn't produce the classic outward symptoms. Might be worth a check if the thyroid doesn't get sorted out.

 

My experience with thyroid meds was getting re-checked after 1 month, then 2, then 3, 6, 12 mos. Now every year or two, sooner if something doesn't feel right or after a dose change. Also ask about what testing you are getting done -- one of my docs (GP) just checks TSH (the primary indicator) as long as I'm on a stable dose, another (sppecialist) does the whole "panel" (2-3 other values as well) as a sort of backup check every time. I'm not sure that's necessary every time, it's just his routine since he deals with pts who have other illnesses as well and are more likely to have things go wacky.

[Flowing Brook]

It's possible to have mild symptoms on the outside, and more going on "invisibly". There are some specific, specialized tests for this family of diseases, not generally included in what a GP/family doc would do. They can uncover disease activity that doesn't produce the classic outward symptoms. Might be worth a check if the thyroid doesn't get sorted out.

 

My experience with thyroid meds was getting re-checked after 1 month, then 2, then 3, 6, 12 mos. Now every year or two, sooner if something doesn't feel right or after a dose change. Also ask about what testing you are getting done -- one of my docs (GP) just checks TSH (the primary indicator) as long as I'm on a stable dose, another (sppecialist) does the whole "panel" (2-3 other values as well) as a sort of backup check every time. I'm not sure that's necessary every time, it's just his routine since he deals with pts who have other illnesses as well and are more likely to have things go wacky.

 

 

 

Thanks my dr wanted to do some kind of test that would test for lupus, ra, and psa. I did not want to do it because I am having so few symptoms. Maybe I should go ahead and do it.

[LMV]

 

LMV thanks for the suggestions. As a midwife I understand that you can't give medical advice.

I have been taking this for right at a month. It is the first time I have ever taken thyroid medication. Or any medicine besides antibiotics.

How would my dr check for hashiomoto's? He did say PsA attacks the thyroid and pancreas.

I have been eating a lot of sugar lately would that have this kind of effect? Tia

 

 

You can do blood work for anti-thyroid peroxidase (anti-TPO) and anti thyroglobulin (anti-TG) antibodies although some (don't quote me I'm not an endocrinologist maybe 10%) of patients with Hashiomoto's may not have detectable antibody levels. With Hashiomoto's specifically patients do usually have goiters (growth in the thyroid area of neck) on exam and these can usually be better evaluated with ultrasound. You can also make the diagnosis based on histology from a needle aspirate sample from the goiter or nodules within the goiter. (Often this is done to exclude malignancy if there are a lot of nodules or if the goiter is very large or growing quickly.) Does this help?

[Plateau Mama]

You should be seeing an endocrinologist, most primaries have no clue how o treat thyroid issues. I have Graves' disease (overavtive thyroid). My Dr. started me on the lowest dose possible and rechecked (and adjusted) every 4-6 weeks. It took us 2 years to get my levels correct (for me). I say for me because there is a spot in the normal range that is your normal. "Normal" is a pretty big variance but I was definitely functioning at one end of normal and could not function at the other end. So once we figured out what my normal was my dr. Always aimed for that #. Once we got me leveled out I was rechecked every 3 months for awhile then every 6 until I went into remission after getting pg with my 2nd child. My primary Dr. now checks my levels once a year. If my levels ever go askew again I would head straight back to the Enocronologist.

[Flowing Brook]

You can do blood work for anti-thyroid peroxidase (anti-TPO) and anti thyroglobulin (anti-TG) antibodies although some (don't quote me I'm not an endocrinologist maybe 10%) of patients with Hashiomoto's may not have detectable antibody levels. With Hashiomoto's specifically patients do usually have goiters (growth in the thyroid area of neck) on exam and these can usually be better evaluated with ultrasound. You can also make the diagnosis based on histology from a needle aspirate sample from the goiter or nodules within the goiter. (Often this is done to exclude malignancy if there are a lot of nodules or if the goiter is very large or growing quickly.) Does this help?

 

 

 

it does help thanks. It is weird because all day I have been laying around because I have been too tired to do anything. During church today I just wanted to come home because I was so tired. Now that it is almost bedtime I am feeling jittery like I need to do something. I just took the dog for a walk and now I want to start cleaning the house. Does this sound strange?

[tabinfl]

it does help thanks. It is weird because all day I have been laying around because I have been too tired to do anything. During church today I just wanted to come home because I was so tired. Now that it is almost bedtime I am feeling jittery like I need to do something. I just took the dog for a walk and now I want to start cleaning the house. Does this sound strange?

 

You might want to ask your doc and/or pharmacist about how & when to take the medication. My thyroid replavement is supposed to be taken early morning, on an empty stomach. If you're on a higher dose & take it later in the day, what you're describing MIGHT fit as a side effect... or it could be something entirely unrelated.

 

Also, always ask about interactions with foods or vitamins/supplements -- grapefruit juice, for example, is a big no-no with many, many medications (boo, I <3 grapefruit!), yet OJ is said to help absorption if you're taking iron supplements. Common antibiotics can undo BC pills (I know a few "bonus babies" who came to be this way). You never know.

 

Just whacking at the low-hanging fruit (no pun intended) here based on my (limited) personal experience. I try to eliminate these sorts of things myself before looking for something else to be wrong. I hope you get it all figured out soon!

[mommymilkies]

Wow. I agree-your dosage is WAY too high to start with!!!! My dd and mother have non-working thyroids and they don't even take that high! Get thee to an endocrinologist ASAP!!!!

[Flowing Brook]

You might want to ask your doc and/or pharmacist about how & when to take the medication. My thyroid replavement is supposed to be taken early morning, on an empty stomach. If you're on a higher dose & take it later in the day, what you're describing MIGHT fit as a side effect... or it could be something entirely unrelated.

 

Also, always ask about interactions with foods or vitamins/supplements -- grapefruit juice, for example, is a big no-no with many, many medications (boo, I <3 grapefruit!), yet OJ is said to help absorption if you're taking iron supplements. Common antibiotics can undo BC pills (I know a few "bonus babies" who came to be this way). You never know.

 

Just whacking at the low-hanging fruit (no pun intended) here based on my (limited) personal experience. I try to eliminate these sorts of things myself before looking for something else to be wrong. I hope you get it all figured out soon!

 

 

 

I take it at night right before I go to bed. I heard that It absorbs better that way. As of right now I am not taking any supplements. I can't stand grapefruit or grapefruit juice so I am good there. I really would like to figure this out on my own so I don't have to go back.

I have to have surgery to remove a cholesteatoma soon and am trying to save my money for that.

[ebunny]

150 is a very high dose to begin treatment with. A doctor with some knowledge of thyroid disorders always starts with low dosage and a recheck every 4-6 weeks.

 

If the dosage is too high, it can cause a LOT of unpleasant symptoms (ask me how I know). Heart palpitations, jitteriness, diarrhoea, insomnia, bone loss....

 

I 10th the suggestion of going to an endocrinologist.

 

 

[LG Gone Wild]

 

The follow up will be after I finish my refills. I have three months left. I am not sure if I can stick it out. I keep thinking it will get better and take a while for the meds to kick in.

I put a tissue across my hand there was a little bit of a tremor. What does this mean?

 

 

tremor means too high (usually)

 

get to an endo

[Lawana]

 

 

 

I take it at night right before I go to bed. I heard that It absorbs better that way. As of right now I am not taking any supplements. I can't stand grapefruit or grapefruit juice so I am good there. I really would like to figure this out on my own so I don't have to go back.

I have to have surgery to remove a cholesteatoma soon and am trying to save my money for that.

I really think it is a false economy to attempt to save money by avoiding an appointment for this. There are serious consequences for being hyperthyroid, as one is if taking too much levothyroxine. And given your mix of symptoms, it may be more complex than just too high a dose.

 

That said, I have tinkered with dosage on my own by cutting pills into halves and quarters.

 

I strongly urge you to contact your provider and describe your symptoms.

[Plateau Mama]

 

 

 

I really would like to figure this out on my own so I don't have to go back.

I have to have surgery to remove a cholesteatoma soon and am trying to save my money for that.

 

I'm going to be blunt, this is not something you can figure out on your own. You must see a Dr. At a minimum get your blood levels rechecked. Taking too high of a dose will send your numbers way to the other spectrum, with a whole new set of problems. An endocrinologist will be the fastest way to get this figured out. I promise you, once you get the right dose you will feel so much better. I went from sleeping 14+ hours a day ( more on weekends) back to 8-9. Not only that but I slept better at night.

 

[tex-bex]

I know nothing about thyroid meds, but you are having autoimmune problems - it sounds like multiple ones, so I suggest you consider a major diet overhaul. This woman is a fantastic source for information: http://www.thepaleomom.com/autoimmunity/living-with-autoimmune-disease

 

Good luck! It sounds miserable!

[Flowing Brook]

I just wanted to thank everyone for their thoughts and suggestions. I got the final push I needed this morning to go back to the dr. When my arm broke out in a bad rash. So anyways thanks for all the ideas.

[Lawana]

I just wanted to thank everyone for their thoughts and suggestions. I got the final push I needed this morning to go back to the dr. When my arm broke out in a bad rash. So anyways thanks for all the ideas.

 

I am glad you are going in. Thanks for the update. And don't leave without having your levels checked!

[Plateau Mama]

I'mI'mI'm glad you are going in too. Check out Endocrineweb.com for info on symptoms etc. If I had to hazard a guess, the high dose he put you on has swung you the other way. (Keep in mind I don't know anything about the medication itself as I've never taken that one.) But some of the symptoms of being more overactive are tremors, itching/hives, fatigue etc. http://www.endocrineweb.com/conditions/hyperthyroidism/hyperthyroidism-symptoms

[Unicorn.]

Just checking in to see if your doc changed your meds, and how things are going for you. My doc is sending me to a new endo, as the last one was an idiot. :p

[Flowing Brook]

I started taking half a pill. The nervousness and extreme fatigue went away. I just recently went back for more blood work. My levels were although still not perfect better. The dr. just yesterday put me on 100 mcg. I am still exhausted.

My family thinks it is because I am doing too much. Here is my schedule this week.

Mon. worked 5 hr then 2 planting flowers

Tuesday 12 hr

Wed I drove for 8 hr straight

Thurs 5 hrs

Today 6 hrs and walked 2 miles

I do not think this is too much work.

I clean houses and I am 29

This is a pretty typical schedule for me.

Would the rest of you be exhausted if this was your schedule?

[Unicorn.]

Tues and Wed would have exhausted me. We drove our girls to camp last week (3 hours one way), and the next day felt like I'd been hit by a bus. But, I'm 46, so..... starting to feel old. At 29, that trip wouldn't have bothered me at all. I hope they figure out something to help you feel better!

[myfunnybunch]

That seems like a really high dose to start. You really should be working with an endocrinologist. My doctor phoned me on a Saturday to tell me that me that my thyroid hormone was very low and I needed to start taking thyroid meds now, and she only put me on 75 mcg to start and sent me to an endocrinologist right away. He's had me go in for blood test every 6-8 weeks and upped my levels gradually, and I am still not to 150. Your schedule doesn't sound too exhausting to me, with the exception of the all-day driving.

[countrygal]

WAY WAY WAY TOO high of a dose to start on. They did that to me on just 88 mcg and I went from feeling tired and foggy-headed to panic attacks in 2 weeks. Feels like being hit by a truck - so much more exhausted being overmedicated than the hypo - but impossible to sleep!! Exhaustion is a sign of overmedication. It's better to start at a lower dose that ends but being not enough and working up. Your suppose to go up 25mcg every 4-6 weeks. REQUEST an endo - I thought all facilities did automatic referral, but I guess not. If he won't get you one, find a dr. that will refer you! Make sure your getting your tsh scheduled every 6 weeks for several times and call in a couple days to find out your results if they don't call you! It's horrible getting adjusted, worse than actual hypo itself, imo. You'll feel better eventually, just get a good endocrinologist first :) Sorry you feel awful. Many have been there, all survive :)