Hypothyroidism Support Group
Hypothyroidism is the disease state caused by insufficient production of thyrohormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. Advanced hypothyroidism may cause severe complications, the most serious one of which is...
Hi everyone,
I have lots of issues, so I'll try to keep this straight and to the point. I have RA, Lupus and Sjogren's. Last December my Rheumatologist tested me for Anti-TPO (over 2500) and TgAbs (18). He said I had Hashimoto's, sent me to a surgeon because the nodules I've had for years grew quick and large. One was 6cm. I had no treatment for the Hashi's. Instead I had a Total Thyroidectomy in April. They also found papillary carcinoma, but it was so small, no RAI treatment.
The surgeon started me on 100mcg Syntroid right after surgery.
My labs at one week:
TSH 12.9
T3 Free 275
he upped me to 125mcg.
My labs at 7 weeks:
TSH 9.7
T3 Free 284
he just upped me to 150mcg. last week and won't go for bloodwork for another 5 weeks.
Don't know if my symptoms are because I'm still going through the process of my body getting opimized or from my other autoimmune diseases and the failing/success of their drug treatment. Currently on Arava for RA and Cellcept for Lupus.
My syptoms are:
Lots of joint and muscular pain. Extreme tiredness. Brain fog. These are the things that bother me the most.And they are also symptoms of the AI problems.
Any thoughts would be greatly appreciated. Oh, and by the way I also am seeing an ENDO. He agrees with how the surgeon is handling the med process.
I have lots of issues, so I'll try to keep this straight and to the point. I have RA, Lupus and Sjogren's. Last December my Rheumatologist tested me for Anti-TPO (over 2500) and TgAbs (18). He said I had Hashimoto's, sent me to a surgeon because the nodules I've had for years grew quick and large. One was 6cm. I had no treatment for the Hashi's. Instead I had a Total Thyroidectomy in April. They also found papillary carcinoma, but it was so small, no RAI treatment.
The surgeon started me on 100mcg Syntroid right after surgery.
My labs at one week:
TSH 12.9
T3 Free 275
he upped me to 125mcg.
My labs at 7 weeks:
TSH 9.7
T3 Free 284
he just upped me to 150mcg. last week and won't go for bloodwork for another 5 weeks.
Don't know if my symptoms are because I'm still going through the process of my body getting opimized or from my other autoimmune diseases and the failing/success of their drug treatment. Currently on Arava for RA and Cellcept for Lupus.
My syptoms are:
Lots of joint and muscular pain. Extreme tiredness. Brain fog. These are the things that bother me the most.And they are also symptoms of the AI problems.
Any thoughts would be greatly appreciated. Oh, and by the way I also am seeing an ENDO. He agrees with how the surgeon is handling the med process.
100mcg is a common post-surgery starting dose.
Your symptoms indicate that your thyroid hormone levels are too low for your body's needs.
Now, Synthroid is a T4 med. T4 is our storage hormone and gets converted into T3, the active hormone.
I'm glad your doctor is watching your FreeT3 level because that is a measurement of T3 that is available for your body's use.
You can see that your dose increase to 125mcg didn't do much for your FreeT3 level.
This indicates that your body is having trouble converting the T4 in your Synthroid into T3.
Since 20% of T3 is produced in the thyroid, the fact that you no longer have a thyroid could be a contributing factor.
It's appropriate for your doctor to also be checking your FreeT4 level as well. This measures how much T4 your body has for use.
Ideally, your FreeT4 level will be in the upper half of the range and more likely closer to the high end of the range.
So, if you can get a FreeT4 level done and find that it's adequate, it would be appropriate to discuss with your doctor just how low your FreeT3 level is.....and ask him/her to start you on a T3 med such as Cytomel.
Both levels need to be optimized if we are to be free of thyroid symptoms.
Thanks for confirming what I suspected was behind my symptoms. Your explanation was a lot simpler to understand than what I've read elsewhere. It's good to hear from someone who has first hand experience. I just wish there was a quicker way to get the FreeT3 and FreeT4 levels to an optimum level. The surgery was a piece of cake compared to this.
I will definitely mention the low FreeT3 and addition of Cytomel to my surgeon. His nurse already mentioned that I must be having a hard time converting. Are there any foods I need to avoid when I have my breakfast an hour after the Synthroid? Somewhere I read that coffee was bad. Is this true?
Post-surgery patients have a few advantages. Firstly, they are able to start a much higher dose since the thought is they had adequate thyroid function before surgery.
Secondly, antibodies usually aren't messing with thyroid levels.
However, the treating doctor needs to run the right labs every 6 wks. and adjust the dose accordingly.
For those of us with autoimmune thyroid disease, the meds titration process can require easily 12 months or slightly longer.
Hopefully, you can achieve wellness much, much sooner.
The only true dietary restrictions are to avoid overconsumption of soy since soy wreaks havoc with thyroid hormone metabolism. The same thing applies to dietary iodine (iodized salt, that which is in shellfish and fast/processed foods). As with everything in life, moderation is key.
Coffee (caffeine in general) is fine as long as you don't take it along with your Synthroid since it negatively affects absorption.
Bests of luck to you moving forward!