<p>Levothyroxine works well for me, but strange as this sounds…I can always tell when I need my dose adjusted because the skin on my elbows gets extremely rough. </p>
<p>Both my mom and I have been told to take the meds first thing in the morning and then wait at least 2 hours before any juice, food or other vitamins.</p>
<p>I never realized how complicated an issue this is. I was hoping once I saw my endo he would give me medication and I would feel better and my blood count would regulate. I too have been feeling very tired and have a low body temperature. I didn’t think anything of it until I went for a physical and the doctor said that my thyroid felt swollen. Then came all the tests, bloodwork, sonogram and biopsy.</p>
<p>Someone mentioned their hypothyroid is caused by autoimmune. Mine is too. I was under the impression, this was the cause of all hypothyroid.</p>
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<p>The vast majority of cases are autoimmune (Hashimoto’s). But, you can also have malnutrition/medicine/injury induced hypothyroidism, or, even more rarely, a pituitary problem (more broadly called secondary hypothyroidism). My doctors think I have the rare form, although I still haven’t had an MRI done of my pituitary too see if I have any kind of tumors that would be causing the problem, but my tests point in that direction.</p>
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<p>This is what they told my mom when she took that pill. Turns out that you can be radioactive for up to a year. Turns out that my dad, who had never had thyroid problems, became hypothyroid within a year after mom took that pill.</p>
<p>Kajon -</p>
<p>That is very interesting about the rough elbow skin. I get that, too, but never connected it to hypothyroid. I always assumed it was incipient psoriasis, which my father had. I also generally only get it on my left elbow and not the right. I accidentally skipped a couple of doses earlier this week and my elbow got rough, now I am back on track, it is getting smoother.</p>
<p>As for autoimmune connections, I don’t have Hashimoto’s but I do have rheumatoid arthritis, which is also autoimmune in nature.</p>
<p>When I see the endo, I am going to ask about the Armour and Cytomel.</p>
<p>Ditto on the elbow skin. My right elbow gets so chapped and painful that sometimes I have to wear a bandage on it to keep it from touching surfaces. And I’m left-handed. Never knew that was a symptom of hypothyroidism.</p>
<p>I’m sitting here this morning researching symptoms of hypothyroid and am beginning to realize a lot of what has been going on with me may be attributed to that:</p>
<p>severely dry eyes
trouble concentrating
brain fog
hair loss
trouble losing weight
low energy</p>
<p>The list goes on but you would think for someone who has been on T4 for 12 years, these won’t be occurring. Something is definitely going on. I had never even heard of Cytomel until this thread. Thanks, everyone, this has been most helpful. We’ll see what my doctor says tomorrow. I plan to make that the sole focus of my regularly scheduled appointment.</p>
<p>My endo has finetuned my dosage to the point where I was taking 175 mcg four times a week and 150 three times a week – and she changed it to 175 three times a week and 150 four times. Now, that’s finetuning!!</p>
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<p>I hope that you get more from your doctor than I can. Engaging my doc in conversation is about as fruitful as trying to have a discussion with a teenage boy. Mono-syllabic at best. I couldn’t even figure out why I even had an appointment. He had prescribed the thyroid meds two weeks ago based on regularly scheduled blood work. I picked up the prescription from the nurse practicioner when I stopped by to get a copy of the blood work. They told me the doctor wanted to schedule an appointment, but I got zero information from him. It was a complete waste of time.</p>
<p>*“So, are there any signs I should watch out for as the meds kick in?”</p>
<p>“No, not really…”</p>
<p>"I bet you don’t see many patients who have lost 84 pounds while hypothyroid. I guess I “should watch my weight closely so that I don’t start losing like crazy on the thyroid medication?”</p>
<p>“[Monosyllabic grunt]”</p>
<p>“So, it looks like my TSH readings were pretty high right?”</p>
<p>“I’ve seen a lot higher. I’ve seen patients at 1000…”*</p>
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<p>I’m more convinced than ever that you have to do your own research and take control of managing your own health care. I think my doctor is responding to my blood tests in an appropriate way and I guess that’s all I can really ask. It seems that the focus is on filling in the boxes on the forms. They spent several minutes asking mandatory “government” questions about my primary language and ethnicity, but provided essentially zero information about what I should expect as I start this medication. I would never have known not to take the meds with my morning coffee.</p>
<p>I am seeing quite a few similarities between doctors and guidance counselors! :p</p>
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<p>Apparently this is the M.O. for most endocrinologists…very nerdy types that don’t have much personality and don’t communicate as freely/openly as we might like.</p>
<p>Oh my gosh, No!! My endo is wonderful!!! When I improved my bone density scores (she also monitors and treats my osteoporosis), she was the best cheerleader I could have asked for: “This is fantastic! You are doing so well!! You are the poster child for lifting weights to improve your bones! Keep it up!! This is awesome!!!”</p>
<p>It was a great motivator. I couldn’t have asked for anything more.</p>
<p>Also, remember that endos treat a heck of a lot of diabetics, many of whom don’t manage their disease very well. Having energized, compliant patients is probably a thrill for them.</p>
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I take the same dosages. When I was in hospital last year for something unrelated, the nurses just told me to handle it myself because their recordkeeping couldn’t handle different dosages every day.</p>
<p>My elbows don’t get chapped when my dosage is off, my toe nails all fall out.</p>
<p>The endo I was seeing was horrible and I quit and returned to my primary care provider. I don’t care if she might not be as qualified. I got to detest that endo. He was just obsessed with getting me on statins as my bad cholesterol is borderline (but good chol. is excellent). The last time I had blood work done for my appt. with him, he FORGOT to check the box to test for the thyroid issues, only checked for chol. Terrible personality and full of himself. I was so mad about him forgetting to check my blood for the thyroid issues, as that was what I was seeing him for!</p>
<p>Why is it so easy to gain weight and hard to lose it when you are hypothyroid?</p>
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<p>You just answered your own question. </p>
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<p>Think of each live cell in your body as a sort of tiny little furnace. Your thyroid system is the thermostat. If the thermostat is set low (hypothyroid) not much fuel is getting burned, so the body stores the unused fuel in the form of fat.</p>
<p>Yep. Thyroid regulates basal metabolic rate – the amount of energy the cells of your body burn 24/7. Low thyroid = low basal metabolic rate, burning fewer calories. In addition, thyroid is one of several hormones (insulin being a biggie) that regulate how much of the incoming calories are stored as fat.</p>
<p>Naturally skinny people have fast metabolisms that burn a lot of calories and bodies that tend to burn energy instead of storing it. Naturally chubby people have slow metabolisms and hormonal balances that favor fat storage rather than burning energy. Just all around revving slower.</p>
<p>Over active thyroid or an excessive dose of thyroid supplement will tend to make you edgy, jumpy, rev’d up, and losing weight.</p>
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<p>There is a school of thought regarding weight issues that the amount we eat is determined by hormonal balance and metabolism. In other words, we don’t get fat because we eat too much, but rather our hormonal balance makes us store fat and requires us to eat too much. It’s easy to say that somebody should “just exercise more”, but if they are hypothyroid, their metabolism and energy levels may not let them exercise. Dr. Robert Lustig did some pioneering research with kids who got obese following hormonal side effects of brain tumor surgery. He gave them a drug that changed their hormonal balance (reducing insulin secretion) and they spontaneously started eating significantly fewer carbohydrates and became active in sports – without being told to. He duplicated the results in a group of obese adults.</p>
<p>My PCP won’t even discuss the idea of hypothyroidism with me. She merely tells me my levels are normal and that I’m fine. I tried to ask about the possibility of sub-clinical hypothyroidism and whether or not she had had my TSH, as well as T4 and T3 levels tested, and she dismissed my questions out-of-hand. She pretty much expressed the belief that thyroid issues are non-existent if one’s TSH levels are within normal limits. I’ll admit I don’t know a lot about hypothyroidism, and certainly don’t know what it means to be “sub-clinical” in this category. Does it mean that, although one’s TSH levels are “normal”, one might still be suffering from hypothyroidism? I’ve googled a few sites and read the symptoms lists, and I exemplify quite a few of them. I’m diabetic, also. I have a hugh vitamin D deficiency (true of over 80 percent of people, according to my doctor). Does an elevated ANA (320) indicate the possibility that one might have an autoimmune process going? So many questions…</p>
<p>Elevated ANA absolutely indicates an autoimmune process going on. Get thee to a rheumatologist; they specialize in those diseases. You might not be hypothyroid, subclinical or not; but you might have something else going on.</p>
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<p>That’s what a lot of PCPs believe. I don’t have the technical knowledge to refute that but I do know that not every physician subscribes to that theory. Some believe that you need to look at TSH, T4 and T3 to get a true picture.</p>
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A lot of diabetics see endocrinologists, who also treat thyroid issues. That might be the way to get some of your questions answered. My hypothyroidism was initially diagnosed by a reproductive endocrinologist - not my PCP. After we finished with infertility treatment my previous PCP just kept subscribing the thyroid medication. After he died and I had to switch to a new PCP, the new one did the same thing. At the time, I asked the reproductive endo if I could continue to see him for the thyroid issues and he said he only treated infertility problems. I’m beginning to think I made a big mistake by not asking for a referral to another endocrinologist. In my town, endocrinologists don’t take self-referrals.</p>
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<p>It is really tricky to get prescriptions filled when you are on an x times a week basis. I had such a bizarre conversation with the pharmacy as they tried to explain to me how 28 pills was a one month supply. (BTW, I lost the argument.)</p>