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Diagnosed With Hypothyroidism. Using Nature Throid. Suffer From Headache. Help?

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Posted on Sun, 18 Aug 2013
Question: Dear Doctor,

My female friend has been diagnosed with Hypothyroidism type 2. To treat this, she has been advised by her doctor to take NDT (natural desiccated thyroid) together with adrenal gland tablets. She has there for been using Nature Throid for a while now and she has reached the dose where she is using 1,5 grain which equals 56mcg of T4 and 13,5mcg T4. The pills also contain 17mg of calcium per 1 grain. This dose is taken once a day in the morning.

The pills at this dose don't make any difference to her hypothyroidism symptoms. When she tries to raise the dose by 1/4 grain, she suffers from head ache. She has been on 1,5 grain for at least a year now.

Please give me your take on this. Does she need to raise the dose and in that case, how can this be done without sufferfing from head ache? Could the dose be "ok" but something else be interfering with the treatment?

Regards
doctor
Answered by Dr. Rahul Tawde (31 hours later)
Hi,
Thanks for writing in. The most important thing in your friend's case is to determine if the TSH is in normal range. The goal of treatment of hypothyroidism is to keep thyroid hormone levels and TSH in normal range. Dose which maintains TSH in normal range has to be continued in long term. If her TSH is in normal range then there is no need to increase the dose. Not all her symptoms can be attributed to hypothyroidism and itf common for may people to complain of persistent symptoms even after TSH has got down to normal. In such cases nothing much can be achieved by trying to increase the thyroxine dosage. Instead she should try taking multivitamins, calcium, vitamins, omega 3 fatty acid supplementation to resolve the residual symptoms.
So the bottom line is if the thyroid profile is normal or not. if it is then we cant attribute them wholly and solely to hypothyroidism. After all these symptoms are non specific and patients with hypothyroidism will also have such complaints.

I hope you understand

Shivaprasad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rahul Tawde (4 days later)
Hi Doctor,

Thank you for you valuable answer.

Could you please make some clarification about the vitamines part. If hormones and TSH is in normal range (but patient is still complaining of symptoms possibly related to hypothyroidism) why would one start taking vitamines? Are you saying that the "thyroid treatment" needs to be complemented with vitamines?

Regards
doctor
Answered by Dr. Rahul Tawde (7 hours later)
Basically, for hypothyroidism all that can be done is replace thyroxine and keep thyroid function tests in normal range. Nothing else is available. Symptoms which persist after thyroid function test have come to normal are probably unrelated to hypothyroidism. Symptoms of hypothyroidism are non specific and can be seen in patients without hypothyroidism. In many hypothyroid patients, taking B complex supplementation helps to get rid of many symptoms that have not improved with thyroxine. So take B complex tablets along with calcium and vitamin D.

Hope this helps
Shivaprasad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rahul Tawde (42 hours later)
Hi

Thank you for the clarification.

Could you please let me know what dose you recommend for the B complex, calcium and vitamin D?

Also, what more actions would you recommend for hypo patients that have symptoms that have not improved with thyroxine?

Regards
doctor
Answered by Dr. Rahul Tawde (4 hours later)
I recommend 500 to 1000mg of Calcium and 1000 IU of vitamin D per day. There is no dose as such for B complex because they contain multiple components - take at least one tablet a day. Omega 3 fatty acid is one more thing I recommend for patients with hypothyroidism who don't improve on thyroxine. Apart from that a healthy diet XXXXXXX in greenies and fresh fruits, at least 2-3L/day water intake daily and regular physical activity.
Hope this helps,
Shivaprasad
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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Diagnosed With Hypothyroidism. Using Nature Throid. Suffer From Headache. Help?

Hi,
Thanks for writing in. The most important thing in your friend's case is to determine if the TSH is in normal range. The goal of treatment of hypothyroidism is to keep thyroid hormone levels and TSH in normal range. Dose which maintains TSH in normal range has to be continued in long term. If her TSH is in normal range then there is no need to increase the dose. Not all her symptoms can be attributed to hypothyroidism and itf common for may people to complain of persistent symptoms even after TSH has got down to normal. In such cases nothing much can be achieved by trying to increase the thyroxine dosage. Instead she should try taking multivitamins, calcium, vitamins, omega 3 fatty acid supplementation to resolve the residual symptoms.
So the bottom line is if the thyroid profile is normal or not. if it is then we cant attribute them wholly and solely to hypothyroidism. After all these symptoms are non specific and patients with hypothyroidism will also have such complaints.

I hope you understand

Shivaprasad