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Have COPD. Quit smoking. Had done thyroid test. Looking for suggestion

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Internal Medicine Specialist
Practicing since : 2004
Answered : 364 Questions
My Mother had an onset of COPD in May 2012, she immediately quit smoking and the Pulmonologist is happy with her lungs at this stage. All is looking good. The hurdle is that her TSH is at 46 and I cannot get her to see an Endocrinologist. Her IM has just increased the meds and it is now down to 28, but she still feels good some days ,but very tired most days. I have read, and read about the thyroid. My thinking is that she needs the Endo as her Dr. and she also needs to know what the T3 and T4 counts are. Am I over thinking or is this on track?
Many thanks, Concerned Daughter
Posted Sat, 1 Dec 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Enrique Molina 1 hour later
You are on the right track. Her TSH is still abnormal despite the increase on her meds (levothyroxine i suppose). The goal is to bring down the TSH to a normal level (which varies depending on the lab but is around 5). There is no need to check the T3 and T4 at this time because she already has a diagnosis, and the medication (levothyroxine) is actually T4, that also gets converted onto T3, and these labs do not accurately reflect if there is enough medication on her system. It is helpful is some situations.
Keep in mind that her medication dose should not be changed earlier than every 6-8 weeks, since that is the approximate time it takes for the TSH to adjust.
Have your IM doctor or endocrinologist evaluate any other medications that your mother is on, to make sure there no drug interactions. An endocrinologist is always going to have a better input on these issues, as they deal with thyroid problems on a daily basis.
Hope that helped.
Above answer was peer-reviewed by
Follow-up: Have COPD. Quit smoking. Had done thyroid test. Looking for suggestion 1 hour later
Thank you for your quick reply. I have also been reading about the relationship between the smoking and thyroid problems. Would it be possible that since she quit smoking her body took a shock to the system and the thyroid is being affected? She has smoked pretty heavily for yearsssss. But non since May 25, 2012. Last cig was the day that she entered hospital for the onset of COPD, and as I mentioned she is doing great in that regard. Just curious if there is a connection. I'm having her try to find a good Endo. Her IM from years and years of service seems so sweet, but not to be listening as much as I would like. But I am the daughter... :) Just trying to watch you for a MOM~!!! She's St. XXXXXXX MO, I'm in XXXXXXX Tx. Just trying to help from afar!! Thanks for your assistance!!!
Answered by Dr. Enrique Molina 1 hour later
Hi again. There are studies suggesting a link between smoking and thyroid disorders. It has been associated with both hyper and hypothyroidism, however results are controversial. In your mom's case it could be playing a role but i wouldn't bkame the thyroid discontrol just on that. Sometimes tobacco cessation can make somebody gain weight and therefore require more of certain medications to achieve the same effect prior to the weight change, does it make sense? I agree that an endocrinologist will have the best knowledge to follow up your mother.
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