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Suggest Treatment For Increased Weight Gain And Severe Muscle Spasms
Question: My doctor wants to decrease my thyroid medication because she says I am slightly hyperthyroid now. I lost my thyroid to cancer in 1994. I was on .2 mcg for years and felt great. Then the docs started messing with it and lowering it because of new standards. They lowered it way down and I gained 50 plus pounds and had terrible muscle spasms. I finally got them to raise it and I am now on .175 and feel very good. I have no muscle spasms any long. I have lost the 50 pounds, but not a pound more. I still could easily lose 40 pounds and be considered a normal weight. I also have neuroendocrine/carcinoid cancer for the past eight years, so my metabolism doesn't function properly anyway. How do I get the doctors to leave my dosage along. I am very diligent about checking myself for signs of heart palpitations, fluttering, sweating, or other symptoms associated with hyperthyroid. But other than looking at the numbers on the page, they have no other basis to lower my meds.
Brief Answer:
Thyroid
Detailed Answer:
Sorry to learn about your challenges with thyroid dosing.
The fact of the matter is that TSH and Free T4 need to be kept in the target range. Anything outside of this is abnormal and harmful. So if your endocrinologist is aiming to keep your thyroid numbers in the goal range then he or she is doing a good service to you.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day
Thyroid
Detailed Answer:
Sorry to learn about your challenges with thyroid dosing.
The fact of the matter is that TSH and Free T4 need to be kept in the target range. Anything outside of this is abnormal and harmful. So if your endocrinologist is aiming to keep your thyroid numbers in the goal range then he or she is doing a good service to you.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just had a full battery of those blood tests last week, and all is within the normal range, except for Vit. D which is extremely low at 20. I am supplementing with vitamin D, 4000 units a day. Thyroid is not out of range, but it is on the high side. I had metastatic disease when I was operated on in '94, cancer having spread to five lymph nodes and two parathyroids, so they have wanted to keep TSH suppressed. Still waiting on results of neuroendocrine blood tests that have to be sent to a special lab in California. I have distant metastases with secondary tumor found on skin and approximately 6 tumors in my liver. Liver tumors as yet too small to biopsy. With all this going on, what are the real dangers in being slightly elevated with the thyroid?
T3, Free 2.71 2.57-4.43 pg/mL
Free T4 (Thyroxine) 1.71 0.80-1.80 ng/dL
TSH 0.02 (L) 0.27-4.20 µIU/mL
T3, Free 2.71 2.57-4.43 pg/mL
Free T4 (Thyroxine) 1.71 0.80-1.80 ng/dL
TSH 0.02 (L) 0.27-4.20 µIU/mL
Brief Answer:
Follow up
Detailed Answer:
In this case the TSH must be kept suppressed with slightly higher than usual doses. You need to be under the care of an endocrinologist who is experienced in management of patients with thyroid cancer
Follow up
Detailed Answer:
In this case the TSH must be kept suppressed with slightly higher than usual doses. You need to be under the care of an endocrinologist who is experienced in management of patients with thyroid cancer
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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