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TSH test showed 10. Prescribed LevoT. Have constipation and feel fatigue. Continue tablets? What to do?

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Recently had a TSH test and it was 10 in a range of 3-5; the PA and then the doctor immediately tried to put me on LevoT. I said no that I would not take a 'for lifetime drug' on one test. The only signs I may have are constipation, can't lose weight and been fatigued. No hair loss, my nails are beautiful, my skin is dry but always so. I have over the years had a low body temperature of 96 or 97 - always; yet, in the last few years my body is "hot and clammy". I thought it was female hormones because I came off Premarin after 20 years one year ago this XXXXXXX We waited four weeks and I added seaweed, kelp pills and going back to a protein diet, walking twice a day. This time I asked of free T4 and T3 with TSH. FT4 is 0.80 is a range of 0.70-1.80 and FT3 is 2.83 in a range of 2.30 - 4.20 and the TSH was 12.7.
I have numerous allergies including a severe reaction to any kind of soy. Needless to say, I eat natural food and cook a lot because soy is in everything. I have food allergies, severe allergy to bee, wasp, mosquito, ant etc. bites. Severe allergy to most anti-biotics, have slight asthma for which I take no medication. I take two antihistamines a day, carry a E-Pen, take HBP pills w/ the hydrochlorothiazide, Vit D, Omega 3's, take Omeprazole since Feb for GERD pain, and Methocarbamol for rigid and spastic muscles in my back. My liver enzymes have also been elevated since last Feb. I am very protective of myself with all the allergies and do NOT add anything into my life without great caution. I am the one who gets the hives, breathing difficulties, watery nose and eyes, and a choking sensation. So, I am very careful. What bothers me is the "here is high a TSH result – take this pill and come in 8 wks for a lab test. Oh, it is PA by the way ... I am in a large medical plan system in CO. Thanks for any thoughts you might have on this ......
Posted Sat, 3 Aug 2013 in General Health
Answered by Dr. Jorge Brenes-Salazar 21 minutes later
Dear patient

Your tests indeed show low thyroid function; the benefits of thyroid replacement will not only come from improvement of your physical symptoms (actually very important because they are classic) including fatigue (95 percent of patients report profound fatigue), cold intolerance, constipation and weight gain.

There are other less tangible benefits; but in my opinion as important: Patients with TSH of 10 or greater are at increased risk of heart complications on the long term, cholesterol panel is usually abnormal in patients like that and supplementation improves lipid profile

However at the end of the day, you are the decision maker of your health, and our job as doctors is as teachers, counselors and coordinators of care

Hope that helps, Let me know if you need clarification.

God speed

Dr Brenes-Salazar MD
Mayo Clinic MN
Above answer was peer-reviewed by
Follow-up: TSH test showed 10. Prescribed LevoT. Have constipation and feel fatigue. Continue tablets? What to do? 1 hour later
I do not have a cold intolerance. I turn the AC on full blast, have four fans and sleep on ice packs to cool down my body at night to sleep. I have a sweat-clamminess and the place where I lay will melt ice packs; yet, my temperature is at its highest 97.4. The doc has subscriped 50 mg of the LevoT and an 8wk period before the first lab test. With my allergies, I think I need to be more closely monitored. Also, with my auto immune reactions, would I be better under the care of an endocrinologist? I have a concern with the lack of attention to my allergies - I have been hospitalized three times in the past 15 yrs for severe reactions.
Answered by Dr. Jorge Brenes-Salazar 2 hours later

Thanks for clarifying.

I agree with you that closer monitoring will be benefitial to see how your body is adjusting to the medication; this could be achieved with a 1 or 2 week post visit telephone call; I agree that the soonest that you should check the Tsh before dose adjustments is 6 weeks; most family practitioners and internists should be able to manage uncomplicated hypothyroidism, but then if you have ongoing issues after starting replacement a subspecialty consult would be in order

Yours truly,
Above answer was peer-reviewed by
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