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What Causes Trouble Standing Along With Dizziness And Muscle Weakness?
Question: Hi, I had Hashimotos in 2010 my TSH level has been at .22 a bit hyperthyroid for 6 months and I am taking 112 mg of synthroid. I feel brain fog, fatigue, weakness in my legs and cannot concentrate well, really bad for the past two days, worse than usual my doctor could not see me so I am writing to this website, what can be done so I feel better, I am not taking any other meds, looking into supplements now, like selenium, but my energy levels are really low, having trouble standing and walking, feeling dizzy and muscle weakness, brain fog. What else can be done to help me?
Brief Answer:
You have to decrease synthyroid dose
Detailed Answer:
Hi XXXXXX,
Welcome to HCM. I have gone through your question and understand your concerns.
Your TSH is low. In hashimoto's hypothyroidism we try to keep the TSH between 0.5 and 3.5. If I were your treating physician I would have decreased your thyroxine dose to 100 MCG per day.
Regarding your other symptoms, you have to get evaluated and find out the cause for these symptoms. The usual tests I would have done in a similar patient are serum 25 hydroxy vitamin D, B12, lipid profile, calcium, blood routine, blood sugar,etc. Vitamin supplements usually improve the symptoms.
Hope I have answered your questions. If you have any further questions I would be happy to help you.
Regards,
Dr Ajish TP
Consultant Endocrinologist
You have to decrease synthyroid dose
Detailed Answer:
Hi XXXXXX,
Welcome to HCM. I have gone through your question and understand your concerns.
Your TSH is low. In hashimoto's hypothyroidism we try to keep the TSH between 0.5 and 3.5. If I were your treating physician I would have decreased your thyroxine dose to 100 MCG per day.
Regarding your other symptoms, you have to get evaluated and find out the cause for these symptoms. The usual tests I would have done in a similar patient are serum 25 hydroxy vitamin D, B12, lipid profile, calcium, blood routine, blood sugar,etc. Vitamin supplements usually improve the symptoms.
Hope I have answered your questions. If you have any further questions I would be happy to help you.
Regards,
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Yogesh D
Is it better to be on armor thyroid replacement or synthroid, also is adding T3 to my therapy harmful?
Brief Answer:
Both are equally good
Detailed Answer:
Hi XXXXXX,
Welcome back.
Armor thyroid is natural thyroid and is as good as Synthyroid. What ever be the treatment you take, your thyroid function tests should be normal. There are studies comparing both and both drugs are found to be equally good in effects and side effects. You can choose either of these.
T3 is active form of thyroxine. The synthyroid is T4 and is converted naturally to T3 in body. T3 is really indicated in hypothyroid emergencies like myxedema coma - when sudden replacement is needed and active T3 is supplemented. T3/ T4 combinations if available are useful in routine thyroid hormone replacement. It is not harmful if thyroid function tests are within normal limits.
Regards
Dr Ajish TP
Both are equally good
Detailed Answer:
Hi XXXXXX,
Welcome back.
Armor thyroid is natural thyroid and is as good as Synthyroid. What ever be the treatment you take, your thyroid function tests should be normal. There are studies comparing both and both drugs are found to be equally good in effects and side effects. You can choose either of these.
T3 is active form of thyroxine. The synthyroid is T4 and is converted naturally to T3 in body. T3 is really indicated in hypothyroid emergencies like myxedema coma - when sudden replacement is needed and active T3 is supplemented. T3/ T4 combinations if available are useful in routine thyroid hormone replacement. It is not harmful if thyroid function tests are within normal limits.
Regards
Dr Ajish TP
Above answer was peer-reviewed by :
Dr. Yogesh D
Which test can I ask my doctor to run to check T3 and which other tests would be good to run to check why I feel so weak and fatigued. My vitamin d is ok, he ran a complete blood panel nothing came up except Tsh at .22
I feel very bad so do you think this is something they can treat in an emergency room?
I feel very bad so do you think this is something they can treat in an emergency room?
Brief Answer:
Serum T3 and free T3 can be done
Detailed Answer:
Ho XXXXXX,
Welcome back.
I understand your concerns.
1. Serum T3 and free T3 levels can be done. It should be in upper half of normal. If it is in upper half there won't be much improvement in supplying T3 as your body is converting enough T4 to T3.
2. In hypothyroidism there can be fatigue and tiredness even with adequate thyroxine replacement replacement. Since your vitamin D and harmoglobin are normal additional tests needed are serum vitamin B12, calcium, lipid profile. If all investigations are normal, regular exercise, frequent small feeds with more vegetables and fruits, etc can be tried.
Wishing you good health.
Regards
Dr Ajish TP
Serum T3 and free T3 can be done
Detailed Answer:
Ho XXXXXX,
Welcome back.
I understand your concerns.
1. Serum T3 and free T3 levels can be done. It should be in upper half of normal. If it is in upper half there won't be much improvement in supplying T3 as your body is converting enough T4 to T3.
2. In hypothyroidism there can be fatigue and tiredness even with adequate thyroxine replacement replacement. Since your vitamin D and harmoglobin are normal additional tests needed are serum vitamin B12, calcium, lipid profile. If all investigations are normal, regular exercise, frequent small feeds with more vegetables and fruits, etc can be tried.
Wishing you good health.
Regards
Dr Ajish TP
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi,
Can you tell me why Armour dedicated thyroid replacement would be more effective than synthetic synchroid?
Thank you
Can you tell me why Armour dedicated thyroid replacement would be more effective than synthetic synchroid?
Thank you
Brief Answer:
it contains both T4 and T3
Detailed Answer:
Hi XXXXXXX,
Welcome back.
May I make one thing clear before answering the question. Current guidelines (American or European) DO NOT suggest either desiccated thyroid hormone or T3/T4 combination in the routine management of hypothyroidism. This is because no study available has demonstrated superiority of these treatment over T4 (synthytoid).
So armour thyroid is just patient preference. The claim that armour is superior is because it contain both T4 and T3. Some people find it better when T3 is also present, obviously due to faster action.
Till there are definite benefits demonstrated from good studies which compare these agents we go by guidelines and treat hypothyroidism with T4 alone.
Wishing you good health.
Regards
Dr Ajish TP
it contains both T4 and T3
Detailed Answer:
Hi XXXXXXX,
Welcome back.
May I make one thing clear before answering the question. Current guidelines (American or European) DO NOT suggest either desiccated thyroid hormone or T3/T4 combination in the routine management of hypothyroidism. This is because no study available has demonstrated superiority of these treatment over T4 (synthytoid).
So armour thyroid is just patient preference. The claim that armour is superior is because it contain both T4 and T3. Some people find it better when T3 is also present, obviously due to faster action.
Till there are definite benefits demonstrated from good studies which compare these agents we go by guidelines and treat hypothyroidism with T4 alone.
Wishing you good health.
Regards
Dr Ajish TP
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Above answer was peer-reviewed by :
Dr. Raju A.T
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