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Treatment for hashimoto thyroid - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Thyroid Problem and Hormonal Problems
Answered by

General & Family Physician
Practicing since : 2009
Answered : 676 Questions
User :   Hi I have no thyroid gland at all due to Hashimotos thyroiditis. My doctor has me on 175 mcg of levothyroxine, but I still have symptoms of hypothyroidism, especially the weight gain, fatigue, excessive appetite, and sleepiness even after sleeping 10 hours a night. It is also causing me to feel depressed. I am 58 year old female. Now my doctor wants to lower the dosage to 150mcg saying my labs show hyperthyroid. How can that be with these symptoms? I understand how the thyroid works with the gland present, but without a thyroid gland, how does the T4 stay constant in the blood without the correct dosage?
Doctor :   Hi,
Doctor :   Let me read your query for few minutes to be able to have a good discussion here.
Doctor :   may i know the recent thyroid test reports ?
User :   I'm not sure but I think they indicated a level of .225 Isnt that on the low side of normal?
Doctor :   Is it Tsh you are mentioning about ?
User :   Yes sir. The TSH is the only test my doctor does. Im thinking the TSH will always be high in the absence of the thyroid gland because the hypothalmus and pituitary have no thyroid gland to signal to give out thyroxine or take it up. Am I understanding this correctly?
Doctor :   yes, you are right
Doctor :   theTsh may help to know whether the person is hyper or hypo indirectly , but the symptomatic status can be well determined by T3 and T4 levels
User :   So then why would he lower the thyroxine dosage based only on T4? Since T4 converts to T3, wouldn't it be safe to say I dont have enough thryroxine at the current 175mcg dosage?
Doctor :   Has he done the T3 and T4 levels done before getting the dose down ?
User :   No He only does Tsh every time. Ive seen him over and over for the same symptoms. He previously had me on Armours thyroxine for 3 months but the dosage has too large increments, and it kept my BP high, dizzy spells, and sleepless, so we have switched to Unithroid. For some reason the brand name Synthroid is not effective for me at all.
Doctor :   The brands do not influence the symptoms , a good dosing schedule is very important
User :   ok. So how does the thyroxine actually work in the blood without the thyroid gland?
Doctor :   The external thyroxin is similar to T4 which has to be converted to T3
User :   yes. thank you.
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