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Can the intake of Synthroid cause hyperthyroidism and effect the eyesight?

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Posted on Mon, 25 May 2015
Question: Ihave a TSI level of 731 15 years after a thyroid ablation that completely destroyed my thyroid function. I alternate between 137 and 150 mcg of Synthroid a day.It seems that the medicine I'm taking is causing hyperthyroidism which is the disease it is supposed to manage. I am very worried about my eyesight. What can be done to help me?
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Answered by Dr. Binu Parameswaran Pillai (2 hours later)
Brief Answer:
Could you attach the report please

Detailed Answer:
Good day,
Noted yourconcern. If you have had a succesful thyroid ablation with radio iodine, there is no thyroid gland left. After the ablatio, you develop hypothyroidism as the gland is destroyed and can not produce anymore hormone. To treat hypothyroidism, you are given synthroid for life. If the dose of synthroid is in excess, it can cause hyperthyroidism. May i know your weght and height please?

What did your latest Thyroid blood work show? Could you attach the report if possible. The thyroid stimulating immunoglobulin can remain elevated for years even after radio iodine treatment and when you have no thyroid gland left, it can not harm you.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (11 hours later)
The ablation was done 15 years. I now have theTSI level of 731. Two years ago I was diagnosed with Glaucoma. My height is 5' 5". My weight is 145 lbs. My bloodwork as of 5/01/15 shows:
T3 Free 2.2
T4 Free 1.26
TSH 1.295

I have read a number of articles on this issue and understand that no one has come up with an effective non-harmful treatment for Graves. In some cases seleenium has been helpful to some extent. My concern is that no other thyroid medications have been tried eg Armour etc. to see if the TSImight be reduced. Also dietary etc. measures that might assist in the reduction of the TSI. Hyperthyroid is viewed as a cured disease and little attention seems to be paid to problematic cases. PCan you offer some suggestions that might be helpful as guidance in this matter? I started this upward move from125mcg because of chronic serious fatigue but the higher doses have not helped.

doctor
Answered by Dr. Binu Parameswaran Pillai (54 minutes later)
Brief Answer:
Selenium. Avoid smoking

Detailed Answer:
Please do not bother about elevated thyroid stimulating immunoglobulin. In your case, it has not causes Grave's ophthalmopathy. So not to worry.

Your thyroid function tests are looking fantastic on current regimen of Synthroid.
So there is no need to change the current dose. You weigh around 66 kilos. So actual requirement is 112 mcg Synthroid a day. But for some reason, you are requiring a higher dose. As long as your TSH is staying in normal range, please stick to current dose . Please be aware that, synthroid dose/Armour will not influence the levels of TSI.

In some studies, Selenium in a dose of 200 mcg( microgram) a day was found to be helpful in reducing thyroid auto immunity. So there is no harm trying it. It may be of use to reduce TSI. Most endocrinologists use it in mild cases of Grave's ophthalmopathy. There is no great evidence though.

If you smoke or are exposed to cigarette smoke, please avoid it as it is known to worsen thyroid auto immunity. Eat a diet rich in iodine.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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Can the intake of Synthroid cause hyperthyroidism and effect the eyesight?

Brief Answer: Could you attach the report please Detailed Answer: Good day, Noted yourconcern. If you have had a succesful thyroid ablation with radio iodine, there is no thyroid gland left. After the ablatio, you develop hypothyroidism as the gland is destroyed and can not produce anymore hormone. To treat hypothyroidism, you are given synthroid for life. If the dose of synthroid is in excess, it can cause hyperthyroidism. May i know your weght and height please? What did your latest Thyroid blood work show? Could you attach the report if possible. The thyroid stimulating immunoglobulin can remain elevated for years even after radio iodine treatment and when you have no thyroid gland left, it can not harm you. Regards Binu