Hi and thanks for the query,

The concern you express is a common phenomenon experienced by patients on thyroid drugs. It is however important to remark that you are absolutely right with the fact that some people might take some time to adapt to these drugs.

Success thyroid therapy is dependent on three main factors. The first is being adherent to treatment and not changing drugs without the consent of your doctor. secondly, especially for the initial management phase. treatment is adjusted based on periodic measurements and values of T4, TSH, TRH> depending on their values, the endocrinologist varies the dosage of drugs. The thyroid has direct effects on the metabolism generally in the body, and especially the heart with increased heart rates and when excessive palpitations. Excessive thyroid hormones could even lead hyperthyroidism induced heart failure. It becomes therefore compelling to do these follow up examinations and adhere to treatment.

I would strongly advice you consult your endocrinologist for a proper review and adaptation of therapy, and agreeing with you that it might take sometime for some patients to be very comfortable with anti thyroid drugs. You must not change or modify your treatment on your own, and serial testing of the other thyroid hormones is mandatory in control and guaranteeing therapeutic success.

Thanks as I hope it addresses your worries, Feel very free asking further questions, I would be very glad contributing to better your health.

Best regards,

Bain LE, MD.

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Hi and thanks for the query,

I perfectly understand how it could be like under such circumstances. However, I think an anti depressant would not be the solution. The most urgent issue now with respect to your treatment is having an appropriate management of the thyroid condition, which should produce long term benefits with considerable improvement in quality of life.

I honestly think you have to take the drugs slowly. I think I buy the idea of your cardiologist. This should be done as such for you to be able to take them, so your body get s used to the drugs, and you might increase the dosage gradually. It, to me actually makes perfect sense. If you feel really too bad at 125mg, it might difficult for you to take the drug regular, and might react to it drastically at some point.

I understand it could be real difficult, but YOU JUST HAVE TO TAKE THE DRUGS AT A DOSAGE THAT YOU CAN MANAGE, AT LEAST FOR THE START. You could increase the dosage gradually. Do not forget to monitor other thyroid parameters (TSH, T4, TRH) as you take the drug.

You might have to tell your endocrinologist once again you really cannot support that "huge dosage" for your system for a beginning. I honestly would not advice anti depressants at this point in time.

Thanks once again and hope this helps. Feel free asking further questions if need be.

Best regards,

Bain LE, MD.

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Hi and thanks for the query,

You cannot say you are a mess. Please, very far from that. It is understood anyone worried could easily forget and make mistakes. It s but normal to be worried, disturbed and sometimes forget when faced with particular non addressed health concerns.

I strongly suggest that planning the taking of the drugs requires the active participation and monitoring of a physician or your caring nurse attendant. I am afraid you shall need to plan this with your treating doctor. Please, you might need to take an appointment with him to discuss your health concerns with him. I think he should be able to listen to you and address these concerns. I am actually really very worried and disturbed with the fact that youhave some difficulties discussing your treatment plan with your doctor, which is to me very improper.

I suggest for now, you take the dose your body can support and book an appointment to XXXXXXX him to discuss about modifying your therapy and addressing your concerns. He has very good intentions for sure, but maybe doing it step wise so your system adapts gradually could be very helpful. He could even have, with his expertise, some given clues to reduce side effects from this medication. I strongly suggest patient - physician dialogue should be the main clue to the success of your treatment.

Continue with your other medications as prescribed as you arrange to see your doctor. I shall be very glad if you stop being this worried or thinking you are by any means, a mess please. You are not for sure.

Thanks once again and wishing you the best of health. do not hesitate asking any further questions if need be. take care.

Bain LE,MD.

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