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Suggest treatment for hashimotos thyroiditis

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Posted on Mon, 8 Dec 2014
Question: I have recently been diagnosed with hashimotos thyroiditis. My labs reflected TSH only at 4.8 and normal t3 and T4. My primary was not going to treat but I was symptomatic so he suggested I go on levothyroxine 0.05 mg. I opted not to go on this because levothyroxine only treats T4 and it has side effects. I wanted to have more tests done so I went to holistic MD and my labs are as follows:
thyroid peroxidase antibodies 2
thyroid peroxidase 138
ferritin 20
DHEA sulfate 244
progesterone 2.2
Vitamin D 27
HE suggested I take iodizym-HP 1 tab daily with selenium. Also naturthroid 1 grain every other day. In addition to ferrofood 1 tab daily for iron. Gluten free diet. I tried this regimen yesterday and my anxiety was really bad and I was retaining water. I felt like I gained 5 lbs in one day. My symptoms so far are anxiety, itching, insomnia, hair loss and cloudy thinking, forgetfulness. In addition, I get very dizzy while eating. the first a couple of bites, I feel like I am on a rollercoaster. I am so dizzy. I am going to make an appointment with a endocrinologist but it is going to take a month to get in. I feel miserable everyday and thought you could suggest a regimen in the meantime with the medications I already have. Also, hashimotos and hypothyroidism usually is accompanied by fatigue and weight gain and mine has been the opposite. I have a lot of energy and no weight gain. I did not gain weight until I started medication. I have no goiter. but I feel that I have symptoms of hyperthyroidism.
Also, my glucose is normal according to labs feel as though I live like a diabetic. I have to eat every two to three hours or I crash, I get dehydrated very easy and have to drink water more then the average person and urinate frequently. I try to eat higher protein foods to stay with me longer but it doesn't seem to hold me beyond 2 or three hours. Since I am an RN and work 12 hour shifts, it's practically impossible to continue this regimen. My reaction to carbs or simple sugars on a empty stomach is anxiety and then extreme fatigue so I stay away from these foods. I have lived this way for most of my adult life but feel I have reached a critical point with my health status and my body cannot compensate anymore. Do you suggest a glucose tolerance test?
thank you for your time in this matter.
XXXXXXX

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Answered by Dr. Ajish TP (35 minutes later)
Brief Answer:
Repeat thyroid function test, Do GTT

Detailed Answer:
Hi XXXXXXX

Welcome to HCM. I had gone through your question and understand your concerns.

May I clear few points about your health concerns

1. Hashimoto's thyroiditis mean your thyroid is getting attacked by thyroid antibodies - this essentially doesn't mean you have hypothyroidism at present. But you are at a higher risk of developing hypothyroidism.

2. Thyroid hormone replacement is based on thyroid function tests and not based on symptoms

3. Initial phase of thyroiditis will have features of hyperthyroidism as when thyroid is destroyed by auto antibodies the stored thyroxine in thyroid is released into blood.

Regarding your Thyroid:

I suggest you to have your thyroid function tests repeated after a month, ideal time when you meet your Endocrinologist. This will tell you whether you have progressed to hypothyroidism or not. If your TSH is on a rise you can start on thyroid hormone replacement. Hashimoto's thyroiditis is not iodine deficiency hypothyroidism - so your Iodizym HP1 has got no role. Selenium is useful in early stages. Gluten free diet - doubtful role.
So better treatment option is to wait and follow up your thyroid function test and start on thyroid hormone replacement when needed as suggested by your GP. Your options will be T4 alone, T3 + T4 or if you are going for natural products armour thyroid. It is not of much side effects if you are taking this medication with periodic thyroid function monitoring.

Regarding Diabetes:

In early stages of glucose intolerance your sugars 2-3 hours after a meal will drop. This is due to high insulin levels in blood seen in early diabetes. The ideal treatment for this is to cut down your carbohydrate diet , refined sugar and have frequent low calorie high fibre diet every 3 hours. Extra XXXXXXX corn flakes and oats may help. You can do a glucose tolerance test to confirm whether you have diabetes or you blood glucose after sugar intake is coming down

Hope I have answered your question. If you have any further questions I will be happy to help.


Regards
Dr Ajish TP
Consultant Endocrinologist



Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Ajish TP

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Practicing since :2002

Answered : 819 Questions

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Suggest treatment for hashimotos thyroiditis

Brief Answer: Repeat thyroid function test, Do GTT Detailed Answer: Hi XXXXXXX Welcome to HCM. I had gone through your question and understand your concerns. May I clear few points about your health concerns 1. Hashimoto's thyroiditis mean your thyroid is getting attacked by thyroid antibodies - this essentially doesn't mean you have hypothyroidism at present. But you are at a higher risk of developing hypothyroidism. 2. Thyroid hormone replacement is based on thyroid function tests and not based on symptoms 3. Initial phase of thyroiditis will have features of hyperthyroidism as when thyroid is destroyed by auto antibodies the stored thyroxine in thyroid is released into blood. Regarding your Thyroid: I suggest you to have your thyroid function tests repeated after a month, ideal time when you meet your Endocrinologist. This will tell you whether you have progressed to hypothyroidism or not. If your TSH is on a rise you can start on thyroid hormone replacement. Hashimoto's thyroiditis is not iodine deficiency hypothyroidism - so your Iodizym HP1 has got no role. Selenium is useful in early stages. Gluten free diet - doubtful role. So better treatment option is to wait and follow up your thyroid function test and start on thyroid hormone replacement when needed as suggested by your GP. Your options will be T4 alone, T3 + T4 or if you are going for natural products armour thyroid. It is not of much side effects if you are taking this medication with periodic thyroid function monitoring. Regarding Diabetes: In early stages of glucose intolerance your sugars 2-3 hours after a meal will drop. This is due to high insulin levels in blood seen in early diabetes. The ideal treatment for this is to cut down your carbohydrate diet , refined sugar and have frequent low calorie high fibre diet every 3 hours. Extra XXXXXXX corn flakes and oats may help. You can do a glucose tolerance test to confirm whether you have diabetes or you blood glucose after sugar intake is coming down Hope I have answered your question. If you have any further questions I will be happy to help. Regards Dr Ajish TP Consultant Endocrinologist