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Find a doctor who will run the actual complete thyroid panel. That includes antibodies, TSH, T3,T4, reverse T3, free T3, free T4, T3 uptake, and thyroid antibodies. What you do about it (if anything) depends on those tests. The basic thyroid panel doesn't paint the whole picture.
Insurance should pay for those blood tests, but most doctors won't even test for them. Ask around on some local forums to find a doctor that is well versed on thyroid function and will do those tests. It may not be an endocrinologist. The doctor who treats my hypothyroidism is a general practitioner who just happens to be very knowledgeable about thyroid issues, more so than any endocrinologist I've seen.
There are options other than Synthroid. If that's your doctor's go-to treatment, it tells me he doesn't know much about the complexities of thyroid issues. Does he know if you're not producing enough hormone or if you are producing enough, but your body isn't processing it properly? The answer is no if he's only going by the basic tests. How you treat it will be different depending on the cause of the imbalance. I take NP Thyroid. It's still a prescription medication, but it's a natural desiccated thyroid rather than synthetic. There are other brands.
Hypothyroid patients have higher cholesterol levels compared to people with normal thyroid function. Properly treating your thyroid issues will also address your cholesterol issues.
But start there. A good doctor will treat you based on how you feel. Everyone's baseline "normal" is a little different. Someone may feel great at one level where another will feel horrible. Find a good doctor and discuss your options.
Hello doctor! Thanks again for taking the time to reply! What would be a good dosage of Levithroxine (that’s what my doc prescribed) for the new TSH which is ~21?
If you are young and otherwise healthy, I'd be inclined to jump right in with 100ug of thyroxine. If you're over, say 60, or have cardiac or BP issues, I'd start 50ug and titrate up by 25ug every month until the T4 is in the normal range and the TSH is a low normal-- monitoring BP, HR and looking for things like fine tremors developing along the way.
CarnivalGirl apparently didn't read my post where I addressed her concerns. Getting the fancier tests are only important for academic reasons and very occasionally to differentiate between rare genetic problems of converting T4 to T3 or helping to understand "sick euthyroid" situations....Dessicated thyroid preps contain non-human proteins (porcine &/or bovine) that may theoretically sensitize the pt and cause immune problems. They are subject to assay problems because each animal used would have different thyroid levels. Given no advantage and some possible pitfalls to their use, no sense at all to use them....but they were used universally for decades without major problems accruing for most pts before synthetic thyroxine became available....You could chew on willow bark for your aspirin or tamoxifen too, but synthetic preps have the advantage of consistency and purity.
Huh. Interesting, OP, I think I'm the flip of your situation. I have only slightly elevated TSH (around 9) and my docs say I'm "subclinical" and need to be monitored but not yet started on medication. But I have noticed increasingly dry hair and skin, fatigue, and I've had sensitivity to cold for a long time. I hate being cold and will complain and suffer at higher temps than most people I know, and my extremities get cold easily. The only missing thing is weight gain, and that's a strange one. Every woman in both sides of my family gained weight after having kids and were overweight by their 30s but I have not. I'm not complaining, but it's odd. But I've always felt compelled to sleep a lot (10 hours/day is optimal for me - I love sleep and crave it, but I hate losing the time) and I've been told that my body temperature is alarmingly high when I'm asleep, "like a little furnace" and people thought I had a fever, but it never bothers me.
I'm also a smoker, and the last time I tried to quit I started gaining weight rapidly, so I think that is related. But anyhow, I knew to get my thyroid levels checked, because thyroid disorders are pretty universal among women on my mother's side of the family and she bugs me about it if I don't. She's been on synthroid for most of her life.
I often wonder if starting synthroid would help with the dry, thinning/breaking hair, dry skin, and maybe help me have more energy and be OK on less sleep...and if it would help me be able to not gain a bunch of weight when I stop smoking, which I really need to do. I often feel like pondering other health things when I'm a smoker is a bit like considering new paint on a house that's burning down...but anything that will make quitting less painful and problematic for me will help, I think.
But OP, I get you about generally feeling wary of adding a daily medication to your life. I watch some folks sit down to a small pile of supplements and prescription pills every day and that's not the kind of life I want to have, if I can avoid it.
Our bodies are so complex and strange, though, you'd really think that with TSH levels that high you'd have some sense of it, some symptom? I dunno.
If you are young and otherwise healthy, I'd be inclined to jump right in with 100ug of thyroxine. If you're over, say 60, or have cardiac or BP issues, I'd start 50ug and titrate up by 25ug every month until the T4 is in the normal range and the TSH is a low normal-- monitoring BP, HR and looking for things like fine tremors developing along the way.
CarnivalGirl apparently didn't read my post where I addressed her concerns. Getting the fancier tests are only important for academic reasons and very occasionally to differentiate between rare genetic problems of converting T4 to T3 or helping to understand "sick euthyroid" situations....Dessicated thyroid preps contain non-human proteins (porcine &/or bovine) that may theoretically sensitize the pt and cause immune problems. They are subject to assay problems because each animal used would have different thyroid levels. Given no advantage and some possible pitfalls to their use, no sense at all to use them....but they were used universally for decades without major problems accruing for most pts before synthetic thyroxine became available....You could chew on willow bark for your aspirin or tamoxifen too, but synthetic preps have the advantage of consistency and purity.
Very useful information, thank you for sharing your inputs as well as the guidance on dosage. I definitely feel more equipped now for my follow up with the doctor.
Huh. Interesting, OP, I think I'm the flip of your situation. I have only slightly elevated TSH (around 9) and my docs say I'm "subclinical" and need to be monitored but not yet started on medication. ....
Your mildly elevated TSH tells us your thryoid is failing-- needing stronger "whipping" from your pituitary telling it to work harder.... I would start full replacement therapy now. Why wait until you actually can't put out enough thyroxine to stay healthy?...If there were a cure for wrinkles, how long would you wait to start it?
BTW- your experience with weight gain after quitting smoking tells us you have an urge to go to your mouth with your hand. When that hand was holding a cigarette, you took in fewer calories. When that hand started to have a fork full of food in it insteasd of a cigarette, you gained weight.
We all are constantly losing hair, some of us faster than others, and often in spurts-- kinda like a molt. Hypothyroidism causes drying of the skin, including the scalp, so hair becomes drier. Dry hair breaks off more easily, hence the "hair loss." Real loss of hair (at the roots) is a later complication of severe hypothyroidism....Inexplicably, there can be loss of the outer thrid of the eye brow in hypothyroidism.
Probably the earliest and most reliable sign of thyroid disease is a change in menstruation- longer & heavier in under-active, and more scant in over-active.
They would help if thyroid issues are causing the hair loss. There are other possibilities, like Crohn's disease and low iron.
I don't have those. The meds themselves can make your hair fall out.
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