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What is the logic in this?


Forum: Thyroid Disorders

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  #1  
August 18th, 2010, 08:44 AM
*Cyndee*'s Avatar Platinum Supermommy
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(History: Developed Hashimotos Hypothyroidism after having Maddie in 1/08 - was diagnosed in August since no return of cycle and sinus problems and generally feeling like crap - levels were off the charts. DR couldn't regulate it and sent me to Endo in Jan. Second visit with Endo was right after I found out I was pregnant with #2. I lost #2 at 11 weeks on July 7, still waiting on my cycle to return - currently CD45)


I had my thyroid levels checked again since the last time I was 5 or 6 weeks pregnant. Since I started seeing the Endo on 175mcg of levothyroxine, my numbers came back on the side of hyper, so she told me to skip a dose on Sundays and only take my meds 6 days a week.

The DR who called me today (mine is on vacation) said that it is still too high and is cutting my dose to 150mcg 7 days a week. This doesn't make sense to me - if I'm skipping 175mcg a week now , cutting my dose 25 a day still eliminates 175mcg a week.

Anyway, she's sending me a new script and a script for new labs in 4-6 weeks.

I was reading that while hypothyroid (too low) symptoms can cause problems trying to conceive and (for me) causes longer or missed cycles, Hyperthyroidism (too high) can cause miscarriage big issues while pregnant. I am wondering why she wasn't more aggressive getting my levels in range while I was pregnant, rather than just "skipping a dose" on Sundays and we'll check it in 6 weeks. 5 weeks later I lost the baby. Grrr

Quote:
In women who are not pregnant, hyperthyroidism can affect menstrual periods, making them irregular, lighter, or disappear altogether. It may be harder for hyperthyroid women to become pregnant, and they are more likely to have miscarriages. If a woman with infertility or repeated miscarriages has symptoms of hyperthyroidism, it is important to rule out this condition with thyroid blood tests. It is very important that hyperthyroidism be controlled in pregnant women since the risks of miscarriage or birth defects are much higher without therapy. Fortunately, there are effective treatments available.
I'm wondering if I start taking half doses until I start my new script if I will get my period back. But I don't really want to start messing with things. I'm anxious to get my cycle back.

I just don't understand why my daily dose wasn't lowered from the start, and why now it's being lowered to a number that still equates to the same amount per week I'm already taking. 1050mcg/wk

Can anyone help me understand this logic?
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  #2  
August 19th, 2010, 06:16 PM
The Purple Butterfly's Avatar Stacey
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I don't understand the skipping on Sunday thing. They should lower your overall dose. Otherwise, you'll have high levels on every day except for Sunday and Sundays you'll plummet. Another thing to keep in mind, they need to be checking your Free T3 and free T4s while checking your TSH. TSH means nothing by itself. If your TSH says you are borderline hyper but the free T3 and free T4 are in the high end of normal, then you're fine. Most people need both T4 (synthroid, levox) and T3 (cytomel) supplementation. A combo of both is available in Armour or Naturethroid.

Being hyper during pg does increase the risk for m/c but I think it would have to be a significant amount unless you're sensitive. HTH!
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Noah (11) C/S, 8lbs 12oz, 19"
Oliver (5) VBA2C, 7lbs 3oz, 19.5"
Grayson (10/16/13)2VBA2C, 9lbs 12oz, 22"
born sleeping at 39w pg; Protein C def, FVL, PAI-1 , & MTHFR
Lavender Kate (5/20/14) 2.5oz, 6" Lost at 16w

EDD May 12th with identical twin GIRLS!!


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  #3  
August 19th, 2010, 06:19 PM
~InHisHands~'s Avatar Platinum Supermommy
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Ditto to Stacey!
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  #4  
August 19th, 2010, 07:31 PM
The Purple Butterfly's Avatar Stacey
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On a side note... they should check your levels at 6w and you should be tested every 4w after that.
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Stacey, wife to Allan & Mom to:
Anastasia (14) C/S, 8lbs 7oz, 20.5"
Noah (11) C/S, 8lbs 12oz, 19"
Oliver (5) VBA2C, 7lbs 3oz, 19.5"
Grayson (10/16/13)2VBA2C, 9lbs 12oz, 22"
born sleeping at 39w pg; Protein C def, FVL, PAI-1 , & MTHFR
Lavender Kate (5/20/14) 2.5oz, 6" Lost at 16w

EDD May 12th with identical twin GIRLS!!


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  #5  
August 19th, 2010, 11:37 PM
LisaB's Avatar Mom to twins + 1
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That is strange they didn't adjust your dost rather than telling you to skip a day. My old endo also told me to skip a day when I was hyper, and I thought that sounded like sloppy medicine. I switched endos, and my new endo would never suggest that. She always adjusts my meds very carefully & fine tunes things accordingly.

If it makes any difference, when I had my miscarriages, I was hypo (TSH was around 3.0 or higher). When I conceived successfully, my TSH was around 1.0, even though according to my new RE, I should have been around 0.2 for optimal neural development for the baby (babies supposedly have higher IQs when the mom's TSH levels are around 0.2 and gets lower if the TSH is higher than that, if that makes sense). While pregnant, I had to increase my meds by 50% because my TSH levels kept rising, typical while pregnant.
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  #6  
August 20th, 2010, 07:55 AM
*Cyndee*'s Avatar Platinum Supermommy
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I agree it sounds like sloppy medicine to me too, skipping a day makes no sense. If I had my bloodwork done on Monday instead of a Friday I wonder if it would have made a difference.

My T3, T4 and TSH have been like High High low or a combination, none have fallen in line with 'normal'.

I've been all over the map with my hypothyroidism since being diagnosed 2 years ago. It's driving me bananas.

I think I might switch endo's if she can't make sense of this for me. I'm also going to ask about switching meds, this generic Levothyroixine obviously isn't working.
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  #7  
August 20th, 2010, 08:42 AM
LisaB's Avatar Mom to twins + 1
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I'm glad you're thinking of switching endos - you should be happy with yours! My new endo is great, she listens, explains things carefully and even makes notes during the appointment which she gives me at the end so I have something to refer to. She doesn't treat with a cookie cutter, like my old endo did. Maybe you're having trouble titrating your meds because you're using generics? My endo said generic levothyroxine can vary as much as 50% in efficacy, which is why she put me on a brand-name levo (Levothroid?). She also added Cytomel, which has helped my energy levels tremendously. She says she stays away from natural T4/T3 combo drugs like Armour because since they are naturally occurring (it's dessicated cow thyroid or something like that) the levels of T4/T3 can vary with the cow that's used. Not that variance is necessarily a bad thing, since it takes a month to titrate thyroid hormone levels (which is why some doctors say go ahead and skip a day/week of levo, you probably won't be able to feel a difference), but when there's T3 involved, I personally feel tired if the dose is lower or if I miss even one day. My best friend who takes Armour is constantly tired, even though her TSH is acceptable (marginal but not bad). I keep telling her to try synthetic brand-name drugs! I think it makes a big difference. Good luck!!
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Me: Lisa, Mommy to twins +1
8/5/08 Beautiful twin girls Leigh and Lucy born after 4-year struggle with RPL & 6 losses
12/10/09 Surprise! Baby #3 is on the way, EDD 6/22/10

12/29/09 2nd ultrasound - joining team blue

6/16/10 Baby Ben is born!



Last edited by LisaB; August 20th, 2010 at 09:06 AM.
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  #8  
August 20th, 2010, 10:00 AM
The Purple Butterfly's Avatar Stacey
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Quote:
Originally Posted by LisaB View Post
I'm glad you're thinking of switching endos - you should be happy with yours! My new endo is great, she listens, explains things carefully and even makes notes during the appointment which she gives me at the end so I have something to refer to. She doesn't treat with a cookie cutter, like my old endo did. Maybe you're having trouble titrating your meds because you're using generics? My endo said generic levothyroxine can vary as much as 50% in efficacy, which is why she put me on a brand-name levo (Levothroid?). She also added Cytomel, which has helped my energy levels tremendously. She says she stays away from natural T4/T3 combo drugs like Armour because since they are naturally occurring (it's dessicated cow thyroid or something like that) the levels of T4/T3 can vary with the cow that's used. Not that variance is necessarily a bad thing, since it takes a month to titrate thyroid hormone levels (which is why some doctors say go ahead and skip a day/week of levo, you probably won't be able to feel a difference), but when there's T3 involved, I personally feel tired if the dose is lower or if I miss even one day. My best friend who takes Armour is constantly tired, even though her TSH is acceptable (marginal but not bad). I keep telling her to try synthetic brand-name drugs! I think it makes a big difference. Good luck!!
I am on Armour and LOVE it! (it's pig btw) I was on Synthroid/Levox for 4yrs and felt horrible. It did nothing for me. I've never felt better since switching! You have to crush the pills....go tell your friend she needs to crush hers. Maybe you need a new endo too. Any dr that would make a comment like that about Armour is obviously very misinformed and many drs don't know how to regulate using Armour, so they don't prescribe it. There's no research to back what she is saying up (none that I have found anyway) and if you read the about.com link below, it will tell you otherwise. I took it my entire pg with Oliver and never once had a single issue. I don't go to an endo. I found a GP who seems to know more about the thyroid then any endo I've gone to. Even my OB knows more.

I have found these websites to be very informative...

Thyroid Mistreatment, Hypothyroidism Scandals, and Thyroid Treatment Problems | Stop The Thyroid Madness?
Armour Thyroid and Thyrolar: Alternatives to Synthroid and the Other T4-Only Drugs

You may also want to get Living Well With Hypothyroidism. EXCELLENT book!
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Stacey, wife to Allan & Mom to:
Anastasia (14) C/S, 8lbs 7oz, 20.5"
Noah (11) C/S, 8lbs 12oz, 19"
Oliver (5) VBA2C, 7lbs 3oz, 19.5"
Grayson (10/16/13)2VBA2C, 9lbs 12oz, 22"
born sleeping at 39w pg; Protein C def, FVL, PAI-1 , & MTHFR
Lavender Kate (5/20/14) 2.5oz, 6" Lost at 16w

EDD May 12th with identical twin GIRLS!!


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