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Hypothyroidism and synthroid

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well I just got my synthroid today as I have newly be diagnosed with hypothyroidism, now I know there are a few people on this board on this drug and with this condition, I was just wondering what should I expect to see in the days/ weeks to come?
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I really didn't notice anything at all.
The week before I started -- I was REALLY depressed and irritable all the time, and for the two months before I got those pills, I dieted and exercised all the time, and instead of losing weight or even maintaining, I GAINED six pounds in two months.

About a week after I started taking synthroid, I felt a lot better... I wasn't depressed and irritable at all. I continued dieting and exercising, and I lost 10 lbs. in six weeks!

Let me know if you need any help in this journey... I only started my synthroid two months ago, so I'm still fairly new in terms of getting used to these pills. I'm pretty happy with them thus far though!
As I posted in the hypothyroid club post, regular blood testing is critical - especially when you are newly diagnosed.  Your first prescription will probably not be your last - most doctors will start you on a low dosage then slowly work up to a point where the thyroid levels are in the acceptable "range".  This process can take up to a year or more and requires new blood tests about every 2-3 months and assessment of them by your doctor.

You will find that your moods will greatly improve - for me, if my levels are off I get irritable, impatient, sad.  If my levels are REALLY out to lunch, I get pretty severe mood swings where I can be bawling one minute and laughing the next, I am so tired my eyes won't stay open, and I just don't care about doing anything.  In the years to come, it will be YOU, not your doctor, who will become the best person able to determine when your thyroid med's need to be re-evaluated.  I don't say this to slight your doctor - it's just that no one knows you better than you!

I peeked at your profile and see you are in the Canadian Armed Forces.  So, just a quick attaboy to you and all your great comrades for the difficult but important work you are doing these days!  Canadian Soldiers give every Canadian citizen good right to be very, very proud!
I have been on synthyroid for years.  Actually about 25 years.  I just switched a week ago to Armour.   I am already doing better.  I just could not lose much weight on the synthriod, always tired, moody.    It has only been a week and without trying I lost 2 pounds and I am feeling better.  I really need to wait and see how it goes but find what works the best for you.  My doctors never told me about anything else, I read up on it and requested to be switched.  Just keep an eye on how you feel.
Hi greenkev,

Welcome to the world of hypo... I think... :)

Synthroid, I find, takes an extremely long time to feel its full benefits.  It maybe take you a few weeks for you to begin to feel better.  I started on synthroid when I was 11 years old, in 1995.  I just recently started a combination of synthroid and cytomel which I feel even better on.

Synthroid will (hopefully) make you feel not so tired.  That was one thing that I noticed when I started taking it (so long ago, it seems).  I used to have a really hard time getting up for school, and I would have to nap in the afternoons after school to make it through.  Another thing that I noticed was that I began growing taller.  Being so young, that is to be expected.  It made me look like I started losing weight when I began the synthroid, but to be honest, I didn't lose, I just stopped gaining, and grew taller.  My hypothyroidism had actually stunted my growth (hence the reason that now I stand only 5'3" and my mom is 6 feet tall...)

So what to expect with synthroid?  Well, give it time, but after maybe 6 weeks, you hopefully should not feel so tired and sluggish and perhaps weight maintenence will become easier for you.

One caveat that I've heard but am not sure is true, but am not willing to find out... be sure that you get the brand name Synthroid from your pharmacy.  Do not let them substitute the generic for Synthroid, levothyroxine... I heard that the generic does not work as well...
this is not an answer to greenkev's question, just another question. I was recently talking to some people about how difficult it is for me to lose weight. They suggested (along with lots of other people over the past 5 or so years) that I get my thyroid checked. I told them that I already did, and my TSH levels came back at 2.85. I was then informed that this was a hypothyroid level, and that the normal range for a thyroid condition has recently changed. I did a whole bunch of research, and sure enough, I found PLENTY of supporting documentation about this new normal level. I also spoke to my mom, who said that my grandmother was hypothyroid. And, my aunt was also severely overweight, but never diagnosed. So, I went back to my doctor to talk to her about the thyroid results, and she wouldn't hear it. So, I wonder if it's possible for someone to have thyroid problems for their entire life (I'm now 29), and not be diagnosed, AND, if anyone knows of a doctor who is aware of this new testing range in the NYC area.
ale2121:  some doctors still adhere to the old acceptable levels.  You've done the research and are aware that your TSH should be between .5 and 1.5.  If you are seeing a general practioner, you could request to see an endocrinologist.  If you are already seeing and endocrinologist - find another one.
Hello all!  I am new to this sight.  I have read everything possible on hypothyroidism.  I was diagnosed about 6 weeks ago with subclinical hypothyroidism.  I was having difficulty losing weight and was having sudden swelling in my ankles.  My TSH level originally was a 3.85, T4 was 1.0, T3 3.2.  The doctor put me on Synthroid 25mcg.  My follow up test revealed a TSH level of 2.19, T4 1.2, T3 2.9.  The doctor felt that I was moving in the right direction but increased my dosage to 50mcg.  He believes that this should eventually get my TSH levels to as close to 1.0 as possible.  I work out 5 times a week a hour at a time and include an extra hour of strength training per week.  I do believe with a proper diet, medication, and exercise I can slowly drop the weight.  I haven't had any bad side effects with Synthroid yet.  However, the most annoying thing is the swelling in my ankles.  It doesn't happen every single day.  But it is at least 4 times a week and generally in the afternoon betweem 2-4 pm.  The swelling subsides at night and in the morning my ankles are pretty normal looking.  Just wondering if anyone has this problem!  I have a snack of yogurt every afternoon, and I am wondering if the calcium is interfering with the drug.  Additionally, is salt a huge problem with hypothroidism.  I don't salt anything but of course I realize most stuff already contains a huge amount of sodium.  Please give me any suggestions to what will remedy this problem.  Thanks!
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hi Greenkev!

regarding immediacy of effects:  the hormone enters the bloodstream + acts immediately, but it takes time to determine the proper dosage + calibrate to your needs (frequent testing, adding more of the drug) - no dr is going to start you on more than 100mcg (they may start you on much much less and often do), no matter how hypothyroid you are, and if, like many, you need high-dose, it can take a long time to get to those levels. 

about weight loss: thyroid hormones in general neither cause weight gain nor loss (despite many people abusing them for this effect, the only way in which they will cause weight loss will be if you artifically induce a hypERthyroid state; this is dangerous - really a heart attack waiting to happen - and the synthetic T4 replaces the natural T4 so when the drug is discontinued, metabolism is slowed to lower than its pre-hyperthyroidism state, just like when people abuse diet pills, though by a different mechanism).  However, when people start taking thyroid hormones, many times their weight DOES change.  this may seem counterintuitive, but more often when weight does change, people GAIN weight, not lose it (check medical textbooks if you don't believe me on this, or just do an internet search).  it's believed that this isn't caused by the drug, but by changes in dietary habits (a symptom of hypo is depression, a lot of people don't eat while depressed, even though their metabolisms might be slightly depressed while hypo, once their euthymic and eating normally again, they gain weight).  Others, but a smaller number, lose weight.  Some of this may be due to a placebo effect (believing that hypothyroidism is the reason they were overweight;  just b/c it's not the drug's pharmacological effects that made them lose weight doesn't make it any less 'real' that taking the drug is what allows them to finally shed their excess pounds).  Or they may be people who, while hypo, suffered from fatigue and are now more able to exercise or people who suffered from symptoms of 'atypical depression' (depression characterized by increased eating/weight gain rather than weight loss).  In any case, if you want to lose weight, it is probably helpful to believe that hypothyroidism was an obstacle to doing so in your case (if, despite diet and exercise, you couldn't shed lbs as fast as other people, if fatigue and depression prevented you from losing weight, it very well could have been) + then you can use your treatment as an opportunity to change your life.

Regarding synthroid vs. generics: in 2004, when 3 companies filed patent applications to market generic levothyroxine in the same form as synthroid, synthroid's manufacturers argued that they weren't bioequivalent (FDA rejected this argument) + began a media campaign against the synthroid generics (and suppressed one of its own studies which showed that they were identical!).  but, regardless of the politics, is there evidence that the generics aren't 'as good', like melbo18 says?  The active ingredient (levothyroxine) is identical, but there may be some variation in the exact dosage (the FDA allows for this).  That is, an 100mcg synthroid tablet might actually contain 98mcg, generic A might contain 104 mcg, and generic B might contain 95 mcg.  None varies from the 100mcg by more than 10%, and this occurs with ALL generic drugs (the brand name drugs are no more exact on the dosage than the generics most of the time, however).  With most medical conditions, a 10% variance will not matter very much (it is actually up to a 22% variance in the extreme case that you're switched from a pill w/ 90mcg to one with 110mcg, though getting slightly too much T4 is less serious than getting too little, as long as it's only slightly too much), but with thyroid conditions, dosage has to be very precise and small variations can make a big difference.  Your dosage is not based on any formula (starting dosage is guided by your starting thyroid levels - it's all about getting you to a euthymic state, but it's not like they just give you 10mg for every kg you weigh.  They just add more and more until they get you there, and they can't be certain how much of the drug you're even absorbing b/c individuals differ, and there are a lot of factors that can affect how much you'll need).  So you can use ANY version of the drug to get you to the right level - the important thing is that ONCE YOU'VE GOTTEN TO A EUTHYMIC STATE, DON'T GO SWITCHING TO A DIFFERENT MANUFACTURER.  it's not that synthroid is 'better' than generics.  it's just that when the generics came out, people were switched FROM synthroid TO generics (and that's how insurance companies always do it - generics are cheaper), not the other way around, so that's how problems were experienced, and this was misinterpreted (even by some doctors who should've known better) as 'synthroid is better'.  if people had switched from generics to synthroid, similar problems would've been experienced.   pick one manufacturer and stick with it.  the one advantage to using name-brand synthroid is that different pharmacies often stock different generics (as there is more than one, though they look different), but as long as you either (1) use the same pharmacy (or a mail-order pharmacy, where you can get a 90-day supply for the price of a 30-day supply thru your insurance company most of the time) or (2) request a specific generic, you shouldn't have a problem.  but if it's easier for you to just take synthroid, it's only about $5-8 a month more.

- careful about eating too much soy.  you can eat it, just tell your doctor and have your thyroid checked more often (it can lower your levels but only if you eat a LOT of it.  easier to just take more hormone than eliminate it if it's a large part of your diet - at least if you're a vegetarian like me). 

- don't take the drug at the same time as a multi-vitamin.  that has iron in it + will mess up your absorption.

best of luck! a lot of people really do feel much better once their thyroid condition is treated + i hope that you're one of them.  please feel free to contact me privately any time if you have any ?s about any of this.  hugs! -erin
hi wannabehealthy,

it sounds like you're having some peripheral edema, which is a common symptom of hypothyroidism (i assume it's just fluid being retained in your ankles, not a painful swelling) - low thyroid hormone causes decreased renal function which should improve with treatment.  the fact that it still exists may be an indication that you're not yet euthyroid.  BUT, peripheral edema of the legs has MANY causes (one of which is actually HYPERthyroidism, which can cause pritibial myxedema - a swelling that is often specific to the ankles).  Is the swelling pitting (that is, if you press on your ankle, will it leave an indentation that is persistent?)?  If not, it may be pritibial myxedema; if so (much more common + not as difficult to treat), it may be a symptom of hypothyroidism.  The key word is MAY -

you should talk to your doctor.  if it is caused by an underlying thyroid condition (and i don't really see any reason to think that it is), you should continue to fix the thyroid condition + the edema should then resolve itself.  However, for symptom relief, eat less salt (to answer your ?, thyroid meds + salt from diet aren't interacting in any direct way, but thyroid levels can affect kidney function, causing salt retention + edema).   

there's a condition called 'idiopathic edema' which generally hits young (pre-menopausal) women.  it occurs because these women have leaks in their capillaries + fluids passing thru blood vessels therefore leak into interstitial spaces, causing a decreased blood volume + na retention by kidneys.  i'm mentioning this (as opposed to the many other causes of edema) because it's typical (or, at the very least, frequently seen) that people with idiopathic edema have much more variable amounts of fluid retention at specific times of the day, which is what you're experiencing.  in the time before you experience it (or during), are you on your feet a lot, or dangling your legs downwards (like from a chair)?

the fact that you haven't experienced swelling anywhere else (really think - when you wake up, are your eyes very puffy? do you sometimes have trouble getting your rings off? do you sometimes retain more water, appear more bloated than other people that's not related to any cause you can think of, like your period?) may also indicate venous insufficiency as a cause.  Are your ankles equally swollen (if not, this may indicate v.i.)?  do you have varicose veins in your legs?   if you think it may be this, you can try wearing compression stockings (and, of course, keeping your legs elevated as much as possible), tho people differ in their views of efficacy.

are you taking any meds?  certain meds can cause edema (eg NSAIDS + COX-2 inhibitors, antideps, estrogens, corticosteroids) 

basically - reduce salt intake + talk to your doctor.  don't necessarily assume that hypothyroidism is the underlying cause.   this is really something you need to let your doctor look at.  it's sometimes a symptom of something serious, but it's usually pretty non-specific, and if you can find the underlying cause, it just might be something easy to treat.  at the very least, he should be able to offer various options for symptom relief, altho how much he can do will be dependent on what the underlying cause is (diuretics work much better for edema caused by some conditions than those caused by others, for example).   good luck!

You seem to be very knowledgable regarding thyroid conditions so maybe you can help me with my current dilemma.  I am hypothyroid and was diagnosed 6 years ago after major surgery (full hysterectomy).  Once my dosage was determined, I did fine on 0.2mg levothyroxine ever since - until I quit smoking (March, 2007)and everything went haywire.  My T4 is 6.2, I don't know my T3 at the moment, and my TSH is currently 38.6 and increasing (it was 14.32 in May). 

I lost 10 pounds before I quit smoking but was unable to shed anything since until I drastically reduced my carbs and the result was I dropped 5 pounds in one week.  I am averaging 110-125 carbs per day.  I have a good breakfast cereal in the morning (Kashi, Fibre1, etc.) and the rest of my diet is fruits, veggies, lean white meats, fish,  milk, cottage cheese, cream cheese (Laughing Cow)almonds or pine nuts.

I have discussed the low carb diet with my doctor and he allows that, while my metabolism is so slow and messed up, that my body may only need the amount of grains it's currently getting despite it being much lower than the Canada Food Guide recommendation of 6 servings of grains per day. 

I don't completely understand your statement,  ..."thyroid hormones in general neither cause weight gain nor loss (despite many people abusing them for this effect, the only way in which they will cause weight loss will be if you artifically induce a hypERthyroid state" and I'm having difficulty relating it to my current situation.  Could you please clarify?


Thanks for the great information.  I went back to the doctor office, and they are pretty much convinced that it is idiopathic cyclic edema.  He gave me a prescription diuretic to take and it has definitely helped.  They didn't really believe it was really all that bad but of course to me it was terrible.  The swelling does seem to come on at certain times of the day.  I am accountant so I sit at a desk the entire day.  Generally, I don't allow my feet to hang, and I have been trying to keep them elevated at my desk.  They said it is just one of things that may require me take a diuretic for sometime but that there are plenty of people that only need to for a short period of time.  I haven't had any swelling in my hands, but I had a little under my eyes.  But I believe this has improved since taking the Synthroid.  Oh, and yes most of the swelling is in both ankles and if bad there tends to be some in my calves.  In regards to other medication I take, I do take Othro Tri Cyclen Lo.  Bascially, I take it to control the bleeding of small unterine fibroid.  My thyroid doctor is not a fan of this at all.  He believes I should get off the medication and just use the nuvo-ring.  So, that is another issue I have to explore.

Maybe you can help me with another recent problem?  My doctor was not available at my last visit.  Therefore, my thryoid medication levels were not really addressed.  But I increased my meds this past week from 25 mcg to 50 mcg.  Oddly enough, that is when my ankle swelling increased.  Additionally, when my blood pressure was taken it had increased from 120/76 to 124/88!  That is a pretty big jump in a week for the bottom number.  Also, I noticed today that I was having periods of heat intolerance.  I guess you could say it was like having a hot flash.  I kind of started feeling clammy and warm.  It didn't last for long periods of time; however, I am a little concerned.  During this week also I have had a few small headaches here and there.  Do you think that possibly I might need to decrease the dosage?  I wasn't having any of these side effects when I was on the lower dosage.
Hi lornajean!

Sorry it took me so long to answer ‚?? I didn‚??t see the message until wannabehealthy posted again + this thread jumped to the top in my profile.  First, congrats on quitting!  I‚??ve been smoking since i was a teenager, am up to 2 packs a day + am very impressed at anyone who‚??s able to quit.

The first 5 lbs you dropped from reducing carbs was likely water weight (every gram of carbs in your body causes you to retain 3 grams of water ‚?? eliminating the carbs eliminates that water).  but lo-carb diets can work in the long-term (but know about the water thing just so you don‚??t see the fact that you lost 5 lbs the first week and none the 2nd as a symptom of something else, like thyroid dysfunction).  i‚??ve never done lo-carb dieting + am not an expert on it ‚?? i‚??m sure you can find info on it elsewhere on your own and have likely already done so.

Smoking for so long, and then quitting, likely had a substantial effect on your thyroid function: there are multiple mechanisms by which various compounds in cigarettes affect thyroid function (going well beyond nicotine; cyanide (thiocyanate), for example, by its competetive inhibition of iodine uptake).  b/c of so many different effects at so many levels, smoking can actually make hypothyroidism more severe in affected individuals (lower mean t4 levels), but the data makes it seem that it can also mask hypothyroidism (smokers, compared with never-smokers, had lower prevalence of overt hypothyroidism, according to most recent study, which is the first report of this, though there has been anecdotal evidence for years of people being dx‚??d as hypo immediately after they quit).  so how to apply this to your situation?  Your t4 is normal (low end of normal ‚?? what was it before is pretty important to know; i‚??m assuming the number you gave was total, not free t4, since your number would be a VERY high free t4, but if you‚??re only going to test one of them, you should test the free, not the total.), but your TSH is high, which indicates that you‚??re currently hypo.  What to do?  monitor, monitor, monitor ‚?? frequent testing + tweaking of your synthroid to get you back to right levels.  when function goes so, in your words, haywire, like this, it‚??s often helpful to do a more full panel of thyroid function ‚?? check out EVERYTHING, not just the tsh + t4.  you quit several months ago, so it‚??s probably too late for a nicotine patch (the effects of smoking on thyroid function go so far beyond the nicotine itself, but it couldn‚??t HURT). 

There are unfortunately too many doctors (a lot of general practitioners and even some endocrinologists) who think that as long as your #s are in the range of ‚??normal‚?Ě, you should be feeling fine.   A lot of people who are hypo actually have to be kept in the ‚??high‚?Ě range of normal (how high this is will vary ‚?? for some, it‚??s just over 70%, for other‚??s it‚??s just a drop under being abnormally HIGH!).  there are 2 groups of patients for whom ‚??high range/normal‚?? numbers should be especially considered: those who are clinically depressed (most psychiatrists these days do not even wait a few weeks on a dose of synthroid that produces low or medium normal thyroid range numbers to see if it works; years of experience has taught them that basically all depressed patients do far better in the higher ranges) and for those whose heroic efforts at weight loss are STILL not bringing them ‚??normal‚?? results at lower numbers in the range, a high-normal trial is worth considering. 

Another thing to consider: once your ranges are normal, if you‚??re still experiencing sxs (difficulty losing weight, depression ‚?? i clicked on your profile + read your other post to get more of a sense about your situation), LT4 alone (synthroid) may not be enough, even though all your numbers are showing up normal, even high-normal.  there is some doubt over the ability of levothyroxine therapy alone to restore normal thyroid levels in all of a person‚??s tissues + a T3/T4 combo appears to help many of those patients who are dissatisfied (t3 does have a shorter half-life + has to be taken more frequently).  from a weight-loss perspective, a double-blind randomized clinical trial showed that those taking t4 alone experienced no weight loss, those taking the combo in a 5:1 ratio experienced an average of 3.75lbs loss.

What did i mean by the statement, ...‚?Ěthyroid hormones in general neither cause weight gain nor loss (despite many people abusing them for this effect, the only way in which they will cause weight loss will be if you artifically induce a hypERthyroid state‚?Ě.  I meant that there‚??s no direct (or even indirect) physiological mechanism by which the addition of SYNTHETIC t-levothyroxine causes weight loss.  If it did, we could give it to euthyroid individuals who were overweight and see the same changes (that is, it would be used as a weight loss drug; all attempts at this have failed miserably).  When people who are hyperthyroid take anti-thyroid drugs, some become euthyroid, some become hypo ‚?? those who become hypo gain more weight than those who don‚??t, EVEN THOUGH they are put on synthroid, which artificially restores them to a euthyroid state (that is, their levels are the same as those who aren‚??t hypo, but the synthroid doesn‚??t PREVENT them from gaining more weight; this is strong evidence NOT that synthroid ‚??causes weight gain‚?? ‚?? it‚??s the hypothyroid state, or the removal of the hyperthyroid state plus the onset of the hypothyroid state that causes weight gain ‚?? but that synthroid cannot ‚??cause‚?? weight loss or even prevent more weight gain).  Now, that doesn‚??t mean that people, after taking synthroid, cannot gain or lose weight, and that synthroid is not the immediately precipitating ‚??cause‚??.  People who have made heroic, unsuccessful efforts at weight loss while hypothyroid often ARE able to lose weight (though with greater difficulty than normally euthyroid individuals) after replacement therapy, but it is not the levothyroxine that is ‚??causing‚?? the weight loss - it is the heroic efforts.  the LT4 just removes an obstacle to weight loss (hypothyroidism) that those who were making heroic efforts faced; if LT4 ‚??caused‚?? weight loss (like, say, amphetamines in most people, in the short term at least, cause weight loss through appetite suppression and other catecholamine-mediated mechanisms), by, say, increasing metabolism, then those people who ate ho-hos and didn‚??t exercise would lose weight too (it‚??s counterintuitive, because one would think, lower BMR is a symptom of hypothyroidism so taking LT4 should reverse this, at least for people who are hypo, but it doesn‚??t appear to work this way;  as noted above, taking T3/T4 combo has much better results, though some of the people in the study had TSH‚??s BELOW normal).  also, as many hypos GAIN weight after taking synthroid as lose weight.  while people may gain or lose weight after taking synthroid, it is largely about the individual habits, not the synthroid.

An exception to thyroid hormones not ‚??causing‚?? weight loss is if they are used to artificially induce a hyperthyroid state ‚?? to raise the T4 and T3 above normal and to put the TSH below normal (this is clearly NOT your situation).  This is a VERY dangerous strategy (‚??heart attack waiting to happen‚??, all the sxs of hyperthyroidism), plus the weight loss can not be expected to be dramatic ‚?? bodybuilders, individuals who need to shed a lb or two to get ‚??really cut‚?? or make a weight class sometimes do this, but it‚??s a short-term strategy, very stupid, and like i said, if it‚??s successful, weight loss won‚??t be dramatic. also, when the thyroid hormones are stopped (hyperthyroid state is reversed), weight GAIN + even hypothyroid state can be expected as the body rebounds, b/c the artificial hormone often comes to replace the body‚??s own (dependence). 

About your depression + not wanting to take antideps b/c of potential weight gain, here‚??s the VERY quick run-down on what anti-deps cause/don‚??t cause weight gain (write again if you have any questions about any of these): most of the tricyclics + MAOIs (monoamine oxidase inhibitors) will cause weight gain (among the tricyclics, protriptyline can be an exception, often causing weight LOSS), but i doubt that you will be given a tricyclic/MAOI - these are older-generation anti-depressants w/ significant side-effects/risks); the SSRIs also have a reputation for weight gain.  Paxil absolutely causes weight gain, so you might want to avoid this one.  Otherwise, the evidence of weight gain from other SSRIs is very low to non-existent + seems to be related, where it does exist, to recovery from depression (patients not eating previously b/c they were depressed so they gain weight when on the meds) or carbohydrate craving, not the med itself.  Prozac has also been associated w/ some weight LOSS.  As far as other antidepressants, Remeron is absolutely associated with weight gain and Serzone + Effexor are believed to have no effect.  Lastly, the antidepressant Wellbutrin has been shown to cause weight loss (average of 2.5 lbs in a 12 week study where patients weren't dieting or exercising; patients not taking it gained weight; 28% of people who took it lost 5lbs or more; in another randomized double blind study that put two groups of non-depressed obese people on the same moderate exercise regimen + reduced-cal diet, the group that also took 400 mg of Wellbutrin per day lost 10.1% of their body fat, while the group that took a placebo lost only 5% - a pretty big difference!) - wellbutrin is believed to cause weight loss by several mechanisms but it is a dopamine agonist that is believed to reduce cravings (it is used for smoking cessation under a different brand name), so if you are concerned with weight gain, it is something to consider.  also, topiramate, which is a mood stabilizer, is associated with weight loss (and people actually take it for this purpose).

If you‚??re seeing a psychiatrist, it may be worth letting him help monitor your thyroid.  often shrinks are the first to catch that a pt IS hypo (better at recognizing the symptoms + screening for it than GPs) + patients often see their psychiatrists much more frequently (weekly, bi-weekly, etc.) than they see their regular doctors/endocrinologists.  i‚??m not saying let your shrink be the ONLY dr monitoring your thyroid, just let him be part of it ‚?? it‚??ll lead to more frequent monitoring + he may even know more about thyroid conditions than your endocrinologist (you‚??d be surprised!) or be better at treating them.  if he‚??s reluctant to do so (sometimes shrinks seem to forget that they ARE medical doctors and don‚??t want to treat beyond your Axis I disorders ‚?? Axis III‚??s for your ‚??real‚?? doctors, Axis IV for your therapist, and Axis II ‚?? we‚??ll just pretend that doesn‚??t exist [like it‚??s not staring us in the face], since there‚??s nothing medication can do for it anyways + it‚??s SO unpleasant!), really insist on its centrality to your psychiatric tx, if he still seems uncomfortable, consider finding a new shrink.

Good luck! -Erin
Hi Wannabehealthy:

I think what you have is just idiopathic edema: cyclical edema refers to edema that is ‚??cyclical‚?? (occurs at certain times of the menstrual cycle, usually just prior to the period, and is therefore often confused with PMS, even though it is actually a distinct condition) ‚?? unless i misread your post, you have ankle swelling 4 days per week, all weeks.  some people (including doctors) however, use the terms interchangeably, but they should be kept distinct to avoid confusion (sometimes idiopathic edema starts cyclically then becomes full-time).  when edema is cyclical, progesterone is sometimes tried.  if on birth control, it may also be worth trying NOT taking the dummy pills/stopping the birth control (that is, if you‚??re only having edema around your period, try taking your birth control round-the-clock so that you don‚??t get the synthetic period; the period isn‚??t real anyways, and at least two groups of women ‚?? gynecologists and prostitutes ‚?? have been using this method for decades).

As far as your jump in thyroid meds, i think you already know that you‚??re not supposed to do that on your own!!!  obviously you‚??re an adult, you can make your decisions, and i‚??m not here to ‚??yell at you‚?? (or whatever the online version of that would be) for doing so, but it just isn‚??t a good idea to unilaterally raise your meds w/o at least having your levels checked beforehand.   i can‚??t make a diagnosis over the computer (no one can), but it sounds like you might have put yourself into a hyperthyroid state.  the jump in blood pressure is not huge, and these variations happen (were you tested at the same time of day?  were you nervous? blood pressure varies in response to how much you‚??ve slept, whether you‚??ve exercised beforehand, your emotional state, etc.  while you may have heard that 120/80 is ‚??normal‚?? and anything above that is ‚??high blood pressure‚?? this is not entirely accurate ‚?? you cannot diagnose hypertension with just one reading, individuals differ, and for you, since the jump was not terribly high, i wouldn‚??t worry TOO much, but talk to your doctor if you‚??re worried.  i‚??ve seen jumps way bigger than this, and the next reading was fine).

In conjuction with other symptoms, this MAY indicate that you‚??ve put yourself into a mildly hyperthyroid state.  flushing, hot flashes, and warm clammy skin can be symptoms of being hyper; headaches?  not a classic symptom (doesn‚??t make it impossible, nothing‚??s impossible, people with graves have light sensitivity and double vision sometimes, but a mild case of hyperthyroidism causing a headache?  possible, but i wouldn‚??t interpret such a vague, non-specific symptom as being necessarily caused by your medication change).  more classic symptoms would be increased heart rate/palpitations, tremors/trembling, muscle weakness, fatigue, changes in mood (like irritability), shortness of breath + insomnia ‚?? if you‚??re having any of these, it might be easier to say that you‚??ve taken too much meds.  otherwise, it might be just as likely that you‚??re experiencing a bit of a psychosomatic reaction (you‚??ve worried that you‚??ve taken too much meds + that‚??s causing some of your symptoms; this is actually very common.  like when people have unsafe sex encounters ‚?? or even relatively safe sex encounters, but are just neurotic! ‚?? they suddenly start developing ALL the symptoms of HIV viremia (flu, swollen lymph nodes, even thrush!) and believe that they are seroconverting; it is the rare case that this is actually happening ‚?? often they have just looked up the symptoms online ‚?? the mind is a powerful thing).

I cannot say what is happening to you (obviously). hyperthyroidism can present without ANY symptoms, so the fact that you don‚??t have a lot of symptoms doesn‚??t mean that you haven‚??t taken too much meds; on the other hand, the fact that you have some symptoms doesn‚??t mean that you HAVE necessarily over-done it.  you see what i mean?  You need to actually have a physical exam and, more likely, have your levels checked, in order to know for sure.  your doc ain‚??t gonna be real happy about what you did, but if he‚??s a nice guy who cares about you, he shouldn‚??t lecture or yell at you ‚?? really, the fact that you felt the need to do this on your own is an indication of how previous treatment was inadequate + how desperate you were feeling + hopefully he‚??ll understand that.  Unfortunately, sometimes doctors don‚??t.  Just don‚??t take it personally if he doesn‚??t.  see the previous post to lornajean about the possible benefits of combined T4/T3 treatment, which may be a better option for you than just raising your T4.   And good luck!

hi wannabehealthy

i meant to write this the first time + got sidetracked.

while diuretics can provide temporary relief, it often makes it worse.  it generally is not indicated unless it is a last resort.  people often get severely dependent on them + they will often make it worse when the edema is idiopathic.

Oops sorry I must clarify something from my pervious posting.  After reading it I now realize why you would be confused.  I stated I increased my dosage; however, the doctor actually increased my dosage last week prior to my return visit for the edema.  Oh, believe me I would never increase a drug without speaking to my doctor for sure!  I definitely don't know enough about my condition to even begin guessing!  But I knew I wasn't feeling well and decided to make an appointment to be sure.

In regards to the edema you are correct they do use terms interchangably.  The doctor did advise that I only use it when needed.  I was given a very small prescription of 5 pills.  Of which I only used one so far and the swelling has subsided.  It has been non-existent for 2 days now.   Additionally, the clammy and hot feeling has now decreased.  Therefore, I am not sure if the fluid retention, higher blood pressure, and clamminess are all related.  But you are correct you can start thinking yourself into believing there is a more serious problem.  But the doctor didn't seem to concerned about the fluid retention.  He believed it was something that could be corrected quickly.  Additionally, he suggested of course watching my sodium intake, continuing to exercise, keeping my feet elevated at work if possible, eating foods that are natural diuretics (grapes, etc.) and introducing vitamins/spices.  More less try some natural good things rather than having to rely on water pills.

Thanks for referring to the previous posting of lornajean.  I have read some on the benefits of T3/T4 treatment.  I will definitely discuss that with the doctor when I see him in 5 weeks.  I will have my levels tested again at that time since my dosage was increased this past week.  Each testing I have the TSH, FT4, and FT3 ran.  So, I will definitely be looking at the lab results.  We will see how I change from my last results:

FT4 1.2 (.8-1.5)

FT3 2.6 (2.0-4.9)

TSH 2.19 (.50-5.0)

My FT3 prior to treatment was actually 3.0 so it has gone down.  Therefore, I will keep an eye on it.  Thanks again for all of your great advice.  I appreciate you taking the time to answer my questions. 

I have sent you a cc-mail.
hey lornajean + wannabehealthy:

just wanted to see how you guys were doing - are you two alright?  -erin
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Hi.  I was just curious about why you switched to the Armour.  I have been taking synthroid for about 4 months now and they did my blood work and my tsh levels are back to normal but I haven't noticed anything positive at all.  In fact, I have gained twenty pounds since starting it  and I feel miserable.  Nothing I am doing seems to make my weight budge.  This is the heaviest that I have ever been.  Prior to starting I was around 190 and was stuck there forever.  I have to say that was better than this though!

I had switched to Armour because somebody I knew just raved about it.  But I didn't notice any positive effect from Armour at all,  so I have switched back to Synthroid.  Tell me,  are you taking the brand name synthroid or the generic.  The generic did not do well for me at all,  so I have to take the brand name.  I asked the pharmacist why that would be and she said that the amount of medicine in those are so small,  that in keeping with FDA guidelines,  just a little variation in the amount can make a big difference to people,  so it is advised that you stay with what works for you.  If you take synthroid,  don't switch to the generic,  and vice versa.

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