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So my general doctor and I have been tracking my thyroid stimulating hormone (TSH) and my free T4. My TSH consistently comes in high or at the high-end of normal, while my T4 is always low but just barely low. My father has the same problem and has been taking low-dose Synthroid for some time now and it has helped him immensely.

I wanted to put it out to the boards what people's experiences have been. If you have depression that also comes with a lot of low energy fatigue and you found out you had hypothyroidism and added Synthroid, what was that like? What should I look out for? I imagine I only need a low-dose and not a full replacement dose. My TSH is between 4.5 and 4.75 and my T4 is about 0.66.

My appt with my gdoc is on Tuesday and I'm going to add it then hopefully. Curious to hear what everyone has to say.

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3 hours ago, browri said:

 Curious to hear what everyone has to say.

I'm going through this now with my gdoc, too......He suspected low thyroid because my heart rate was so low (54 bpm), and I also had pretty low blood pressure-- 92/61........Also have constant feeling of being cold, and constant fatigue.

Like you, my levels are what they call "borderline"......I have appointment to get it checked again this week.

According to what I read on the subject, docs can differ as to when to medicate someone who is "borderline" hypothyroid....So I don't know yet whether or not they will medicate me.....Hope I find out soon.

Sorry I wasn't of much help, but hope you have a good appt on Tuesday.

Edited by CrazyRedhead
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On 12/7/2019 at 4:40 PM, CrazyRedhead said:

I'm going through this now with my gdoc, too......He suspected low thyroid because my heart rate was so low (54 bpm), and I also had pretty low blood pressure-- 92/61........Also have constant feeling of being cold, and constant fatigue.

Like you, my levels are what they call "borderline"......I have appointment to get it checked again this week.

According to what I read on the subject, docs can differ as to when to medicate someone who is "borderline" hypothyroid....So I don't know yet whether or not they will medicate me.....Hope I find out soon.

Sorry I wasn't of much help, but hope you have a good appt on Tuesday.

Thanks @CrazyRedhead. I hope this appt goes well enough for me. I have lots to talk about with my gdoc.

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ive been down this road. May be trending towards it again as ive had hyperthyroid symptoms they think are attributed to the lithium possibly. MY T4 is a bit high, my TSH is "normal" but a bit lower. But when this came up a year ago, my pdoc and Gdoc waffled. Then said well lets give you synthroid its cheap and wont hurt. But from my understanding, once u start it, your on it for life, as your body adjusts to synthetic hormones, and stops naturally producing. Dont quote me on this. So we decided to hold off. But not symptoms are coming up again, and my T4 was just outside the normal range on the high end again. Curious what NEW pdoc says. 

 

Good luck

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Just had the appointment. He was fine adding the Synthroid after having a couple different TSH+T4 results come back high:low. Based on my weight and height, my full replacement dose to start would be 122mcg. However, my father always had the same numbers as me, high TSH with slightly low T4, and he responded fine to low dose levothyroxine. Not sure on the dose, but he doesn't require full replacement.

I said it made sense to start on half that dose which would have been around 50mcg. My pdoc wanted to be more conservative and start with 25mcg, then test TSH+T4 in 8 weeks, see him again in 12 weeks. I'll also be testing things like lipids and vitamin D which I haven't tested in a while.

Anyway, I start it tomorrow. We'll see how this goes.

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On 12/10/2019 at 11:54 AM, browri said:

 Anyway, I start it tomorrow. We'll see how this goes.

I hope everything goes well...makes sense to start out at a low dosage for now and see how it goes.

At my doc appt for thyroid tests, I continue to test "borderline" or "subclinical" as doc likes to call it.

My TSH is high, but T4, and T3 are in normal range....I guess they will continue to monitor it, but they said they are not going to medicate me for it yet.

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So I got the opportunity to check in with my father and find out how much levothyroxine he takes. He said 100mcg. So it looks like I may have a ways to go. Although he is in his early 50s and I may not need as high a dose because I'm in my late 20s.

So far, it seems like I may have side effects from levothyroxine but I also can't tell if they are problems I'm having that are completely unrelated: anxiety/hyperactivity/nervousness, which is very mild and some days feels like jitters that comes and goes. Headaches but I'm also on max dose of vortioxetine, which can cause some pretty bad headaches. What's most curious is the diarrhea. To those who have taken levothyroxine, was diarrhea normal starting out?

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1 hour ago, browri said:

 So far, it seems like I may have side effects from levothyroxine but I also can't tell if they are problems I'm having that are completely unrelated: anxiety/hyperactivity/nervousness, which is very mild and some days feels like jitters that comes and goes. Headaches but I'm also on max dose of vortioxetine, which can cause some pretty bad headaches. What's most curious is the diarrhea. To those who have taken levothyroxine, was diarrhea normal starting out?

I have never taken levothyroxine, but headaches and diarrhea are listed as common side effects:

https://www.healthline.com/health/levothyroxine-oral-tablet#side-effects

Anxiety, hyperactivity, and nervousness are also listed as common side effects.

I think @Wonderful.Cheese takes thyroid medication, too....Maybe she might drop by and give her experience.

Edited by CrazyRedhead
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23 hours ago, browri said:

So I got the opportunity to check in with my father and find out how much levothyroxine he takes. He said 100mcg. So it looks like I may have a ways to go. Although he is in his early 50s and I may not need as high a dose because I'm in my late 20s.

So far, it seems like I may have side effects from levothyroxine but I also can't tell if they are problems I'm having that are completely unrelated: anxiety/hyperactivity/nervousness, which is very mild and some days feels like jitters that comes and goes. Headaches but I'm also on max dose of vortioxetine, which can cause some pretty bad headaches. What's most curious is the diarrhea. To those who have taken levothyroxine, was diarrhea normal starting out?

I never had any diarrhea starting out. I started at the lowest dose (25 mcg, when I was still seeing my GP for this issue). Then my TSH was borderline high again after about 2 years and I was still having symptoms like the extreme tiredness and weight gain and all that jazz (I don't need to explain to you, you get it). So my very good endocrinologist I started seeing agreed to increase to 50 mcg and that's been better for me. I just saw him and he thinks my levels are great! Finally! I feel a lot better too than before when my thyroid was whacky. 

I've also never had nervousness from it. Could it be possible that you started on too high of a dose? You don't want to overshoot it. I'm no Dr. But maybe it's possible? Can you get your levels checked soon ish? Just a thought for you to bring up to your endocrinologist Dr. But my hope is that your body will adjust to it. 

And if you don't have an endocrinologist Dr I highly highly highly recommend getting one vs letting a GP handle this sort of thing. This is just my experience but I have found it to be much more specialized care and more knowledgeable and everything. I even had 2 ultrasounds done to look for nodules or anything funky. Luckily nothing but some excess tissue was found. But my endocrinologist set all this up, not my GP. 

Good luck! If you have any questions about my experiences with this let me know! 

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On 12/17/2019 at 8:28 AM, Wonderful.Cheese said:

I never had any diarrhea starting out. I started at the lowest dose (25 mcg, when I was still seeing my GP for this issue). Then my TSH was borderline high again after about 2 years and I was still having symptoms like the extreme tiredness and weight gain and all that jazz (I don't need to explain to you, you get it). So my very good endocrinologist I started seeing agreed to increase to 50 mcg and that's been better for me. I just saw him and he thinks my levels are great! Finally! I feel a lot better too than before when my thyroid was whacky. 

I've also never had nervousness from it. Could it be possible that you started on too high of a dose? You don't want to overshoot it. I'm no Dr. But maybe it's possible? Can you get your levels checked soon ish? Just a thought for you to bring up to your endocrinologist Dr. But my hope is that your body will adjust to it. 

And if you don't have an endocrinologist Dr I highly highly highly recommend getting one vs letting a GP handle this sort of thing. This is just my experience but I have found it to be much more specialized care and more knowledgeable and everything. I even had 2 ultrasounds done to look for nodules or anything funky. Luckily nothing but some excess tissue was found. But my endocrinologist set all this up, not my GP. 

Good luck! If you have any questions about my experiences with this let me know! 

Then in this case I'm inclined to think that the diarrhea is likely a side effect of the Trintellix because I'm on a high dose and doesn't really have anything to do with the Synthroid.

To be fair @Wonderful.Cheese there's been other stuff going on that could be causing the jitters such as other med changes that further muddy the waters. I am letting my GP handle the Synthroid for now until he feels outside of his comfort zone. Only reason I don't go see an endocrinologist is because I know for a fact that it's hereditary because my father had the same problems. TSH is just slightly too high, and T4 is just slightly too low. 100mcg of Synthroid and everything is normal for him. So I figured that it would be predictable. My father and I have proven to be biologically and psychologically quite similar in numerous ways that I have to imagine there is a level of predictability in our medical treatments.

My gdoc did say that I shouldn't have blood work done for at least 6 weeks from starting Synthroid but preferably 8 weeks to be sure. That puts me in mid-February. I see my pdoc again in early March to go over the numbers. Likely we'll have to increase the Synthroid. I'm hoping though that starting Synthroid earlier and not waiting until I'm super symptomatic should allow me to take a lower dose and potentially not need to go to 100mcg.

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7 minutes ago, browri said:

Then in this case I'm inclined to think that the diarrhea is likely a side effect of the Trintellix because I'm on a high dose and doesn't really have anything to do with the Synthroid.

To be fair @Wonderful.Cheese there's been other stuff going on that could be causing the jitters such as other med changes that further muddy the waters. I am letting my GP handle the Synthroid for now until he feels outside of his comfort zone. Only reason I don't go see an endocrinologist is because I know for a fact that it's hereditary because my father had the same problems. TSH is just slightly too high, and T4 is just slightly too low. 100mcg of Synthroid and everything is normal for him. So I figured that it would be predictable. My father and I have proven to be biologically and psychologically quite similar in numerous ways that I have to imagine there is a level of predictability in our medical treatments.

My gdoc did say that I shouldn't have blood work done for at least 6 weeks from starting Synthroid but preferably 8 weeks to be sure. That puts me in mid-February. I see my pdoc again in early March to go over the numbers. Likely we'll have to increase the Synthroid. I'm hoping though that starting Synthroid earlier and not waiting until I'm super symptomatic should allow me to take a lower dose and potentially not need to go to 100mcg.

Gotcha. It does seem like a good idea to start the synthroid early and hopefully avoid needing a higher dose and avoid becoming highly symptomatic. Sounds like you have a good plan in place. I wish you good luck with your starting of your treatment with synthroid. It has helped me so I hope it can help you a lot too. 

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