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Underactive thyroid

Discussion in 'Health and wellbeing' started by jubileebabe, Apr 21, 2011.

  1. I've just been diagnosed with an underactive thyroid.
    I have suspected a problem for at least 4 years but all tests came back OK. (I've since found out that the tests can come back OK even if there is a problem and I should have been checked more regularly.)
    I was tested in February last year and the TSH level was 3.56. This was considered in the normal range. I am TTC and recently found out that this level is considered to high for pregnancy so I went back to the doctor and asked to be referred to a specialist. She initially refused because the levels were "normal" but I persuaded her to let me be tested again and this time the level was 10.7!!!
    I have been for a scan which revealed the thyroid is enlarged and on the notes it is written that this is not something new.
    I am really scared about what will happen now. I am going to see an endocrinologist (privately so as not to wait 6 weeks) but I am worried that a lot of damage has already been done.
    I have done a quick search on here and found that someone had written that their mother had this problem untreated for a long time and died a month after starting treatment.
    Has anyone got any positive stories to share to give me some hope? I'm really scared right now.
     
  2. lilachardy

    lilachardy Star commenter

    My sister's thyroid gland packed up about 15 years ago.
    You'd not know anything was wrong unless you noticed her popping the pills every morning.

    For most people it's not a big deal - you just take thyroxine and then you are "normal" again!
     
  3. Has she had any (thyroid related) problems since starting the thyroxine?
    How old was she when she was diagnosed? I'm 33 but suspect I have had a problem for at least 4 years, if not longer.
     
  4. lilachardy

    lilachardy Star commenter

    Nope
    16ish. We suspect it'd been there for several years before she was diagnosed, but her lethargy was confused with teenage grumpiness!
     
  5. Mine's knackered. I knew it was that and had several tests at my own request which all came back low-normal. Well what is normal for Ms Notional Average UK 40 year old is not quite enough for me, and when I finally managed to convince them of that and got a trial of thyroxine, it was like coming out of a dark stuffy room into the light of shining day.
    I have been taking it for about ten years and have had no problems at all, not even when I accidentally overdosed for months by taking 100mcg tablets that I thought were 25 mcg. [​IMG]
     
  6. I've got this too. Not caused me a problem since I've been diagnosed (touch wood). On the rare occasions that I do forget to take the pills, I feel very lethargic by early evening.

     
  7. Jubileebabe
    I agree with all the other posters who say that once you are taking the tablets things will settle. I take 125mg a day -took 200 at first 11 years ago. I was exhausted,anxious, stressed, snappy and scared before I was diagnosed-but those states are all symptoms so it is very normal to be scared. Things will improve...


     
  8. I was diagnosed with an underactive thyroid (for the first time) in 1991. I popped the thyroxine dutifully for years. Then my levels started messing about and I was on varying levels of thyroxine for years and felt dreadful. Eventually I stopped taking it of my own volition and felt better. As it stands at the moment I <u>don't</u> have an underactive thyroid but I do have high T4 levels which means that something's having to work harder to make the thyroid levels normal (ish). I'm being monitored for T4 levels 6 monthly.
    So, although most people end up taking thyroxine for the rest of their lives, sometimes things right themselves. Bodies are weird eh?
    FWIW, when I started taking thyroxine originally it was amazing - I felt so much better. Hope that happens for you[​IMG]
     
  9. Thanks for the replies :)
    I've seen the endocrinologist and am now on 50mcg per day of medication. She wants to see me again in a couple of months to see if the dose needs to be adjusted or not.
    How long did it take you to stabilise your levels?
    I've not been feeling bad in myself at all apart from being vulnerable to picking up bugs at school. It turns out my hypothyroidism is caused by an autoimmune illness. as anyone else got that?
    Has anyone been told to avoid certain foods? I asked the endo about that and she said I can eat anything but I've read various things that suggest there are some foods that should be avoided.
     
  10. I was told to avoid eating for 30 mins after taking them and not to take them round the same time as indigestion, Iron or Vitamin preparations. Otherwise no.
    They start you off on a dose suggested by your blood test results and then adjust it in the light of later tests. I started on 50mcg and it went up in 25s until I was on 125mcg, the dosage at which I feel best. But blood tests keep showing that the dose is "too high" so my GP will only prescribe 100.
     

  11. Mine's possibly part of an autoimmune thing - not sure which came first but the underactive thyroid stopped my other treatments being effective.

    Thyroxine is my favorite med- it made a hugh difference in days

    lilyofthefield
    Sorry to hear about yout GP - mine is happy to prescribe the amount i feel well on - he says any extra will be excreted in my urine and who am I to argue (obviously if I was taking massively more it would be different)
     
  12. I've never been given advice about when to take it or any foods to avoid. And to me it doesn't make sense to avoid foods.

    Have alook at the info on the leaflet with the pills, not websites, there issome bad science on the www.

    Here's a cut and paste from the BNF - the guidelines Drs use when prescribing

    <h1>LEVOTHYROXINE SODIUM</h1> hypothyroidism; see also notes above
    <h2>Cautions</h2> panhypopituitarism or predisposition to adrenal
    insufficiency (initiate corticosteroid therapy before starting levothyroxine),
    elderly, cardiovascular disorders (including hypertension, myocardial
    insufficiency or myocardial infarction, see Initial Dosage below),
    long-standing hypothyroidism, diabetes
    insipidus, diabetes mellitus (dose of antidiabetic
    drugs including insulin may need to be increased); interactions: Appendix 1 (thyroid hormones)
    <h3>Initial dosage</h3> Baseline
    ECG is valuable
    because changes induced by hypothyroidism can be confused with
    ischaemia. If metabolism increases too rapidly (causing diarrhoea,
    nervousness, rapid pulse, insomnia, tremors and sometimes anginal
    pain where there is latent myocardial ischaemia), reduce dose or
    withhold
    for 1&ndash;2 days and start again at a lower dose
    <h2>Contra-indications</h2> thyrotoxicosis
    <h2>Pregnancy</h2> monitor maternal serum-thyrotrophin concentration&mdash;levothyroxine
    may cross the placenta and excessive maternal concentration can be
    detrimental to fetus
    <h2>Breast-feeding</h2> amount too small to affect tests for neonatal
    hypothyroidism
    <h2>Side-effects</h2> usually at excessive dosage (see Initial Dosage
    above) include diarrhoea, vomiting, anginal pain, arrhythmias, palpitation,
    tachycardia, tremor, restlessness, excitability, insomnia; headache,
    flushing, sweating, fever, heat intolerance, weight-loss, muscle cramp,
    and muscular weakness; transient hair loss in children; hypersensitivity
    reactions including rash, pruritus and oedema also reported
    <h2>Dose</h2> adult over 18 years, initially
    50&ndash;100 micrograms once daily, preferably before breakfast, adjusted
    in steps of 25&ndash;50 micrograms every 3&ndash;4 weeks according to response
    (usual maintenance dose 100&ndash;200 micrograms once daily); in cardiac
    disease, severe hypothyroidism, and patients over 50 years, initially
    25 micrograms once daily, adjusted in steps of 25 micrograms every
    4 weeks according to response; usual maintenance dose 50&ndash;200 micrograms
    once daily; child under 18
    years see BNF for Children (section 6.2.1)
    Congenital hypothyroidism and juvenile myxoedema, see BNF for Children (section
    6.2.1)
    Sub-sections
    <ul class="jT"><li class="jN" id="_4238" style="margin:0pt 0pt 0pt 20px;">Tablets, levothyroxine sodium 25 micrograms,
    net price 28-tab pack = &pound;2.22; 50 micrograms, 28-tab pack = &pound;1.09;
    100 micrograms, 28-tab pack = &pound;1.09Brands include Eltroxin&reg;
    Oral solution, levothyroxine sodium
    25 micrograms/5 mL, net price 100 mL = &pound;42.75; 50 micrograms/5 mL,
    100 mL = &pound;44.90; 100 micrograms/5 mL, 100 mL = &pound;52.75Brands include Evotrox&reg; (sugar-free)
    All strengths of levothyroxine oral solution
    by Almus and branded as Evotrox&reg;, have been reformulated
    (August 2010) leading to an increase in potency of approximately 10%;
    the manufacturer advises that the recommended dose has not changed,
    but recommends increased monitoring of patients on these preparations
    as dose adjustments may be necessary
    [/LIST]This is the Appendix entry - some drugs should not be taken with thyroxine but nothing about food
    <h1>Levothyroxine</h1>Levothyroxine
    has the following interaction information:

    <table cellspacing="2"><tr><td>Antacids</td><td>
    absorption of
    levothyroxine
    possibly reduced by
    antacids

    </td><td>Antacids should preferably not be taken at the same time as other drugs since they may impair absorption</td></tr><tr><td>Calcium Salts</td><td>
    absorption of
    levothyroxine
    reduced by
    calcium salts

    </td><td>see also Antacids</td></tr><tr><td>Cimetidine</td><td>
    absorption of
    levothyroxine
    reduced by
    cimetidine

    </td><td> </td></tr><tr><td>Colesevelam</td><td>
    absorption of
    levothyroxine
    reduced by
    colesevelam

    </td><td>Other drugs should be taken at least 4 hours before or after colesevelam to reduce possible interference with absorption </td></tr><tr><td>Imatinib</td><td>
    plasma concentration of
    levothyroxine
    possibly reduced by
    imatinib

    </td><td> </td></tr><tr><td>Iron</td><td>
    absorption of
    levothyroxine
    reduced by oral
    iron
    (give at least 2 hours apart)
    </td><td> </td></tr><tr><td>Lanthanum</td><td>
    absorption of
    levothyroxine
    reduced by
    lanthanum
    (give at least 2 hours apart)
    </td><td> </td></tr><tr><td>Orlistat</td><td>
    possible increased risk of hypothyroidism when
    levothyroxine
    given with
    orlistat

    </td><td> </td></tr><tr><td>Polystyrene Sulphonate Resins</td><td>
    absorption of
    levothyroxine
    reduced by
    polystyrene sulphonate resins

    </td><td> </td></tr><tr><td>Propranolol</td><td>

    levothyroxine
    accelerates metabolism of
    propranolol

    </td><td> </td></tr><tr><td>Rifampicin</td><td>
    metabolism of
    levothyroxine
    accelerated by
    rifampicin
    (may increase requirements for levothyroxine in hypothyroidism)
    </td><td> </td></tr><tr><td>Sevelamer</td><td>
    absorption of
    levothyroxine
    possibly reduced by
    sevelamer

    </td><td> </td></tr><tr><td>Sucralfate</td><td>
    absorption of
    levothyroxine
    reduced by
    sucralfate

    </td><td> </td></tr></table>Levothyroxine belongs to Thyroid Hormones
    and will have the following interactions:

    <table cellspacing="2">













    <tr>
    <td>Amiodarone</td>
    <td>
    for concomitant use of
    thyroid hormones
    and
    amiodarone
    see section 2.3.2
    </td><td>Amiodarone has a long half-life; there is a potential for drug
    interactions to occur for several weeks (or even months) after treatment
    with it has been stopped</td>
    </tr><tr>
    <td>Amitriptyline</td>
    <td>

    thyroid hormones
    enhance effects of
    amitriptyline

    </td><td> </td>
    </tr><tr>
    <td>Antidepressants, Tricyclic</td>
    <td>

    thyroid hormones
    possibly enhance effects of
    tricyclics

    </td><td> </td>
    </tr><tr>
    <td>Barbiturates</td>
    <td>
    metabolism of
    thyroid hormones
    accelerated by
    barbiturates
    (may increase requirements for thyroid hormones in hypothyroidism)
    </td><td> </td>
    </tr><tr>
    <td>Carbamazepine</td>
    <td>
    metabolism of
    thyroid hormones
    accelerated by
    carbamazepine
    (may increase requirements for thyroid hormones in hypothyroidism)
    </td><td> </td>
    </tr><tr>
    <td>Colestipol</td>
    <td>
    absorption of
    thyroid hormones
    reduced by
    colestipol

    </td><td>Other drugs should be taken at least 1 hour before or 4&ndash;6 hours
    after colestipol to reduce possible interference with absorption </td>
    </tr><tr>
    <td>Colestyramine</td>
    <td>
    absorption of
    thyroid hormones
    reduced by
    colestyramine

    </td><td>Other drugs should be taken at least 1 hour before or 4&ndash;6 hours
    after colestyramine to reduce possible interference with absorption</td>
    </tr><tr>
    <td>Coumarins</td>
    <td class="cDC">

    thyroid hormones
    enhance anticoagulant effect of
    coumarins

    </td><td>Change in patient&rsquo;s clinical condition, particularly
    associated with liver disease, intercurrent illness, or drug
    administration, necessitates more frequent testing. Major changes in
    diet (especially involving salads and vegetables) and in alcohol
    consumption may also affect anticoagulant control</td>
    </tr><tr>
    <td>Imipramine</td>
    <td>

    thyroid hormones
    enhance effects of
    imipramine

    </td><td> </td>
    </tr><tr>
    <td>Oestrogens</td>
    <td>
    requirements for
    thyroid hormones
    in hypothyroidism may be increased by
    oestrogens

    </td><td>Interactions of combined oral contraceptives may also apply to combined contraceptive patches and vaginal rings</td>
    </tr><tr>
    <td>Phenindione</td>
    <td class="cDC">

    thyroid hormones
    enhance anticoagulant effect of
    phenindione

    </td><td>Change in patient&rsquo;s clinical condition particularly
    associated with liver disease, intercurrent illness, or drug
    administration, necessitates more frequent testing. Major changes in
    diet (especially involving salads and vegetables) and in alcohol
    consumption may also affect anticoagulant control </td>
    </tr><tr>
    <td>Phenytoin</td>
    <td>
    metabolism of
    thyroid hormones
    accelerated by
    phenytoin
    (may increase requirements in hypothyroidism), also plasma concentration of phenytoin possibly increased
    </td><td> </td>
    </tr><tr>
    <td>Primidone</td>
    <td>
    metabolism of
    thyroid hormones
    accelerated by
    primidone
    (may increase requirements for thyroid hormones in hypothyroidism)
    </td><td> </td></tr></table>
     
  13. JB I have a friend who also was diagnosed with an underactive thyroid and takes medication regularly. Lately though she's been feeling very tired and it was only when she checked her other medication she realised the problem. She'd bought some tablets in the health shop to prevent ostoporosis and it clearly stated that they effect medication for an underactive thyroid so just be careful you always check other medication. HTH
     
  14. I've been watching this thread with interest whilst waiting for my thyroid blood test results.
    Two years ago I had results of TSH 6.15 & Free T4 14.4 and later, TSH 5.45 &T4 14.0, which followed months of hypothyroidism symptoms. I also have a family history - mother and grandmother both had goitres. I saw an endocrinologist who decided that some of my symptoms could possibly be attributed to the side effects of a beta-blocker (Clonidine) that I'd been prescribed for menopausal symptoms. I was taken off the Clonidine and put on a low dose H.R.T. which seemed to address some symptoms and controlled my hot flushes. Over the past 12 months I've cut the HRT dose in half by taking one every other day.
    Recently, I felt that the hypothyroidism symptoms were back with a vengeance; exhaustion, lack of energy, insomnia, constipation, dry skin, dry and breaking hair, etc., so I've just had another blood test and the results fell with the normal range (TSH 2.64 & T4 14.5). However, my G.P called me in to tell me that I have elevated antibodies and that this almost certainly means I will become hypothyroid at some point. She's going to do some research and let me know if I need any treatment. My own initial research suggests that I have Hashimoto's Thyroiditis and that treatment with Levthyroxine could control it and prevent future problems but that doctors rarely treat it unless the patient's TSH level are also elevated. Does anyone have any helpful advice, information or experience to share?
     

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