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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
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Experience:  14 years as clinician in the field of Family Practice
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I have a thyroid problem and started seeing an endocrinologist

Resolved Question:

I have a thyroid problem and started seeing an endocrinologist 2 years ago. My family doctor revealed that I was being "over medicated" because my tsh level was so low it could not be detected and I had been complaining to her about having trouble breathing when running. My former endocrinologist had said that the tsh will be low during treatment and that we were "treating for T3" and a good T3 number was around 150. At the time I switched endocrinologists I was on 225mg of synthroid. I was losing weight and my hair was not falling out and I was sleeping well. I switched to a new endo who agreed I was being overmedicated and over the course of 5 months my level was brought down first to 200mg and then to 175mg where I am now and my tsh finally is in the low normal range (.85). The problem is that now I am not sleeping well, my hair is falling out like I am on chemo and despite vigorous exercise (running 4 times per week), eliminating sugar from my diet completely, and following a strict 1200 calorie a day diet, I can not lose an ounce! In fact I gained 2 lbs (and I am very short so that matters). My thinking is also pretty foggy. I have no idea whats right or what to do and could use some guidance! I am so frustrated!
Submitted: 9 months ago.
Category: Health
Expert:  Anthony Bray, MD replied 9 months ago.

Anthony Bray, MD : Hello!
Anthony Bray, MD : With regard to the thyroid treatment I have to agree with your primary care doctor and 2nd endocrinologist !! The TSH is technically in normal range between 0.4 to 4.5 but is generally thought that closer to 2.0 is usually more ideal for the body...
Anthony Bray, MD : A higher TSH is a sign that the body "hungers" for more thyroid hormone ...
Anthony Bray, MD : The thyroid gland itself secretes thyroid hormone in two forms -- T4 and T3...
Anthony Bray, MD : most thyroid medicines are based on replacing the most potent form of the thyroid hormone which is T4 ...
Anthony Bray, MD : the body does inter-convert T3 and T4 but the more important markers of treatment would be the T4 and TSH levels...
Anthony Bray, MD : now that being said it is ALWAYS important to treat the PATIENT and not just the lab numbers... You are more than just lab numbers after all!!
Anthony Bray, MD : Based on your symptoms it sounds that 225 mcg/day was too high....
Anthony Bray, MD : the labs would seem to say that your dose of 150 mcg/day would be fine for your dose of thyroxine ....
Anthony Bray, MD : Based on some if your symptoms it could be that you may feel better and function better on a higher dose of thyroxine such as 187mcg/ day ....
Anthony Bray, MD : based on your information my approach would probably include both restoring your thyroxine dose back a bit higher such as 187mcg/ day but also to be evaluating other possible causes of the sympXXXXX XXXXXes that concern you...
Anthony Bray, MD : Whatever reason for not sleeping well may account for the foggy feeling...
Anthony Bray, MD : Sleep disturbances such as restless leg syndrome , obstructive sleep apnea, anxiety or depression caused insomnia ---- any of these could also lead to difficulty with alertness / concentration/ memory...
Anthony Bray, MD : so a sleep study might be a consideration toward some of these causes ...
Anthony Bray, MD : hypothyroidism usually leads to an increased sleep requirement and more hours if sleep and not less...
Anthony Bray, MD : hyperthyroidism may be leading to insomnia but your changes in dose vs sleep pattern of course do not suggest this as cause...
Anthony Bray, MD : too low of thyroid hormone for you would tend to lead to trouble concentrating and possibly trouble with memory ...
Anthony Bray, MD : too little thyroid hormone may be associated with hair loss...
Anthony Bray, MD : it may also be associated with depression...
Anthony Bray, MD : so careful evaluation of you with a. Bit if increase of the dose of thyroid medicine plus careful consideration of other possible causes would be the best overall approach to your situation in my opinion...
Anthony Bray, MD : I hope that this information helps!
Anthony Bray, MD : let me know if you have further questions. I will be happy to get back with you!
Anthony Bray, MD : If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. Thank you and best regards!
Anthony Bray, MD : Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6544
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 6 other Health Specialists are ready to help you
Expert:  Anthony Bray, MD replied 9 months ago.
Hello!

This is Dr. Anthony Bray with Justanswer.com. We spoke the other day with regard to your thyroid treatment and concerning new symptoms. Thank you for using our service and thank you for your positive feedback! That is much appreciated!

Feel welcome to return in the future if you should have other health and medical questions. You are welcome to address me specifically by going to my profile page and then enter your question or comment in the box on that profile page. My profile page is http://www.justanswer.com/medical/expert-anthonybraymd/

I hope that you get your thyroid medicine dose well adjusted for you. I hope that you are soon feeling 100% again!

Take care and best regards to you!

Anthony Bray MD

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