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I was diagnosed with Graves' disease a year ago. I was

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I was diagnosed with Graves'...
I was diagnosed with Graves' disease a year ago. I was allergic to methamazole. I ended up having my thyroid removed nov 2015. I now have blood work that shows hypothyroid and yet I can't take more than 75mcg of synthroid. At 100 mcg I have signs of hyperthyroid--diarrhea, nausea, tachycardia, insomnia. I can't take Levothyroxine and my t3 and t4 are normal and my tsh continues to increase. I have had issues that could be hypothyroid too--weight gain, cold fingers, toes, a stress fracture spontaneously in my foot. No one knows what to do
Submitted: 1 year ago.Category: Endocrinology
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10/14/2016
Endocrinologist: Dr. David, Other replied 1 year ago
Dr. David
Dr. David, Other
Category: Endocrinology
Satisfied Customers: 47,181
Experience: Experienced physician, undergraduate studies at MIT, studied Engineering, qualified to answer your questions.
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Endocrinologist: Dr. David, Other replied 1 year ago

I have graves disease myself

and had my thyroid destroyed on I-131 therapy.

I have been on levothyroxine now for 4 years to get the proper level

it is always best to use blood testing to tell your thyroid hormone levels

symptoms are not reliable

I have many times thought I was hyper or hypo and then got blood tests to show I was wrong.

you can take 75mcg 5 days a week and two days a week take 100mcg

and do that for 6-8 weeks

make sure you take your synthroid always on an empty stomach the same time every day and not with other medications.

and don't forget to take it

and let your blood test show you what your TSH levels and free T4 levels are.

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Customer reply replied 1 year ago
I have done that. To no avail. My tsh continues to rise and I can tolerate only twice a week. My weight could allow me as much as 200 mcg.
Customer reply replied 1 year ago
But t3 and t4 are normal.
Endocrinologist: Dr. David, Other replied 1 year ago

you don't take thyroid hormone because of your weight.

what was your most recent TSH level?

what do you mean your TSH continues to rise?

tolerate what twice a week?

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Customer reply replied 1 year ago
My tsh is around 60. When I take more synthroid I throw up. Get tachycardia. Insomnia over two weeks since increasing to 100 after 10 weeks of three days a week
Customer reply replied 1 year ago
I know I don't take synthroid because of my weight. What I meant was according to body weight I should be on more.
Customer reply replied 1 year ago
I work in health care. So I am familiar with all this.
Endocrinologist: Dr. David, Other replied 1 year ago

it is not your thyroid hormone which is causing your tachycardia, insomnia symptoms

do you have excessive anxiety symptoms? excessive anxiety symptoms can cause tachycardia, insomnia.

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Customer reply replied 1 year ago
No anxiety issues. It is directly related to the synthyroid they have ruled out cardiac and GI issues.
Customer reply replied 1 year ago
It happens within 8 hours of the increased dose. After my surgery for about four months I tolerated 150mcg of levothyroxine with no issues. We had to back off to fifty to get symptoms to dissipate
Endocrinologist: Dr. David, Other replied 1 year ago

with a TSH of 60, your thyroid levels would not cause you tachycardia or insomnia.

you can ask your doctor for Armour dessicated thyroid hormone

perhaps you will do better with that.

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Customer reply replied 1 year ago
She won't prescribe it because my t3 is normal and I am so sensitive to it. They have tried anti anxiety meds including benzodiazepines not to reduce symptoms only reducing Synthroid reduces symptoms. T3 and t4 are normal
Customer reply replied 1 year ago
We have tried a placebo (of course I didn't know) that did not help
Customer reply replied 1 year ago
All my other blood work is normal.
Endocrinologist: Dr. David, Other replied 1 year ago

why would they try anti-anxiety medications if you don't have anxiety?

it sounds like you have excessive anxiety symptoms here causing your nausea and fast heart rate and tachycardia.

it is not the synthroid

if they gave you a placebo and you still had these symptoms, then it is not the synthroid which is causing your symptoms.

it is your own excessive anxiety disorder which is doing this.

benzos will help decrease anxiety related symptoms of nausea, fast heart rate and insomnia. these are not synthroid related symptoms.

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Customer reply replied 1 year ago
I have never had symptoms of anxiety until I was hyperthyroid. I have seen a psychiatrist I am usually very calm. Not anxious at all. It is directly related to my synthroid. Never had anxiety before except when I was clearly hyperthyroid.
Endocrinologist: Dr. David, Other replied 1 year ago

you had Graves disease before.

did you have severe anxiety before when your thyroid gland was producing too much thyroid hormone for your body before Nov 2015?

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Customer reply replied 1 year ago
Never once
Endocrinologist: Dr. David, Other replied 1 year ago

then it is not thyroid hormone causing your symptoms.

it is excessive anxiety on your part, worry of taking these synthroid pills which is causing your symptoms.

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Customer reply replied 1 year ago
I don't worry about it at all. I would take 200 mcg if someone handed me the pills but then I would vomit. Get diarrhea and I feel no anxiety. I never have any trouble sleeping either except 12 hours after the dose of increased amounts. I am very laid back
Customer reply replied 1 year ago
I have tried several times.
Customer reply replied 1 year ago
I really can't say I feel anxious at all. I am not worried and would love to find proper dosage
Endocrinologist: Dr. David, Other replied 1 year ago

when your doctors gave you a placebo sugar pill, you still had these same symptoms you said.

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Customer reply replied 1 year ago
Placebo anxiety pill. Not placebo synthroid.
Endocrinologist: Dr. David, Other replied 1 year ago

what is the point of a placebo anxiety pill?

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Customer reply replied 1 year ago
To tell me they were trying to treat anxiety. I am about as unanimous a person can be.
Customer reply replied 1 year ago
Un anxious
Customer reply replied 1 year ago
I really know most people get anxious. Very few things make me anxious and I wish I could take more synthroid cuz I wouldn't be so tired and feel blah. But my body really reacts significantly.
Endocrinologist: Dr. David, Other replied 1 year ago

I think you only get anxious when you take synthroid pills because you are worried about what it will do for you

and you are creating these symptoms of fast heart rate and can't sleep from your worry about taking the pill.

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Customer reply replied 1 year ago
I know most people would be in denial. I am happy to take more and often try. I am not anxious about taking more.
Endocrinologist: Dr. David, Other replied 1 year ago

then you should take 100mcg of synthroid daily on an empty stomach to get your thyroid hormone levels up.

your TSH level are very low

you are exteremely hypothyroid.

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Customer reply replied 1 year ago
I would love to. I have for two weeks. And my TSH is still increasing and my t3 and t4 are normal and I have monitored my pulse and my sleep and it corresponds directly. Sleep less and less. Get nauseated more and more. My pulse has increased by 2-3 bpm daily since and now I have diarrhea.
Customer reply replied 1 year ago
if I drop even for a day the symptoms all return to nirmal
Endocrinologist: Dr. David, Other replied 1 year ago

you need to stop monitoring your pulse

this only worsens your worry. there is no need to monitor your pulse. the act of checking your pulse will increase your heart rate.

your body is too use to low thyroid hormone levels.

you can take 75mcg.

so take 75mcg.

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