Q. I have been hypothyroid since I had half my thyroid removed years ago. A complete thyroid panel is done every 6 months. My results are always normal but I don’t feel good.
I am sensitive to cold, have no energy and terrible sleep problems. I take Synthroid when I rise and wait an hour to eat. I just don’t know what else I can do to improve my situation.
A. Some doctors prefer to treat strictly according to test results, relying especially on TSH (thyroid stimulating hormone). When TSH is high, the brain is trying to send the thyroid gland a message: make more thyroid hormone! There is controversy about the appropriate cut-off levels for when TSH is considered normal.
Usually Synthroid (levothyroxine, a synthetic form of T4) is adequate for treatment once the proper dose is established. The body converts T4 to T3, which is the active form of the hormone. Some people have difficulty making that conversion, however. They may feel better on desiccated thyroid hormone such as Armour or Westhroid.
You would be surprised to learn how controversial such natural thyroid treatment is. There is an active forum on our website with hundreds of messages. Here are just a few:
This comes from L.M.:
“I’ve been on levothyroxine for around 5 years and have felt crappy ever since starting it. I felt better at the 75 mcg dose but doctors insist I need 100 mcg. At one time they had me on 125 mcg during the early years. Anyway, thanks for all the comments. I’m going to try taking mine before bedtime, which always is well after midnight.
“I usually wake up around noon, take the levo, wait an hour to eat, wait 4 more to take vitamins and supplements. The only time I can really sleep well is when I take about 2 or 3 teaspoons of ZzzQuil, but I don’t like taking it too often.
“I really want this change of taking my levo at bedtime to work, so I can start having coffee or tea again when I first wake up instead of a levo. And I like to drink milk before the coffee or tea. Oh, life will be good again (I hope).
“P.S. I asked my doc if I could have Armour…she said no, she doesnt’t prescribe it. I asked if I could try Synthroid instead of levothyroxine. She said levo’s cheaper and there’s no difference. I don’t believe her but she didn’t seem to want to give me a chance to try the Synthroid. Wonder why?
“Anyway, maybe taking my levo at night will make me feel normal again instead of like death warmed over. I just want my energy back. I’ll be skipping my noon dose today and will start tonight and will post again on how it’s working out.
“I was shocked reading that some were in hospitals that served up thyroid meds along with all the vitamins and supplements. Maybe they should ask the patients first if their dose is based on them taking with or without supplements (if they know)…but I know the norm is to take them apart.”
L.M. is right that taking levothyroxine with minerals like calcium, zinc or magnesium (often found in multivitamins) can affect absorption. It is much better to wait at least two hours before taking such minerals. Here is what M.S. has to say about Armour thyroid:
“I was on Armour thyroid for many years after having thyroid surgery, leaving only 2% intact. I had no problems till a new doc decided that I should be on Synthroid because it was more exact.
“I hated it. I was dead tired all of the time and just had no energy. Finally, I insisted on being put back on Armour. What a difference it made.”
To help you sort through the thyroid confusion so you can discuss your treatment with your doctor, we are sending you our newly revised 25-page Guide to Thyroid Hormones. In it you will find help in interpreting your blood test results as well as information on drugs that can affect test results, autoimmune conditions affecting the thyroid, dietary considerations and helpful supplements. It is available as a download ($3.99) from www.PeoplesPharmacy.com.
