Posted 5/26/2014 3:47 PM (GMT -6)
I am a 40 year old male who was diagnosed hypothyroid almost two years ago based on TSH level testing only done by a nurse practitioner. I was prescribed 50mcg Synthroid after my initial TSH test which I have been taking ever since. My TSH levels were routinely tested.
Testing done by Labcorp, reference range is 0.450 to 4.500
A bit about my other health conditions and medications:
High BP - take 10mg lisinopril. Eye doctor believes that my unchecked high bp lead to my retina detachment in 2012. I was taking the lisinopril with the water pill, but I was referred to a nephrologist after my creatinine levels came back consistently high. They still come back elevated, but are stable. Some of my labs also indicate that I am prediabetic.
High cholesterol - take 20mg pravastatin. My diet isn't the greatest, my job keeps me on the run and I eat a lot of grab and go junk.
Gastritis - take 30mg lansoprazole. I suffered from constipation, nausea, diarrhea, vomiting, acid reflux before seeing a gastroenterologist who did a colonoscopy and an upper endoscopy. A second upper endosocopy since the initial one also revealed some esophagitis. I also had a balloon inserted in my throat the second time because I reported issues with swallowing (which I still have today).
Depression - Was taking 120mg Cymbalta, 450mg Wellbutrin. Cymbalta went generic (Duloxetine) at the beginning of this year, and I got the worst side effects from it. Insurance doubled the price of the brand name after the generic was released, so I decided to try something new. I now take 10mg (just up from 5mg) of a new drug called Brintellix. I have tapered off the Wellbutrin completely and am down to 30mg of Duloxetine with plans to be off of it completely within another two weeks.
ADHD - I was tested over a year ago. I have always had attention issues, but it wasn't until I started seeing a new psychiatrist that she suggested I get tested. I take 60mg Adderall XR for it. It helps me focus but doesn't give me a real boost of energy.
Anxiety/other psychiatric issues - I take 2mg Xanax for my anxiety and 1mg Risperdal for atypical psychiatric issues (irritability mainly)
I have also had multiple oral surgeries to remove all my teeth due to poor dental hygiene and my poor diet.
I was diagnosed with mild sleep apnea (I think a 7 or 8?) but was still given a cpap machine. I am non-compliant.
I developed a cataract in the same eye that the retina detached in, and earlier this year I had a lens replacement done. I have to go back because there is now haziness that is keeping my vision from getting better in that eye.
I take a multivitamin, coq10, vitamin d (suggested by nephrologist), a vegetarian omega oil capsule (didn't care for the fish burps), and i have just started to take a nine type blend of probiotics and I plan to start taking l-tyrosine.
At the beginning of this year, I was excited that I was going to be able to finally start saving some money by using generic Cymbalta over the brand name. My brand name copay for Tier 3 drugs is very high. But little did I know that the switch would be the beginning of my undoing. I started developing bad side effects - feeling really tired, headaches, etc, etc. I tried to go back to the brand name after being on the generic for a few months, but could not afford it.
about this time I also started thinking that there could be other things causing my issues. Our regional health care system has a secure messaging portal where you can communicate with office staff at every location and they will communicate with the doctors and get back to you. Because of my online research, I had asked for a full thyroid panel (because I read that just testing TSH alone is not enough) and also iron tests. My doctor felt like everything was fine and no more testing was needed.
I knew better because I was tired all the time, and would just sleep all day. Caffeine didn't help, the Adderall didn't help, nothing did. So my only choice was to take a leave of absence from work, or lose my job due to excessive tardiness.
I was lucky to get squeezed in with an appointment with an endocrinologist three weeks ago. We spoke for a while, I got a better understanding of things, and she asked me about my family history. I had talked to my mother previous to this, because I knew that she has had thyroid issues ever since she became pregnant with my youngest sister. I learned that both my parents and one of my sisters are hypothyroid and are on 100mcg+ of Synthroid. Two of my aunts and one of my female cousins have been diagnosed with Hashimoto's. My grandmother had her thyroid completely removed when she was younger (not sure when).
The endocrinologist ordered a full thyroid panel. Here are the results along with the reference ranges. Again, testing was done by Labcorp.
Antithyroglobulin antibody 1.0 (0.0-0.9)
Triiodothyronine,free,serum 3.0 (2.0-4.4)
TSH 6.790 (I hadn't taken my Synthroid that morning)
Thyroid peroxidase antibody 102 (0-34)
Thyroxine, free, direct 1.23 (0.82-1.77)
Based on these results, I received a message that I was diagnosed with Hashimoto's. And that my Synthroid was being increased from 50mcg to 75mcg. I am taking 1.5 pills per day until my supply runs out. I have a follow up with the endocrinologist in 1.5 months.
She had also mentioned at the visit about testosterone possibly being an issue. But treating that could make my sleep apnea worse. So we did not test. I later rethought that, and asked for the testing to be done, so we could be sure one way or the other. The results came back normal.
To be diagnosed with Hashimoto's on top of everything else is just too much. I am very hesitant to return to work and have requested an extension on my leave. Our leave is handled by a third party company, so I am pretty much at their mercy. I have also been in contact directly with my human resources department and have been emailing (but gotten no response from) my supervisor with updates.
Having mental illnesses and then trying to deal with physical illnesses on top of that is just too much sometimes. I tend to get easily overwhelmed and just want to shut down and sleep.
Just throwing all of this out there to see what other people think and any advice that you may have for me. Do I need to have any additional thyroid tests done? Should I have a thyroid ultrasound? Am I being undermedicated? I still feel almost just as tired as before and sleep in almost every day. Even if I take an Ambien to help me fall asleep.
I bought a book from Amazon called "Hashimoto's Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause" by Izabella Wentz, PharmD. She is a pharmacist who has Hashimoto's, and it deals with her journey from diagnosis to seeking treatments to heal the root causes of the illness, by disabling the vicious unending cycle of Hashimoto's, including immune system overload, adrenal insufficencty, gut dsyfunction, impaired digestion, inflammation, and thyroid hormone release abnormalities. She also mentions how the disease presents itself with typical and atypical hypothyroid symptoms.
The book is a 350 page paperback and I am already overwhelmed looking at the size of it and have not began to read it. I am also concerned that I will be putting too much faith into it before I read it and will feel let down when I finish. But it has gotten good reviews.
Thanks for listening.
ps. If there is a bright spot to this week it is that I am probably going to visit a cat who is up for adoption. I am a big cat lover, and would like to help another one find a forever home.
pps. I have been reading other threads on the board. Despite the FDA claims that there are virtually no differences between brand name and generic drugs, myself and others who have taken generic Cymbalta (Duloxetine) have found this to just not be true. The FDA's own site only requires a test with 24 to 36 volunteers to show that the required strength of the medicine reaches the bloodstream in a given amount of time. That is setting the bar pretty low. Not to mention the other additives and fillers that generic manufacturers may add to the medication that people have reactions to. One generic version of Wellbutrin, called budeprion, was pulled off the market six years after it was released because it was not equivalent to the brand name or other generics in the 300mg form. I take brand name Synthroid and will continue to do so, I have been told there is too much tolerance in the production of generic levothyroxin. Plus, CVS/Caremark mail order never has it in stock.