A PSA of Sorts

[rolanni]

Those who have been reading along at home will perhaps recall that I have an underachieving thyroid. It's no big deal; is, as I understand it, fairly common, or at least not uncommon; and perfectly treatable with a daily dose of a prescribed medication. You can read about it here, if you're interested.

Now, one of the interesting things about the hormones produced by your thyroid, my thyroid, and the thyroid of the woman at the coffee counter trying to decide if she wants a double-shot of espresso, is that "normal" is a range -- between X and Y is normal function.

With me so far?

Good.

The aim of medicating people with hypothyroidism is to supplement hormone levels to "normal," which makes perfect sense.

Except that -- and despite the fact that hypothyroidism is a pretty common problem for Women of a Certain Age -- apparently no one takes a baseline of "normal" thyroid function when you -- General You -- are young and healthy and presumably firing on all cylinders, so that there's an on-file "normal" to return you to, should your thyroid suddenly come up lazy.

This potentially leads to circular discussions with one's doctor about if one's supplemented hormone level is "normal" on the scale, but one is still experiencing symptoms, could it be that one had been used to a higher "normal" production level of hormone, back in the day?

So! If you're a young woman -- ask your doctor about a thyroid test the next time you get blood work, so you have a baseline on-file, should the day ever come when you need supplements. You might have to get a little chesty with him or her, but, hey, it's your blood and your future.

Now! Another cup of coffee, and to the couch!

Comments

[saffronrose.livejournal.com]

I'm at 125 mcg. My need is for my TSH to be *under* 2, or I am a mess. I am under the care of an internist and an endocrinologist/diabetes specialist, and BOTH listen to me about this. In talking to an observing intern the endo said that some people need to be under 2 to function well.

I have a friend who has the same dosage. She has major depression, I have bipolar NOS. This is not the only thing that can cause the need for a closer titration of synthroid.

Perhaps you need a specialist on this, if insurance allows. I started out at 4ish, and 25mcg. During the worst of recent spells of depression & inability to get myself out of bed, my TSH was 4ish, again...quelle surprise. I always ask for the TSH number, not just "normal"--I have to.

[saruby.livejournal.com]

This is a very useful suggestion. I am also bipolar, bipolar II, and have been arguing for years with my psychiatrist (who I generally love) and my regular M.D., that I am hypothyroid. they keep saying that I am "normal". Maybe I am right. I should yell louder. Thanks.

[saffronrose.livejournal.com]

DO ask them for the TSH number. If you think you can do some research, as opposed to spending time still not getting useful answers online, see what you can find for "narrow titration in hypothyroid treatment". If you know/have access to a medical librarian, even better.

Good luck. I did have to keep arguing until I got someone willing to give it a try. Indeed, normal for the general population is not normal for *everyone*.

[swedishsis.livejournal.com]

Definitely ask for the TSH number. I would suggest also a Free T4 and possibly a T3 level. To see if you have subclinical hypothryoidism.

Another suggestion would be to have them check for the presence of thyroid autoantibodies (Anti-TPO and Anti-TG) since autoimmune thyroiditis or Hashimoto is the most common cause of hypothyroidism in the US.

Ask specifically for an endocrinologist referral if you have doubts.