[SueAndHerZoo]

#1060770

Hi Guys and Gals.
Life after thyroidectomy has been really good for the most part. Finding the right dose was a challenge and every time I had to change doses I went through 6-8 weeks of lousy symptoms. Luckily for the past year or two I have been at the same dosage and the level of TSH has stayed at a place that I feel good at. But last week I went for a physical to a new GP and the doc ran a complete blood work up on me (basically because I was a new patient of hers). Everything came back “normal” but when I got online and looked at all the tests she ran and their results, I was shocked to see my TSH at 3.41! That may very well be in the “normal” range to her but it’s far from normal for me – I finally found my sweet spot at 1.47 and figured I’d stay there forever.

I haven’t made any drastic changes in my life so I am stumped as to why my TSH shot up so drastically (it was 1.47 in April). 2 + 2 is equaling 4 because NOW in hindsight I’m thinking of all the lousy stuff I’ve been feeling physically and emotionally lately and bingo – it’s the same stuff I always felt when I used to change doses! So apparently I always feel it when my TSH goes up or down but I didn’t do anything to raise or lower it this time so I’m confused.

Does the dosage you need change as you age? My health is good, my lifestyle and eating habits are good, and like I said, no drastic changes.

Any thoughts or ideas? I will be calling my endo Monday and I’m sure he’ll want me to go have blood drawn again but I know my body and this stuff I’m feeling says my TSH levels are changing.

Thanks in advance – hope you’re all doing as well as possible considering this life-long challenge we’ve been handed to us.
Sue

[Liz1967]

#1184660

My TSH varies between a little less than 1 and a little more than 2. Prior to Graves, it would be 1.5 one year and 2.5 the next, going up and down within a narrow range. I have friends who have had TT’s for thyroid cancer and it isnt unusual for them to adjust their replacement hormone after getting their yearly labs, up or down, slightly. We dont exist in a vacuum, things in our bodies change a bit all the time. We get older, our estrogen levels change, we have stress, illnesses, weight changes, activity changes, take different meds (like Prilosec, which interferes with absorption) etc., things that change our requirements for thyroid hormone. When my TSH was 2.2 this spring, up from 1.3, my endo wanted to change dose and I refused. Sure enough, next lab was 1.1 and upping my synthroid would not have been a good thing! You are supposed to be between 0.5 and 2.0 on thyroid replacement so maybe a slight increase would be of benefit if you think you are feeling off. I try to pick only objective things, like if I stop growing hair on my legs, I can guarantee my TSH is on the high side, like 4. Things I cannot measure objectively, like mood, or muscle aches, I ignore, I had issues with those things a few times before Graves, whereas I never stopped having to shave my legs before Graves. If my pulse after exercise is up from my normal rate, i would count that as hyper. Feeling hot, cold, tired, mean, headaches, all those are more subjective and could be caused by a lot of other things. Watch things that interefere with absorption, like proton pump inhibitors, or falsely change your labs, like estrogen and prednisone. All in all,the variation is usually small and it is not like you are going to swing hugely hyper or hypo.

[SueAndHerZoo]

#1184661

Hmmmmmm…. may have found the culprit, but it still shouldn’t have this much of an effect, but who knows. I am and always have been VERY sensitive to even tiny changes and things that doctors say won’t affect me or that I won’t even notice, DO affect me and I DO notice. It’s great to be so in-tune with your body, but sometimes it sucks, too.

A few weeks ago I had a bone scan and the doc told me I was now officially in the osteoporosis range. I started taking calcium supplements but I am DILIGENT about not taking it anywhere near my Levothyroxine dose! They suggest four hours before or after, I have been doing 6 hours! But as you said, everyone is different and bodies change so maybe the addition of calcium, even at what is supposed to be a safe time, has affected the absorption of Levothyroxine.

Guess I’ll stop the calcium supplements.
Sue

[Liz1967]

#1184662

If you want or need to stay on calcium, you could just increase your levothyroxine to accommodate that. My daughter in law, who is hypothyroid not Graves, hates waiting an hour for her coffee so she just increased her dose and drinks coffee right away. Coffee can cut absorption by 20 percent. Maybe try 12 hours, not 6 on the calcium. I do better with real food so I get the plain yogurt that is 70% of your daily calcium. Tastes awful but supplements for some reason never work out for me.

[SueAndHerZoo]

#1184663

Thanks, Liz. I actually set my alarm for 6:00 a.m., grab my Levothyroxine and water that I keep by the bed, and then go back to sleep for an hour so I CAN have coffee as soon as I get up.

My doctor wants me off all dairy so that’s why I started taking the calcium supplements (even though she said I should get my calcium from green leafy vegetables instead, but I figured, why not do both).

I don’t really want to mess with my Levo dose because my calcium intake may change a lot in the future and I’ll forever be adjusting. I’ll just stop the calcium for now and see what doc says tomorrow.

I guess what I was really wondering is if t could be the calcium supplements that caused this big, SUDDEN change in TSH even though I take it 6 hours after my Levo. I guess anything’s possible, regardless of the “4 hour rule” that they say to go by.
Sue

[Kimberly]

#1184664

Hi Sue – Nice to “see” you! Rather than stopping the calcium supplements, I would talk to your doctor again about your levo dose to see if you can get your symptoms stabilized.

I had a family member with advanced osteoporosis, and it was awful – it impacted her quality of life far more than Graves’ disease has impacted mine.

It is common for dosages to need adjusting as we age – but in many cases, the adjustment involves reducing the dose to prevent the patient from being on the hyper side.

Also, if you are taking generic levo, see if you can figure out if your pharmacy switched manufacturers. It’s best to stay with the same manufacturer, but if for some reason a switch is necessary, docs usually recommend having follow up labs done in a few weeks to see if the dose needs to be tweaked.

The active ingredient should be the same, but depending on the binders/fillers, the body can absorb the new medication differently.

[SueAndHerZoo]

#1184665

Hello, Kimberly – nice to “see” you, too!

The doc who diagnosed me with osteo didn’t recommend calcium supplements…. she said she’d rather see me get the calcium from green, leafy vegetables, but I figured calcium-rich vegetables AND calcium supplements would be even better.

I’m going to cut down to one calcium supplment a day (instead of two) and make sure it’s about 10 hours after I take my Levo. I wonder, though, if maybe simply having the calcium in my system is causing the problem, regardless of what time I take it. I’m just shocked by how quickly my TSH shot up.

I’ll be talking to both docs (GP and endo) to see what they suggest – maybe it’s not the calcium at all. (shrug). Just when things finally got stable and normal….. as the world turns.
Sue

[snelsen]

#1184666

If you have not done it, ask for a calcium level with your next lab draw.
If it is WNL (within normal limits) then ask if taking “extra” calcium is a good idea.
AND….so nice to hear from you for any reason SueandHerZoo!!
Shirley

[emmtee]

#1184667

What kind of calcium are you taking? I’d heard at one point that Calcium Citrate was better than Calcium Carbonate, and when I looked up the differences, I read that Calcium Carbonate should be taken with food (not required for Calcium Citrate) and also is more likely to cause uncomfortable (intestinal) side effects.

[SueAndHerZoo]

#1184668

Hi Shirley – so nice (and so comforting) to hear from you, to see you’re still here and still helping people out. Your comments, suggestions and advice are always so beneficial. I will definitely ask for a calcium level next time someone wants my blood. For all I know (now that you brought it up) I may not even need extra calcium, it’s probably the age, the thyroid meds, and the steroids I take for my colitis that are causing the osteo.

Thanks, Emmtee… I just checked and it’s calcium carbonate – the last thing I need is something else upsetting my intestinal tract!

The challenge continues, but as long as we’re all still willing and able to keep up the fight, we WILL prevail!
Sue

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