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  • mperry
    Post count: 25

    I had a thyroidectomy on June 3, 2020. I am on levothyroxine 88 mcg. I had my blood work done this week and TSH was 22. I felt really great a week after surgery when I started my hormones. Then started trying to taper off clonazepam, but the pharmacy made a mistake and I went up then down from 1.0 to 1.5 mg. I thought I was going down so when I dropped to 1.0. I had severe side effects. Took a few days to figure out what happened.

    I don’t know if these kind of things influence hormone levels.

    My Endo has upped my levothyroxine to 112 mcg. and put me on (cytomel 25 mcg for 10 days to get me back up.)

    My surgeon said I was very hypo. i have had many symptoms of hyper. Depression, crying, anxiety, some insomnia. Just wondering how long it takes and do medications interfere with getting balanced. I have lost so much weight since being sick. I currently weigh 120 pounds and have lost another 5 in a month.

    My doctor recommended waiting on the taper until my hormones level out. I was having such severe side effects.

    Which I want to do what is wise, but also worry about addiction.

    I am on 1.0 clonasepam
    10 mg Buspar x3
    10 mg Ambien
    200 mg Zoloft
    Plus allergy meds and amovig

    Thanks

    Liz1967
    Post count: 305

    I cannot find any reports of the drugs you are taking interfering with levothyroxine but ask your pharmacist. A TSH of 22 is very hypo and often it is difficult to differentiate hypo symptoms from hyper, they can be the same. You are on a few drugs that affect anxiety and depression and your problem may be with those, especially if any were prescribed for hyperthyroid symptoms prior to your thyroidectomy. It takes about six weeks for your TSH to reflect any changes in your levothyroxine dose so some patience is required there. Cytomel can be taken wth food but if you were taking levothyroxine without waiting an hour to eat and 4 hours before calcium, etc, that would have interfered with absorption. It usually only takes a couple of months to get to the correct dose but they go slowly in increasing the dose so you dont overshoot and end up hyper and seesawing between the two.

    mperry
    Post count: 25

    It has been 5 weeks since I started the Levothyroxine. I take it at 4 am along with the cytomel now. I wasn’t instructed on how to take the cytomel. Food or no food. I have been taking it with my other med on an empty stomach. Is this ok?

    Since my TSH is so high, my doctor recommended I wait to taper off the meds. I tried and it didn’t go well. .

    Weird thing is I felt really good for two weeks after I started my hormones. I felt normal. So weird to now feel so bad.

    I haven’t been taking calcium within 4 hours of my meds.

    I’m 120 pounds now and have lost 5 pounds since I started feeling badly again.

    Any suggestions are welcome. I want good absorption. I was surprised at my TSH level.

    I have friends on much less hormone and they weigh more than me so it doesn’t make sense. I thought they calculate by weight.

    Does exercise affect levels? What are other things which can affect levels?

    Thank you. I am so appreciative to you for the info.

    Liz1967
    Post count: 305

    During thyroidectomy surgery, you get a flood of hormone as they remove the thyroid, which is why they sometimes delay the start of synthetic hormone for a few days. That is why you felt good for the first two weeks until that influx of hormone wore off. They do calculate initial dosing by weight as a starting point, but everyone is different. All sorts of things can affect absorption of levothyroxine, including PPIs, like Prilosec, and your body’s requirements change a bit daily and seasonally but once you reach your optimal dose, any minor variations will not affect you. I dont know much about Cytomel except I think you can eat after taking it but you do need to wait an hour before eating on levothyroxine, and that includes drinking coffee. Give it some time. Once your dosage catches up, you will be fine. I personally keep my TSH between 0.5 and 2. You will know where you feel best.

    mperry
    Post count: 25

    Liz,

    Thank you for your information and to help explain why I felt good and then went down.
    What is a PPI?

    thank you,
    mperry

    mperry
    Post count: 25

    Liz,

    Thank you for your information and to help explain why I felt good and then went down.
    What is a PPI?

    thank you,
    mperry

    Liz1967
    Post count: 305

    PPI is a proton pump inhibitor, for heartburn, like Prilosec or Nexium. They are not the same as Tagamet or Pepcid for heartburn, which are H2 inhibitors and do not affect absorption.

    Kimberly
    Online Facilitator
    Post count: 4262

    Hello – We’ve heard mixed messaging as to whether T3 needs to be taken on an empty stomach. (T4 *definitely* does). You might check with your doctor about this and also ask whether 4:00 a.m. is the best time for dosing – T3 is the more powerful and active form of thyroid hormone, and you might not want a large dump of thyroid hormone if you are going back to bed!

    The prescribing info for generic T3 does have a section on antidepressants and drug interactions, so that would be worth a conversation with your doctor as well:

    https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=03ca9e2a-5a27-43ff-a1cd-9c617a415b62&audience=consumer

    mperry
    Post count: 25

    Kimberly,

    Thank you. i take other meds so I wasn’t sure which to take first. What time do most take their hormones? They didn’t advise me.

    Melanie

    mperry
    Post count: 25

    Kimberly,

    I contacted my doctor and he said to take 30 minutes prior to breakfast.
    I don’t know how much leeway there is on taking it at the same time every day. Does it need to be exactly 24 hours, or is there wiggle room?

    mperry

    Kimberly
    Online Facilitator
    Post count: 4262

    Hello – We’re fellow patients here, so I would ask your doc about specific dosing instructions. My own doc’s instructions were more geared towards honoring the waiting period before breakfast, rather than recommending an exact time.

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