[Anonymous]

#1076843

Hi slb,

I’m sorry you’re feeling so out of sorts! First thing I’d recommend: I would not start making LARGE plans based on how you feel right this minute. Even if you didn’t feel this way when you were hyperthyroid, this could easily be a result of your body’s reaction to fluctuations in your thyroid hormone. When I am given a new dose of thyroid hormone replacement, I am always “on edge” for at least two-three weeks until my body fully adjusts to the dose. I feel up, then down, and that’s upsetting all by itself. It IS an anxious feeling.

Believe it or not, two months after RAI is not soon enough to say you are finished with your treatment, by any means. It will take trial and error to find your correct thyroid hormone replacement dose, and AFTER that is accomplished, your body will *begin* to heal from the hyperthyroidism.

Basically, I’m saying that you need to have patience, you need to give yourself a break, and you need to NOT be on a hectic schedule right now. Whatever you like to do, whatever nourishes you, whatever helps you feel calm, satisfied and happy, THAT is what should be #1 on your agenda every single day. When these feelings come up, you should immediately take a break ~ dark room, cool washcloth on the forehead, earplugs, whatever works for you.

This is likely not a reaction to the thyroid hormone replacement, other than your body adjusting. In other words, I don’t think you’re having an “adverse reaction” that needs to be managed with something like a different brand of replacement. Some people do have allergies to the inert materials put into the pill to make it into a pill, but those reactions are typically very different than those you describe.

For the record, you need at least six weeks on any new dose in order to find out how your body has adjusted and where your thyroid hormone levels are as a result. I realize that makes an interminable timeline in front of you, even if you only need two or three dose changes before you find “your” dose. But it is what needs to be done, and the effort is worth it. Try to measure each day in terms of small improvements, because it will help you to have hope and to see things as getting better all the time. Try to explain to your husband that this will pass, but for now, no neck rubs. Can’t explain it, don’t understand it completely, but they bother you, so for now, don’t. Believe me, everyone around you will feel better by being brought in to the process. And acknowledge that you realize you’re touchy right now, but it’s not something you can change. It’ll level out with time.

Actually, anti-depressants may be an answer, but remember, they can take up to six weeks to build up in your system to provide any relief. You will need to weigh that against how you’re feeling — in other words, your thyroid hormone could balance right at the time the anti-depressants are kicking in. So have the discussion with your doctor. It might be helpful, it might not. Perhaps you’d feel better even thinking you were doing something to help yourself. It’s a tough razor’s edge you’re walking right now. So be good to yourself.

I hope that helps a little!

~Ski
NGDF Assistant Online Facilitator

[Anonymous]

#1020347

Hi there, I’ve posted a few times about how great I felt a few weeks post RAI.

Now, however, it’s been about two months since RAI, and a week and a half since starting on Levoxyl and I’ve become so irritable that I can’t stand myself. Every tiny thing sets me on edge – like cars driving past my house, clients emailing me requests, my husband rubbing my neck when I’m working (which seems crazy, I know, but it makes me want to scream), etc. I’ve never felt like this before, even when I was very hyperthryoid (with a TSH of <.01). My heart is pounding and I feel nauseous, too. It must be a bad reaction to the medicine. I just left a message with my endo to get him to maybe prescribe some valium, or try to do something to help me. Has anyone else experienced this irritability from thryoid replacement drugs? I don’t have some of the other symptoms of being hyperthyroid, though, so maybe it’s not from the thyroid drugs. I’ve started looking to sell my house and move because the cars and trucks driving past my house have become so incredibly annoying – something, that never really bothered me before. I know this is incredibly impulsive, but it’s the only thing that I can focus on right now.

[Anonymous]

#1076844

Hi Ski, As always, thank you so much for your response. This bulletin board is a total lifesaver – I really don’t know what I would do without it and the caring people who take time out of their days to moderate it.

I spoke with my doctor about the irritability (actually, I spoke with the receptionist who passed what I said onto my doctor and then passed on his message to me) and he told me to stop taking the medication for a month and then start it up again. After reading your post, now I’m not sure. It makes sense that, as you said, this is just a stage I have to go through while my body adjusts to the medication. I’m worried about what will happen if I go off the medication and go very hypothyroid (weight gain, etc.). I’ve been very careful to cut way back on what I’m eating so as to not gain any weight, but not sure I can cut back even more. Also, I’m leaving on a big vacation in two weeks and am worried that I’ll be dog tired the whole time and worrying excessively about what I’m eating (which we’ll be difficult since we’ll be staying with a family who will be trying to feed us all the time).

I do feel similar to how you described: yo-yoing between what could be described as hypo symptoms along with hyper symptoms at the same time. I’ve been taking naps during the day, not having as big of an appetite, etc. but also being extraordinarily irritable and impulsive, and having heart palpitations of sorts.

I know you’re not a doctor, but do you think the advice to go off the meds makes sense based on your experience? I’ve never liked or particularly trusted my endo, but treating GD didn’t really seem like anything requiring too much skill (take a radioactive pill, wait, take thyroid replacement, end of story), so didn’t really look into finding another doctor. Plus, I felt like I was nearing the end of the the worse part of things, so I could deal with my current doctor for a little bit more.

Now, I’m not sure, and really don’t want to make the wrong move when it comes to the medication because the short-term consequences seem so difficult to deal with.

[Anonymous]

#1076845

Hi slb,

Well, all I can really say is that, if you don’t have faith in your endo, I’d get a second opinion before doing anything dramatic. You were hypo when you began taking the replacement hormone. If you feel that you really may have gone hyper on this dose, then ask to have your blood drawn. It’s difficult to get a “true” reading this soon after beginning to take it, but it should indicate whether your levels are through the roof. (Ask to test for TSH and T4, because the TSH may not have moved much, but the T4 might show a change in this short period of time.) That would be helpful in making the decision whether to stop taking it or not.

It can be very tough to manage the situation with an endo you don’t feel is “on your side,” so I would urge you to find an endo you CAN feel that way about. I know it sounds like you won’t need a long relationship with the endo (the doctors make it sound SO easy), but the truth is that this will be a long term collaborative relationship. The changes in thyroid hormone levels can be very small, yet the differences in our state of well being can be very large. We need someone who will listen to us AND to our symptoms AND to our levels and operate with the total picture as a guide. I have a friend who needs to adjust her levels for the seasons ~ without a doctor that was willing to monitor her levels quarterly, it never would have been discovered and she’d be living half the year at abnormal levels.

I suggest you build up your store of information to help you make the decision. Let us know how it works out, we’ve all been there!

~Ski
NGDF Assistant Online Facilitator

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