Hi, Vicky:
My first suggestion is that you keep a log. Write down, every day, when you take your pill, what you eat close to the time that you are taking the pill; any supplements/other medications that you are taking, and when you take them; make a note of when your period starts; jot down symptoms. This log will give you something concrete to show your doctor.
If you don’t want to wait, necessarily, for a log to suggest something: It is slightly possible that something you are doing is having an impact on the amount of replacement hormone that gets absorbed into your body. So, you must be careful to take your replacement hormone first thing in the morning, every morning, and wait an hour before having breakfast. I usually drink a cup of coffee while I am waiting, but I do this absolutely every day, so my replacement dose would reflect it. The issue is that some vitamins and minerals are known to interfere with the absorption of thyroid hormone from the digestive track into the blood. So, if you consume a food with these substances in them, it is theoretically possible that less of the replacement dose would make it into your body. Once the dose is absorbed, there are no problems with ingesting these nutritional elements. For similar reasons, it is recommended that we do not take any other medications, either, at the same time as our replacement hormone. One of my friends was having a terrible time with replacement issues. She was on a huge dose (200 mmc) of synthroid, as well as a sizable dose of T3 medication, and she was getting heart problems as a result. But her TSH was still wrong a lot of the time. She switched endos, and he immediately noticed that she was taking a handful of medications at the same time she was taking her synthroid. He lowered the dose of synthroid, removed the T3, and had her take those other medications an hour or so later. And this put things right again. She commented to me, "Nobody ever told me I had to be careful what I ate or took with my synthroid." So, in short, take only your replacement dose, every morning on an empty stomach and wait an hour before eating. Take any multivitamin (or other vitamins), calcium supplements etc. at least four hours after the replacement hormone (a recommendation made by my pharmacist).
Some people have noticed that they become "symptomatic" during certain specific dates of their menstrual cycles. You log will help you figure out if that is what is occurring. If that is what is happening, your doctor may be better able to figure out how to keep you stable.
I hope some of these suggestions help. And one other: make sure your blood tests are reasonably spaced apart. Some people get onto a hormonal yo-yo by getting their blood tested too soon between dose changes. It takes weeks — literally — for the TSH to reflect, accurately, dose changes. The TSH is like a moving average, so it is very slow to reflect a new reality. I experienced this problem very early in my replacement regime: the endo decided that I was looking too hypo, tested my levels, and decided to raise my dose. She commented at the time, that she usually did not do this, but…. And, sure enough a few weeks later, I went in with symptoms and was hyperthyroid again. From there on in, I made myself wait at least six weeks (her recommendation – six weeks to three months) before going in for another blood test. It was hard to do sometimes — if I was symptomatic I absolutely did not want to wait through six weeks of symptoms — but I had learned that having waited, my blood test results were more accurate.
Good luck,
Bobbi — Online Facilitator
Bobbi – Online Facilitator
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