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  • Anonymous
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    Post count: 93172

    Hello Peoples. I just finished reading the American Association Clinical Endocrinologists Guidleines for treating Hyper and Hypothryoidism…developed in 1994 and released in Jan 1995.

    “Following a dose of radioactive iodine the thyroid replacement therapy should be carefully initiated during the time the patient’s thyroid function passes through the normal range into the hypothyroid range. The final thyroid replacement dosage must be individualized. This approach produces a prompt resoulution of the hyperthyroidism with a minimum of hypothryoid morbidity.” ….After treatment with RAI, patients should be seen at fregquent intervals until they are euthyroid and stable….The visits can vary from 4 to 6 weeks, but each case should be individualized…..Once patients are stable, the frequency of visits and reevaluations can be extended. A common schedule of visits is at 3 months, then 6 months, and then annually, but again this can be modified according to the judgement of the physician.”

    Didn’t find too much about troubles like those shared here.
    Dianne’s comments about TSH not being an immediately reliable indicator,as it fails to rise quickly…2 weeks to several months may pass before TSH responsiveness is reestablished.

    There is a passage, (Em you here?) about thyroid hormone absorption being affected by malabsorption states ans age. ” In adddition, commercially available levothyroxine products may not be bioequivalent.
    Since levothyroxine has a narrow therapeutic range, small differences
    in absorption can can produce subclinical or clinical hypothyroidism or hyperthyroidism. Drug interactions also present a problem.
    Certain drugs such as cholestyramine, ferrous sulfate, sucralfate, and some antacids containing aluminum hydroxide interfere with levothyroxine absorption….The physician is challenged to make the appropriate adjustments of levothyroxine dosage….”

    Regarding EYES…Consulation with an opthalmologists experienced in the tratment of orbital disease is encouraged. “The rationale for local mechanical therpaies-such as sunglasses, artificial tears, elelvation of the head of the bed, and eye protectors during sleep- should be explained to the patient to enhance compliance.”

    So that is a peek at what is shared amongst the specialist..when you think about questions you would like to ask….

    Anonymous
    Participant
    Post count: 93172

    Hi, Colleen.

    I think you are smart to, in effect, try to interview these new doctors
    before you go to them.

    I read an article recently about a woman who was in an HMO. She was not
    happy with her primary care physician and wanted to switch. What she
    did was to make a list of doctors who were candidates. She then sent
    them a letter asking about their credentials, treatment philosophies,
    and so on. Out of eight doctors that she sent the letter to, four or
    five sent a detailed resume back to her, and one physician sent her a
    detailed, handwritten letter. She tried the doctor first who took the
    time to write her the letter, was thrilled with him, and has been going
    to him ever since.

    So, you see, your idea really isn’t crazy! Best of luck.

    Anonymous
    Participant
    Post count: 93172

    In Sept.1995 I Had acomplete physical. My bloodwork
    showed a TSH of .06,T4 10.1,T3 uptake 28 .free
    thyroxine index of 2.8. My GP thought the test were
    wrong and scheduled another test 3 weeks later.
    Same results. Next stop a endro.who did the thyroid
    scan and diagnosed hyperthyroidism. I was put on
    tapozole 10 mg. once a day. I stayed on this
    schedule for over a year with monthly blood test
    that showed the tsh levels in line.After about 14
    months I was taken off tapozole to see if the
    condition had stabilized. after about 2 months
    the tsh test were out of range again. I went back
    tapozole and was told I had two options, surgery
    or RAI treatment. I took the RAI about 10 weeks
    ago.Had the first blood test about 6 weeks later.
    Test O.K. Scheduled another test 1 month later.The
    day I was scheduled for the test I wound up in the
    emergency room. I blacked out after finishing up an
    hour of exercise in a fitness center at the
    hospital.(The reason I got to the emergency room so
    quickly).3 days in the hospital and all the testing
    found nothing wrong.catscan,thallum stress test,
    heart echo and a MRI.I had been sorta tired out for
    about a week before this happened. I asked the
    Tyyroid could have caused this and they said no.I
    called my endro. and to reschedle my appointment
    and asked if the thyroid could have caused my
    problem and he said I don’t think so. I am schedul
    ed for a blood test 4 days from now. Any idea or
    comment will be appreciated.
    thanks

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