Yet Another Thyroid Question
August 20, 2013 11:37 AM   Subscribe

Are there any alternatives to prescription thyroid supplementation? I'm working with a doctor but the process is slow, and in the meantime I'm exhausted.

I recently went to my PCP for help with extreme fatigue. Given some of my other symptoms (weight gain, brain fog) and my family history (both grandmothers have hypothyroid), he gave me some thyroid tests. He seemed to think my numbers were fine:

TSH: 3.59 [Reference Range: 0.40-4.50]
T4, Free, Calculated: 1.63 [Reference Range: 1.4-3.8]
T4, Total: 4.6 [Reference Range 4.5-12.0]
T3 Uptake: 35.5 [Reference Range 22.0-35.0]

My A.M. cortisol was also tested: 18.0 mcg/dl [Reference Range 4.0-22.0 mcg/dl]

He then ran some other tests. While waiting for these, out of desperation I did something I know I probably shouldn’t have (but I was so, so tired): I took a month’s supply of a friend’s old script of Synthroid, 25 mg (I’m not sure if that’s the correct unit, but that’s the number.) I took it for a month and felt much better. Those three symptoms improved noticeably. I felt like doing things instead of laying on the couch, I could concentrate at work/when reading again, and I was able to eat more than one meal a day without gaining weight. I also noticed my hair and nails weren’t so dry and brittle. I didn’t notice any side effects.

I returned to the doctor and told him what I’d done. He said that that’s pretty much what happens in general when you increase someone’s thyroid, and that given the age of the medication (about 3 years) it may not have even been doing anything. I conceded it could have been placebo effect, and we decided to do another round of thyroid testing to see if the Synthroid had even made any difference. I also mentioned that I thought the cut point for TSH was now 3.0, but he said the difference between 3.0 and 3.59 was minute.

In the meantime, my other test results came back, and he thought my B12 was problematic: 309 pg/ml [Reference Range 200-1100]. So I am supplementing with that via tablets and not using any Synthroid. (I already take a multivitamin and a B Complex vitamin most days and have for years.) I feel worse.

I've had this same triumvirate of symptoms over the years, waxing and waning at certain periods. My thyroid has been tested at various points over these years, and I think the highest the TSH ever got was 4.59, and the lowest was in the 2 something range. I don't have the paperwork with me so I'm not sure of the other test results. One of these doctors I saw over the years was an endo, but he was kind of crazy (He spent most of the appointment talking about local politics.), and I went to him because he only had a one month waiting time versus two for everyone else recommended in my area.

Supplementation with Vitamin D helped a lot at one point several years ago, and I've continued with that. On this most recent round of testing my levels were:

Vitamin D, 25-OH, Total: 35 ng/mL [Reference Range 30-100]
Vitamin D, 25-OH, D3: 35
Vitamin D, 25-OH, D2: less than 4

tl;dr: I think I may have a thyroid problem, I can’t see my PCP for another two weeks, and I’m not sure if he will treat based on symptoms. Waiting time for good endos run upwards of two months. Is there any supplement or a source of non-prescription medication I can take to help my thyroid chug along? Feel free to MeMail me if you prefer. Thank you!
posted by unannihilated to Health & Fitness (9 answers total) 10 users marked this as a favorite
The Mayo clinic website is my goto resource for health questions, because they generally give a fair if skeptical hearing to alternative medicine. They don't have much to offer for the thyroid.
posted by COD at 11:51 AM on August 20, 2013 [1 favorite]

I'm sorry I can't directly answer your main question but for what it's worth, I once had thyroid problems years ago and was seen by a PCP, and long story short, he probably did more harm than good, plus he never explained anything nor warned me about possible future trouble. I had two miscarriages before my OB thought to check my thyroid and sent me STRAIGHT to an endocrinologist. My endo now is a very good doctor and has waiting times of forever but it's definetly worth it. The sort of symptoms you get from a high (or highish) TSH are not big drama-making things, but definetly something that spoils your quality of life. Get started on getting to see an endocrinologist. Stop seeing a general doctor for something that a medical specialty exists for.
Also, my doctor tries to adjust my Synthroid to keep my TSH always close to 1.0 (non-pregnant) YMMV.
posted by CrazyLemonade at 12:39 PM on August 20, 2013

Oh and look at that, we're the same age. According to anecdata from me and two other hypothyroid friends, TSH above 3.0 is definetly addressed with medication from our doctors. You can memail me if you want to talk about it.
posted by CrazyLemonade at 12:42 PM on August 20, 2013

Well, I memailed you and then thought about other people in similar straits reading this question. So, here's an excerpt for them:

"Years ago, when I had the same symptoms you're describing and could make no progress with primary care physicians, I saw a nutritionist who had me start taking these supplements:

Thyroid Caps:
Adrenal Caps:

Said nutritionist also told me to cut out wheat, dairy, and sugar.

I did feel better, but once I bypassed primary care docs and saw an old-school endocrinologist (paying out of pocket to do so) I finally got a proper, full thyroid panel run (which included an antibody count; I don't think any of the other docs did that) and learned I had Hashimoto's Thyroiditis. The endo started me on Armour Thyroid supplementation (and a brief course of steroids -- he said my adrenals were burnt out after going so long without a diagnosis) and that's what really turned everything around."

I then warned you about supplements possibly having an effect on test results, and mentioned you would want to ask the endo's office about it.

PCPs speculated the problem was chronic fatigue syndrome or Epstein Barr or depression or, most memorably, "the kind of anger young women suppress that needs to find an outlet somehow." I'll show you anger, you HACK...
posted by Iris Gambol at 1:02 PM on August 20, 2013 [4 favorites]

My partner's hypothyroidism really didn't get taken seriously until he found a good endo. I strongly recommend getting on a wait list right now for a good endo.

Meanwhile, you might look at dietary options. I know there are some things he tries to eat more or less of, and he feels that helps. Could be placebo effect, I can't say. I'll try to remember to ask him tonight. All I remember offhand is iodine supplementation. Usually in the form of sushi and a seaweed salad but I would assume there are other options if that's not your thing.
posted by Stacey at 1:22 PM on August 20, 2013

Unless you're a vegan, a low B12 should make you concerned about various digestive problems that can reduce your ability to absorb various nutrients and cause fatigue, among other symptoms.
posted by the young rope-rider at 1:51 PM on August 20, 2013 [1 favorite]

Anyway, ask your PCP about B12 injections.
posted by the young rope-rider at 1:53 PM on August 20, 2013

I am your age as well and have a family history of hypothyroid. I also had slightly worse numbers than you about a year ago, along with low Vitamin D and B12 levels - however, I was pretty asymptomatic aside from some fatigue. I am also, for what it's worth, kind of a "try anything before I have to start taking medication" type. My doctor had me take 2000mcg of Vitamin D and a B Complex vitamin with 30mcg of B12. This combo really helped my TSH number normalize, and also brought up my B12 and Vitamin D levels. I realize I may have to go on Synthroid someday, but this seems to be holding me over for now.
posted by emily37 at 2:39 PM on August 20, 2013

You should definitely go to a good endo. I was ignored for years and told that I was speculating and projecting even though my mother and daughter had diagnosed Graves' disease. I had a goiter and when that came out I went on thyroid supplementation and immediately felt much better. My endo tested me for everything because she said I probably developed any number of problems due to the delay. I was D 3 and B 12 deficient and was finally treated for it all. I also developed afibrillation with my heart. I blame the long failure of my PCP and ob/gyn for ignoring my symptoms in favor of writing me of as a hysterical female. Moral of this story: you have probably diagnosed yourself and need medical confirmation.
posted by OhSusannah at 9:10 PM on August 20, 2013

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