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[IPk] Thyroid Problems

 Hi Karen

I have probably come into this conversation a  bit late but with regards to
thyroid problems, but my daughter has had Hashimotos for 18months and my
mother was also a sufferer.

Under active thyroid is auto immune - like diabetes, and is known as
Hashimotos Disease. It is part of the endocrine system, so like diabetes
should be managed by an endocrinologist..such as a Diabetic Consultant-
preferably the same one. I would never recommend a GP be left to manage
thyroid porblems when other auto immune diseases are present.

Since it is an auto immune disease this means you are producing anti-thyroid
antibodies, the more you produce, the more damaged your thyroid will become
and goitres requiring surgery may result, you would also gain excessive
weight as well as other nasties.The real problem is the more thyroxine the
thyroid is forced to produce itself , the larger it will grow, not only
becoming visible but potentially blocking the wind pipe.

The best method of dealing with Hashimotos is Thyroid Suppression Therapy
(more used in the US than here). This involves giving quite high doses of
eltroxine (Thryoxine) to stop the production of TSH (Thyroid Stimulating
Hormone) and also reduce the level of anti-thyroid antibodies. Without TSH,
the thyroid does not produce thyroxine, so this then stops the above
problems in their track. This sounds like what your Consultant is quite
rightly doing!

(GPs tend to go for the traditional approach of not giving thyroxine or
giving very low levels, to top up your own deficiencies.. but this will not
stop progression of the disease.. just treat it. This method is only
concerned with getting T3 levels within a "normal" range, not suppressing
antibodies or TSh production. Some GPs will not even prescribe thyroxine
until natural levels are seriously low, by this time the thyroid has all but
packed up and longer term problems set in.

There is also much dispute, both here and in the US as to what a "normal"
range is, with the UK accepting much lower levels of thyroxine (T3 and
T4) and higher levels of TSH.( A bit like saying that bgs could be 12mmol
and that's still normal)

Theoretically thyroxine takes weeks to kick in, this was not the case with
my daughter. Her energy levels and metabolism showed marked improvement
within 5 days and her hives all disappeared. It only takes a long time for
people who have been undiagnosed for many years and whose natural levels of
thyroxine are very low).

With Thyroid Suppression Therapy thryoid levels can and do get up to
"normal" quickly, because initially the thyroid is still producing
thyroxine. In fact there may be days when they are too high and you feel
abit hyper. Eventually less TSH will be produced and you will produce less
thyroxine yourself. Once TSH levels get very low, no new antithyroid
antibodies will be made and you will stop any progression of illness.

It sounds to me that your Consultant did great to pick this up and get you
on treatment. I'd stick with his recommended dose but ask to have TSH, T3,
T4 and antithyroid antibodies checked monthly for 3 months and then every 3
months until you get stabilised. After that, twice a year should be
sufficient. Not taking enough thryroxine, is like not taking enough insulin
in terms of future long term damage and really not a good idea.

 Thyroxine regulates (amonst other things) the metabolism, including the of
digestion of carbohyrdrates, protein and fat.. it will therefore have a
direct influence on blood glucose control and timing of insulin.  I find
that my daughter digests foods far quicker since being on thyroxin which
means we no longer need to used extended or delayed delivery of insulin.
This is particularly more noticeable with fats and protain, bearing in mind
that 10% of fat and 50% of protein is metabolised into glucose.

Please be aware that different generic brands of thryoxine are not all the
same in their stated strength!!! There is much variability between brands
and instability within batches. Thryroxine is one of the oldest drugs on the
market and somehow manages to predate many current regulations. Therefore
make sure that you stick to one brand only. The most stable is Eltroxin
Goldshield and I make sure that the GP (who writes the prescription)
actually states this brand. My daughter is on 125mcg a day, but if she has a
few days feeling tired,she may up it to 150mcg for just 2 or 3 days or if
she's feeling hyper.. she says it feels like her heart is beating too fast..
she may drop to 100mcg, again just for a few days.

*Karen Persov*.. mum to Sarah (age 11.5).. diabetic 10 yrs, Hashimotos 18m.
Pumping 4 years, on Dexcom 2 weeks. Hba1c 6.6%

> Date: Tue, 20 May 2008 17:47:24 +0100
> From: <email @ redacted>
> Subject: Re: [IPk] Help please thyroid problems
> Hi Di,
> The condition was picked up at my annual review, so it was diabetes
> consultant that put me on thyroxine.
> Karen
> - ----- Original Message -----
> From: "Diana Maynard" <email @ redacted>
> To: <email @ redacted>
> Sent: Tuesday, May 20, 2008 1:21 PM
> Subject: Re: [IPk] Help please thyroid problems
> >> Hi Karen
> > I'm a bit confused, why are you getting in touch with your diabetes
> > consultant? Surely he wasn't the one who put you on thyroxine? Shouldn't
> > you be talking to either your GP or thyroid specialist? Or is your
> > diabetes consultant also managing your thyroid condition???
> > Di
> >
> > email @ redacted wrote:
> >> Hi Melissa,
> >> Many thanks for your reply, it all sounds quite familiar and makes me
> >> feel a little better. I have rung up the secretary of my diabetes
> >> consultant and asked her to speak to him and hopefully he might give me
> a
> >> call this pm. I know I am very sensitive to alot of medication, had
> loads
> >> of problems with statins etc, and I would feel better if they would
> >> reduce dose of thyroxine, it seems strange to me that after 8 days of
> >> taking thyroxine my levels are ok, I understood it took weeks.
> >> Karen
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