We're seeing patients with hypothyroidism more and more in the teaching clinic. We're also seeing them having to ramp up on their Thyroxin drug every couple months as they still have hypothyroidism according to the lab tests.
At the original dose, the patient seems to do well for about a week or two. Then they feel their symptoms come back again. Doc retests and the blood tests show hypothyroidism. So the Doc ramps up the Thyroxin. The patient then feels good for about another week or so and then begins to crash with the original hypothyroid symptoms again.
This continues to happen for years for unlucky ones. For the lucky ones, this cycle stops in its tracks after a few months worth of chasing proper thyroid function.
What to do?
There are a few things your doc can check:
Thyroid Antibodies - is your body attacking your own thyroid and causing it to be unstable? Find out by ordering the anti-TPO and anti-TG tests. If hypothyroid and one or two of these are elevated, then you have Hashimoto's Thyroiditis. Not too worry - a good doc can truely help you out here.
Adrenal Function - are you stressed like nuts, get a bit dizzy when you stand up or get out of bed, tough to get out of bed in the morning due to exhaustion? If so, your doc may want to order the DHEA-S test to see how your adrenal glands are functioning. Physical exam tests such as hippus, CVA tenderness, orthostatic hypotension also help pin point adrenal fatigue.
Celiac Disease - you go to the bathroom and have mucousy stools, diarrhea mixed with constipation at times, gas and bloating after many meals especially noticeable after eating wheat or any gliadin containing foods? If so, your doc may want to order the celiac panel.
All three of the above may disrupt thyroid function and if they are not discovered and addressed, thyroid function may not stablize. It takes only one of the above three to cause disruption in thyroid function - not all three.
Each of the above has pretty solid treatments which is great news. The even better news is if you suffer from having to keep ramping up on your thyroid meds and still not improving, these three other conditions may be affecting it and if resolved or contained, then the likelihood of having to keep ramping up may disappear.
Keep in mind there are other issues as well which may cause one to have to chase the proper dosage of thyroid meds. Celiac disease, adrenal issues, and autoimmunity are simply three.
I will explain why these may be indicated a bit more. At the moment, I gotta jet to clinic for a 13 hour day. Arrrgh.
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