Most people do not understand what it is like to be on thyroid hormones, and assume since you are replacing it that you should just " be back to normal". I thought I would share my analogy that I give my patients when we discuss thyroid issues, I case it helps someone else explain their fatigue/memory fog/ disinterest better.
Pretend your body is a high end motor vehicle like a Lamborghini that requires the 93 or higher gasoline to run. This is the kind of gasoline your body can make-93 high octane. Now if you are hypothyroid (normals tsh range 0.5-4.5 and your tsh is on the high end of this range, think sub clinical hypothyroidism. meaning you do not make enough thyroid hormone for your body but in the law of averages (ranges) you are still within normal limits. we measure TSH -thyroid Stimulating Hormone. It has an inverse relationship with the gland. Ie a high tsh means you are stimulating your thyroid to make more. So if you do not make enough thyroid then you must replace it with a pill. Seems logical right? Ok so here is the rest of the analogy. You require a specific amount of thyroid to function in your body, you replace with synthroid (brand ) ..this is the equivelant of 91 gasoline not the 93 your body expected to get. So yea you function but 91 and 93 are not quite the same so you are more susceptible to sleeping time changes, weight gain, depression etc. and if your insurance company has put you on the cheaper alternative of levy thyroxine then it's like putting 87 gasoline into a car requiring 93. All the studies have been on brand synthroid, while the generics use different fillers to make the pills (can be metro lied differently), do not have the same amount of thyroid hormone (could be 5-10% difference between one pill and the next, generally have a lower efficacy rate.
Recap: thyroid fro your gland ,Rams 93 gas in a 93 requiring car. Synthroid is like 91 in a 93 reqiuring car, and generic is 87 gas in a 93 gasoline requiring sedan. This is why if you supplement thyroid you can still feel crappy. So take home is that your own hormone is best, then brand (request this if you are generic and not feeling 100%) then generic. Make sure you are waiting at least an hour before ingesting any food/drink/ proteins. If you can't get brand then try different generic manufacturers until you find a pill that works best for you. Everyone metabolizes differently and each company has their own fillers, etc to for, the pill.
Now if you have also had a total Thyroidectomy - as I have - you are now stuck in your beautiful body/Lamborghini in third gear. When your body is in an acute stress or infection, etc you need to be able to shift into higher gear...you can't because you take the same dose each day of the wrong kind of gas (87 or 91 when you need 93!) and when you don't need the extra gas ...guess what you are on the same dose of the wrong gas for your body/car. This is why we tend to take longer to recover from scedule changes, infections, stressors. We are in the wrong gear with the wrong gas. Yea we move, but not like we are designed too.
Some people asked what happens if you miss a dose...you can but it is not recommended. We can keep about 3-4 days worth of hormone stored I our gland or in blood stream (harder with total thyroidectomy) however, the longer you go without the thyroid replacement the higher risk you have of a condition called myxedema coma. This is when you become severely hypothyroid .. I have had patients come in with a tsh of 110 and crump on me. Your body shuts down, your heart rate brady's down, facial swelling, etc. this condition once diagnosed and even with IV synthroid/glucocorticoids/vented in the icu has over a 50% mortality rate. Bad news.
Depression is common in hypothyroid patients. I have used and recommended a supplement by Thorne pharmaceuticals called deproloft with great success. Now remember every person is different. What works for one person may not work for the next.
Also please keep that in mind with lab values and make sure your clinician is treating you and not the lab values! I personally never had a TSH above 6.6 even with the cancer. Most clinicians would look at the number and not think it very significant at all. For me it was devastating to my ability to function. Even at a TSH of 5.5 (normal at that time- ranges were higher back then) I gained 60 pounds, slept easily 18 hours a day, etc. so each person is different and sometimes you need to remind the doctor of that. And make sure they are testing your t3 (active form, free and bound) and your free t4 ( inactive form) plus the thyroglobulin proteins etc if you aren't feeling right. Sometimes you need to be on a combination of t4 and t3. Sythroid is t4.
So 1) use brand name if possible
2) find where in the ranges you feel best and treat the symptoms not the numbers
3) depression, try the deproloft (Amazon), seasonal affective light therapy, psychotherapy, weighted blankets (google it) , eat healthy foods (cut out the high fructose corn syrups, etc) and exercise. Be aware that ssri/snri antidepressants can be very very difficult to get off of. So if you are out on one please plan on how you are going to taper off- I took six months to get off mine after being placed on one 12 years ago! And I still get discontinuation symptoms.
4) don't miss pills.
Hope this helps!
DrHoffy
Comment Reply
Most people do not understand what it is like to be on thyroid hormones, and assume since you are replacing it that you should just " be back to normal". I thought I would share my analogy that I give my patients when we discuss thyroid issues, I case it helps someone else explain their fatigue/memory fog/ disinterest better.
October 6, 2015 - 8:03pmPretend your body is a high end motor vehicle like a Lamborghini that requires the 93 or higher gasoline to run. This is the kind of gasoline your body can make-93 high octane. Now if you are hypothyroid (normals tsh range 0.5-4.5 and your tsh is on the high end of this range, think sub clinical hypothyroidism. meaning you do not make enough thyroid hormone for your body but in the law of averages (ranges) you are still within normal limits. we measure TSH -thyroid Stimulating Hormone. It has an inverse relationship with the gland. Ie a high tsh means you are stimulating your thyroid to make more. So if you do not make enough thyroid then you must replace it with a pill. Seems logical right? Ok so here is the rest of the analogy. You require a specific amount of thyroid to function in your body, you replace with synthroid (brand ) ..this is the equivelant of 91 gasoline not the 93 your body expected to get. So yea you function but 91 and 93 are not quite the same so you are more susceptible to sleeping time changes, weight gain, depression etc. and if your insurance company has put you on the cheaper alternative of levy thyroxine then it's like putting 87 gasoline into a car requiring 93. All the studies have been on brand synthroid, while the generics use different fillers to make the pills (can be metro lied differently), do not have the same amount of thyroid hormone (could be 5-10% difference between one pill and the next, generally have a lower efficacy rate.
Recap: thyroid fro your gland ,Rams 93 gas in a 93 requiring car. Synthroid is like 91 in a 93 reqiuring car, and generic is 87 gas in a 93 gasoline requiring sedan. This is why if you supplement thyroid you can still feel crappy. So take home is that your own hormone is best, then brand (request this if you are generic and not feeling 100%) then generic. Make sure you are waiting at least an hour before ingesting any food/drink/ proteins. If you can't get brand then try different generic manufacturers until you find a pill that works best for you. Everyone metabolizes differently and each company has their own fillers, etc to for, the pill.
Now if you have also had a total Thyroidectomy - as I have - you are now stuck in your beautiful body/Lamborghini in third gear. When your body is in an acute stress or infection, etc you need to be able to shift into higher gear...you can't because you take the same dose each day of the wrong kind of gas (87 or 91 when you need 93!) and when you don't need the extra gas ...guess what you are on the same dose of the wrong gas for your body/car. This is why we tend to take longer to recover from scedule changes, infections, stressors. We are in the wrong gear with the wrong gas. Yea we move, but not like we are designed too.
Some people asked what happens if you miss a dose...you can but it is not recommended. We can keep about 3-4 days worth of hormone stored I our gland or in blood stream (harder with total thyroidectomy) however, the longer you go without the thyroid replacement the higher risk you have of a condition called myxedema coma. This is when you become severely hypothyroid .. I have had patients come in with a tsh of 110 and crump on me. Your body shuts down, your heart rate brady's down, facial swelling, etc. this condition once diagnosed and even with IV synthroid/glucocorticoids/vented in the icu has over a 50% mortality rate. Bad news.
Depression is common in hypothyroid patients. I have used and recommended a supplement by Thorne pharmaceuticals called deproloft with great success. Now remember every person is different. What works for one person may not work for the next.
Also please keep that in mind with lab values and make sure your clinician is treating you and not the lab values! I personally never had a TSH above 6.6 even with the cancer. Most clinicians would look at the number and not think it very significant at all. For me it was devastating to my ability to function. Even at a TSH of 5.5 (normal at that time- ranges were higher back then) I gained 60 pounds, slept easily 18 hours a day, etc. so each person is different and sometimes you need to remind the doctor of that. And make sure they are testing your t3 (active form, free and bound) and your free t4 ( inactive form) plus the thyroglobulin proteins etc if you aren't feeling right. Sometimes you need to be on a combination of t4 and t3. Sythroid is t4.
So 1) use brand name if possible
2) find where in the ranges you feel best and treat the symptoms not the numbers
3) depression, try the deproloft (Amazon), seasonal affective light therapy, psychotherapy, weighted blankets (google it) , eat healthy foods (cut out the high fructose corn syrups, etc) and exercise. Be aware that ssri/snri antidepressants can be very very difficult to get off of. So if you are out on one please plan on how you are going to taper off- I took six months to get off mine after being placed on one 12 years ago! And I still get discontinuation symptoms.
4) don't miss pills.
Hope this helps!
DrHoffy
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