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Hypothyroidism and Thyroid Hair Loss in Women

Claire, one of our lovely forum members, put together this incredibly informative post on hypothyroidism, TSH levels and doctors…

Just a little background. I was diagnosed with Hypothyroid in June of 2005. After over a year of fighting with doctors I finally reached a TSH level below 3.0 in August of 2006.

I am not a doctor, nor a health professional. I’ve read, experimented, and suffered through this thyroid maze. As I would say if you came to me with someone else information, please take everything I say about my treatment with a grain of salt. What works for me may not work for you, but I feel it’s important to give you an idea of what can be done.

The reason I had so much trouble with doctors is that many of them have been out of med school longer than the newest findings.

As of 2012 the AACE (American Association of Clinical Endocrinologists) published new findings on the correct thyroid levels in most individuals. No longer is the range between .5 and 5.0 but a smaller range of .3 to 3.0

AACE guidelines for correct thyroid levels in women to help find solutions to hair lossThe full AACE Guidelines can be viewed by clicking this link.

What does this mean? That many many doctors are under treating their patients. Even more frightening is that there are doctors who have not been updated on thyroid function for an even longer period of time and think that a TSH level under 10 is appropriate. Luckily those doctors are few and far between. What this teaches us is that educating oneself on ones health matters is most important. We assume that doctors are knowledgable about all health matters. The truth is, scientists and specialists come to new findings every year and general practitioners are the last to know. Doctors are well educated on health matters, unfortunately, they are well educated within the time frame in which they went to medical school. This leaves several years of updated information that they have not had access too. Even more frightening is that many of them dismiss new findings if such information is brought to them by a patient.

Synthroid tablets are a common treatment option for women who suffer from thyroid problems and hair lossIf you are hypothyroid and still suffering with symptoms and your doctor is telling you that your thyroid is functioning normally it is time to start taking control of your situation.

First, obtain a copy of your most recent lab work. Find out what your thyroid levels really are. Second approach your doctor about what issues you are having. If he is unwilling to listen, then you have a couple of options.
A. you can take in a copy of the AACE’s newest research {http://online.liebertpub.com/doi/abs/10.1089/thy.2012.0205?journalCode=thy}, a copy of a checklist of your symptoms {http://thyroid.about.com/cs/hypothyroidism/a/checklist.htm}

If you have any other symptoms that seem abnormal to you, but are not listed, please list them as well. Recently, I’ve discovered that overnight leg cramps is also a symptom of hypothyroid.

B. you can switch doctors.

You may have to do B. anyway, if your doctor is unwilling to work with you. The best thing you can do is request to be sent to an endocrinologist. If your doctor is unwilling to refer you, you are not without hope. Most insurance companies have patient outreach programs. Obtain a copy of your records, including blood tests (you have the RIGHT, by law to get copies of your medical records), a copy of the AACE’s findings, a list of ongoing symptoms and a letter requesting referral to see a specialist. It is possible to go over your doctor’s head in order to do this. You can also switch doctors and request this of your newest doctor. Be warned, even some endocrinologists go by an older TSH scale. If you find this to be so, request a second opinion.

Most important, do not think that the doctor knows more than you. You, and only you truly knows how you feel. Do not worry about offending your doctor. As it is, your doctor doesn’t seem to worry about offending you. You are the boss in this situation. He works for you, if he is unwilling to do his job, then you’ve every right to hire someone else.

Once you find someone willing to work with you ( and if you already have, thank your lucky stars) do not expect your symptoms to alleviate as soon as you start a new dosage. Do not expect your symptoms to alleviate as soon as you reach a healthy TSH level. It’s going to take some time for your body to begin to heal itself. However, you will notice some changes within weeks.

Anatomy image of the thyroid gland courtesy of UpToDate.com

Anatomy image of the thyroid gland courtesy of UpToDate.com

The Thyroid also changes with time. As you begin to reach a healthier TSH level things may plateau and you may have to adjust your meds as needed. It’s not uncommon to reach a healthy TSH level and a few weeks later begin to feel bad. It’s important that within the first year of reaching a healthy TSH goal to be checked every 3 months. After that it’s important to be tested twice a year. Some doctors say only once a year is enough, this is not true. Thyroid levels change with temperature changes. One of the best ideas is to check your thyroid levels a few weeks into the first cold snap of winter and within the first few weeks of summer heat. Many thyroid patients find they need to adjust their dose with the extreme temperatures of both seasons. Cold weather slows thyroid function, hot weather tends to call for less thyroid supplement.

It is also not uncommon for a short period of time in which you have a few of the sensations associated with HypERthyroid upon starting a new dosage. I’ve found the best way to avoid this is to titer up. My doctor is willing to work with me on this. This consists of me cutting pills and slowly adding till I reach my newest dosage level. Thyroid hormone takes time to build within the system. This is why titering up works in many cases. This is also why you do not retest your thyroid till 6-8 weeks after beginning a new dose. If you decide to titer up, do not retest till the 6-8 week mark after you reach your INTENDED dosage. My pm box is always open if you have additional questions about this. It is important to discuss this with your doctor as well. Do not raise your dosage above what he recommends till you’ve had your TSH checked. Then be sure to inform him of anything you intend to do, so that you may have another test lined up.

There is no magic number. Not when it comes to TSH, not when it comes to dosage. The ideal setting is for you and your doctor to work together by using both blood work and how you feel.

When taking thyroid medications it’s important to understand a couple of things. First, any food or vitamins taken with the thyroid med will change the absorption rate of the hormone. Your best bet is to take the thyroid med first thing in the morning and an hour before and after eating. So, no food for an hour on either side of taking your med. Even more important is delaying the taking of vitamins. Especially iron and calcium. Both of those can have an effect on the way your body absorbs the thyroid hormone. It is best to take your vitamins either in the middle of the day (2-3 hours) after your hormone or at night (6-8 hours) before.

If you are the type that has to eat first thing in the morning then know that you must follow the pattern every day. If you eat less than an hour after taking your thyroid hormone then it is important to follow this habit daily. It is also important to stick to a similar breakfast food. For instance if you drink milk, it will have an effect on how your body absorbs the hormone, so it’s important to have dairy at the same time, every day as to keep the hormone absorption similar.

Cipro Interacts with Thyroid Medication

Popular Antibiotic Interacts with Thyroid Medication

The British Medical Journal has reported on a several cases of unexplained hypothyroidism in thyroid patients (on levothyroxine) who were taking the popular antibiotic ciprofloxacin. Ciprofloxacin is the generic name for the fluoroquinolone antibiotic sold under the brand names Cipro, Ciproxin and Ciprobay, Cirpoxine, and Ciflox. The drug is primarily used to treat urinary tract infections, pneumonia, and sexually transmitted diseases. Ciprofloxacin was also in the news during the anthrax scare, given its use in treatment for anthrax exposure.
What the researchers found in these cases were evidence that oral ciprofloxacin interacts with levothyroxine (i.e., Synthroid, Levoxyl, Levothroid) if taken together. It’s thought that the ciprofloxacin may somehow decrease the absorption of the levothyroxine.

In one case, a woman taking 125 mcg a day of levothyroxine took ciprofloxacin (750 mg twice a day) and her TSH level rose to 44 after four weeks. Even when her dosage was raised to 200 mcg a day, her TSH didn’t respond. Only when the ciprofloxacin was stopped did the TSH return to normal. In another case, a woman who was stabilized on 150 mcg a day of levothyroxine saw her TSH go from 1.6 to 19 after 3 weeks of treatment with ciprofloxacin at 500 mg twice a day.

What Can You Do?

If you’re a thyroid patient who is taking ciprofloxacin, what should you do?

The research suggested that thyroid tests were normalized if patients took the levothyroxine and ciprofloxacin at least six hours apart.

So, if you are on levothyroxine, it makes sense to allow at least six hours apart from taking your ciprofloxacin. And if you have to take the antibiotic for a lengthy period, you should discuss the potential impact on your thyroid with your doctor, and possibly request period thyroid testing to ensure that your thyroid treatment is not affected.

Source: Cooper, John, “Ciprofloxacin interacts with thyroid replacement therapy,” British Medical Journal, 2005

Thyroid levels affect Alzheimer’s risk – study

WASHINGTON (Reuters) – Women with low or high levels of a hormone that affects thyroid gland function and thyroid hormone levels may have a higher risk of Alzheimer’s disease, researchers reported Monday.

While it is not clear whether Alzheimer’s affects thyroid function or the other way around, the findings dovetail with long-standing knowledge that having an underactive or overactive thyroid can affect memory.

Dr. Zaldy Tan of Hebrew SeniorLife, Beth Israel Deaconess Medical Center and Harvard Medical School in Boston and colleagues looked at measured levels of a thyroid-regulating hormone called thyrotropin in 1,864 healthy men and women with an average age of 71.

They had blood drawn as part of the larger Framingham Health Study in which practically everyone in a Massachusetts town has had their health scrutinized for decades.

Writing in the journal Archives of Internal Medicine, Tan and colleagues said 209 of the volunteers had developed Alzheimer’s disease after nearly 13 years.

Women with the lowest and highest levels of thyrotropin had more than double the risk of developing Alzheimer’s disease. No such relationship was seen in men.

Changes in the brain caused by Alzheimer’s disease may reduce the amount of thyrotropin released, Tan’s team said. Alternately, low or high thyrotropin levels could damage brain cells or blood vessels.

They said the findings should be tested in a larger population. (Reporting by Maggie Fox; editing by Todd Eastham)

Source: Reuters North American News Service

Temperature Regulation for Thyroid Testing

One of the ladies here sent me a wonderful article on Basal Temperature taking… I found some more info and wanted to share it with you…

Do you ever experience fatigue, depression, difficulty concentrating, difficulty getting up in the morning, cold hands and feet or intolerance to cold, constipation, loss of hair, fluid retention, dry skin, poor resistance to infection, high cholesterol, psoriasis, eczema, acne, premenstrual syndrome, loss of menstrual periods, painful or irregular menstrual periods, excessive menstrual bleeding, infertility (male or female), fibrocystic breast disease, or ovarian cysts? If so, you may have an underactive thyroid. It is often seen in people who suffer from multiple allergies, immune disorders and chronic fatigue.

Normal temperature regulation in the body is essential for enzyme functions and preservation of health. Whenever our molecular and immune defenses are stressed, three body organs take the brunt of the injury; the thyroid, pancreas and adrenal glands. The evaluation of the functional status of the thyroid gland — hypothyroidism or under-active thyroid gland — requires blood tests as well as temperature records.

There is considerable evidence, however, that blood tests fail to detect many cases of hypothyroidism (underactive thyroid). It appears that many individuals have “tissue resistance” to thyroid hormone. Therefore, their body may need more thyroid hormone, even though the amount in their blood is normal (or even on the high side of normal). A low axillary temperature suggests (but does not prove) hypothyroidism. Optimal temperature regulation is an essential aspect of holistic therapy for these disorders.

There is a simple way to test this. Simply follow the instructions below and bring your results to your next visit with the doctor.

INSTRUCTIONS:

1. Use any digital or mercury thermometer. Shake it down before going to bed to 96 degrees or less and put it by your bedside.

2. In the morning, as soon as you wake up, put the thermometer deep in your armpit for ten minutes and record the temperature. Do this before you get out of bed, have anything to eat or drink, or engage in any activity. This will measure your lowest temperature of the day, which correlates with thyroid gland function. The normal underarm temperature averages 97.8-98.2 degrees F. We frequently recommend treatment if the temperature averages 97.4 or less. The temperature should be taken for four days.

3. Each time you are taking your temperature, it is imperative that you take both axillary (underarm) and oral (mouth) temperatures. Both temperatures need to be taken upon waking up as well as three hours later and then six hours after that. It is important to do this for four days and to follow these instructions carefully in order to get accurate results.

4. For women, the temperature should be taken starting the second day of menstruation. The reason is because a considerable temperature rise may occur around the time of ovulation and give incorrect results. If you miss a day, that is okay, but be sure to finish the testing before ovulation. For men, and for postmenopausal women, it makes no difference when the temperatures are taken. However, do not do the test when you have an infection or any other condition which would raise your temperature.

Basal Body Temperature: This is a test of your core body temperature and is a very useful test to determine if your thyroid hormonal system is underactive (ie hypothyroid).

What does being hypothyroid have to do with cardiovascular disease?

Hypothyroidism causes abnormal lipid metabolism which results in accelerated cardiovascular disease. Cholesterol and other lipids can become elevated due to diminished function of lipid metabolism enzymes caused by the lower body temperatures. Many body enzymes are highly temperature dependent, malfunctioning at abnormally low or high temperatures. The more abnormal the temperature, the more malfunctional the enzyme. On a molecular basis, this is why we become listless as our body temperatures go out of the normal range and we die at temperature extremes.

Although the frequency of hypothyroidism has been hotly debated for many decades, I am convinced that hypothyroidism is common and often unrecognized. The official normal range of thyroid blood tests are virtually useless except for obvious hypothyroidism and hyperthyroidism. These blood tests are useful if much tighter normal ranges are used. Additionally, accurate assessments of thyroid function can be obtained with basal body temperatures.

Ideally body temperature is taken immediately upon awakening and while still in bed, but it can be taken during the day at least 15 minutes after eating or drinking and when you haven’t been exercising. Men and post-menopausal women can take their temperatures on any day but menstruating women have some restrictions. Their temperature fluctuates with their menstrual cycle, lowest at ovulation and highest just before menstrual flow. They can most accurately measure the temperature on the second and third day of the period after the flow begins. Normal temperatures are: Armpit 98.0 +/- 0.2, Oral 98.6 +/- 0.2, and Rectal 99.0 +/- 0.2 degrees Fahrenheit.

Another useful assessment is an exceedingly low-tech question, “Do you tend to be very hot or cold when most others are not”? Characteristically, hypothyroid patients are very “cold blooded” and are cold to their core even when wearing warm clothes. As a corollary, these patients rarely can create any significant sweat. As an aside, two other conditions that can cause low body temperature are adrenal exhaustion and profound hypoglycemia but these diagnoses are usually quite obvious.

melanie