General Medicine

» dana65 - Current

Hi Elaine . . I just read an article by you on AboutThyroid.com that said GD patients must avoid Novocaine. Several days before my labs, I had dental work done. I asked the dentist if the numbing substance had iodine in it. He said it did not. Now I'm wondering if my FT4 jump from 1.3 to 2.75 (reference 0.5-1.2)was possibly due to that plus my acute infections. Do you think I should ask the endo for one more lab test before going on Tapazol . . or do you think I should just go forward with the medicine for now?

Dana

-- posted by dana65

» u25000 - RE: DOSING

What does your experience and research tell you about which wreaks most havoc on your body (hair) and systems: increasing dose, decreasing dose, 2 dose changes within several weeks, or brand changes from Generic to Brand-vice versa-Synth to Levoxyl-vice versa. JUST CURIOUS if you have any studies or feelings. Doctors never tell us these things to be aware of as we go thru this rollercoaster. It seems studies are not done out of concern for us. And we lack the community access to do our own. Unless the medication manufacturers know, but it would seem they wouldn't want to tell us.

-- posted by u25000

» dana65 - Doctors and Iodine Solutions

Thanks, Elaine. Is there some reason that an endo at a well-respected academic medical center would say otherwise? Do doctors in general not believe that?

On another note, I had surgery today on an infected thumb, and I imagine that the stuff the nurse put on my thumb to disinfect it was an iodine solution. (I also wonder if the nerve block had any iodine in it.) I didn't even think about it until after it was done. I imagine that did bad things to me, right? Perhaps there was no alternative, though.
Dana

-- posted by dana65

» Elaine Moore - Current

In response to Current posted by dana65:

Hi Dana,
The novocaine doesn't contain iodine but it contains epinephrine. This will raise blood pressure and heart rate and it can raise your thyroid hormone levels. It's best to request carbocaine, which is a lidocaine preparation that doesn't contain the epinephrine.
If your FT4 test was done using the same method used before with that lower normal range, this is quite a jump and you'd probably want to use Tapazole. If the lab switched to the more conventional methods that use a range as high as 2.0 then your elevation of FT4 would be modest and you might want to hold off. Best,Elaine

» Elaine Moore - Doctors and Iodine Solutions

In response to Doctors and Iodine Solutions posted by dana65:

Hi Dana,
Many doctors, especially specialists, frown at any notion that diet, stress reduction or lifestyle changes matter. This holistic or common sense approach is contrary to the business side of medicine, which takes profit into consideration.
Now that more of the top medical schools are adding courses in nutrition and immunology to their medical school curriculums you'll be seeing some changes depending on what pharmaceutical and other incentives are still available. Best, Elaine

» Elaine Moore - RE: DOSING

In response to RE: DOSING posted by u25000:

Hi,
Most troubles arise from doses that cause extremely high or extremely low thyroid hormone levels. Thyroid hormone is very potent and it affects every cell within the body. These extremes are hardest on the body. That's why slight or gradual adjustments work best when making changes.

It's also important to take both FT4 and FT3 levels into consideration when trying to determine optimal replacement hormone. Some people, usually those with milder hypothyroidism, do well with levothyroxine alone whereas those of us with very little thyroid function usually need both levothyroxine and T3 replacement hormone. Many things interfere with lab results so it's also important to correlate symptoms and signs, especially body temperature, to the lab results to help determine the best treatment.

Also, treatment needs change over time. Normally, the body is producing varying amounts of thyroid hormone every day depending on our needs. It's impossible to find a dose of replacement hormone that will be optimal for extended periods. Frequent labs and close attention to symptoms are key factors here. Take care, Elaine

» nurseheatherone - Another Graves questions

In response to Another Graves questions posted by daisyelaine:

So I think that I must be having hypo symptoms for sure, I got my new labs back and they are as follows:
FT3- 7/25 453,9/10 300,10/15 282
FT4-7/25 2.96,9/10 1.15,10/15 1.1
TSH-7/25 .0001,9/10 0.65, 10/15 2.61
so is this an adequate reason to have my medication lowered?or should I wait to talk to my endo at my next apt. late Novemember?
Thanks again, Heather

-- posted by nurseheatherone

» nurseheatherone - Another Graves questions

In response to Another Graves questions posted by nurseheatherone:
One more thing, if it is indeed this rapid change in my thyroid levels that is causing my throat tightness, back pain, weight gain and swelling and dark circles under my eyes, if I were to lower my dosage would this eventually fix my symptoms or would I need to add thyroid hormone to the mix. What are the ranges I want these levels to ideally be at? Would it take just as long as it did for my labs to change( even though they seem to be within normal range) to get to a better level for GD. I am worried that I had such a mild case of GD that I was too agressively treated, I think I felt better when I was hyper. I am just really confused of why my TSH has already moved into almost a hypo range when it is supposed to stay low, a little over 1 year ago my TSH was 2.25 and I felt pretty normal. The only things that have suddenly improved are, my skin has cleared up nicely and this month I finally had a normal period. Sorry I am rambling now,
Thanks again
Heather

-- posted by nurseheatherone

» Elaine Moore - Another Graves questions

In response to Another Graves questions posted by nurseheatherone:

Hi Heather,
Your TSH suggests that you're no longer producing enough thyroid hormone for your body's needs. Today, TSH levels higher than 2.5 suggest hypothyroidism.
If you have symptoms of hypothyroidism, you can call your doctor's office and report the symptoms. Then ask, in light of your last labs, if you could lower your ATD dose. By late November, you could be quite hypothyroid if you stay on your current dose. Take care, elaine

» Elaine Moore - Another Graves questions

In response to Another Graves questions posted by nurseheatherone:

Hi Heather,
Most people feel best with a TSH of about 0.4. Studies of normal healthy adults show that the majority of people have a TSH level between 0.3 and 1.0. However, the TSH level is falsely decreased in Graves' disease so your level is misleading.
With a range of 0.8-1.8 most people feel best with an FT4 of around 1.6. With an FT3 range of 230-420, most people feel best with an FT3 of around 350-380. But we're all different with optimal ranges. Some people need even higher levels than this to feel optimal.
You wouldn't need replacement hormone unless you were on a very low ATD dose and had levels like yours. Just cutting the ATD dose should bring your levels back to a more optimal range. Take care, Elaine