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Doctors' Answers to "Frequently Asked Questions" - Hashimotos Disease


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Hashimoto's Thyroiditis [posted 1/7/99]
Question: I had abnormal TSH blood tests twice in October. I had a scan and sonogram of the thyroid. The tests showed nodules. I went to a specialist who wanted to do a biopsy. I went for the biopsy and the suspected cancerous nodule could not be located. My Family physician sent me to another specialist. I saw her in February. My TSH had returned to normal, but I had positive antibodies. The doctor put me on synthroid for a year to combat the antibodies. Blood tests since have indicated the doses of synthroid are too high. My TSH is in the too small to measure range. The doctor keeps reducing the dose - down from 1.0 to .075 and it's still too high. Heart disease and high blood pressure runs in my family. Is it risky for me to be overdosed in this manner? Will the treatment of synthroid for a year stop the development of hypothyroidism? I feel run down also - can this be the overdose?

Answer: The doctor is doing it the way most of us do. Whether the fatigue will change will depend on several factors and can't be predicted, but it could be the thyroid.

TSH Range
Question: We have a patient that 4 months ago was on 0.2 mg l-thyroxin with a TSH reading of 12. Gradually, in increments of 25 mcg. of l-thyroxin over a 4 1/2 month period, the TSH has INCREASED to a reading of 28 from an in initial reading of 12. T3 remains within a normal range as does T4. Other blood tests do not indicate anything other than TSH as being outside normal ranges. The patient is otherwise healthy. The lot #s of l-throne were changed in case dissolution rates were providing a "biologically inert substance". Synthroid was used rather than Eltroxin inasmuch as the patient has been on Synthroid for 20 years.

Answer: I suspect the patient has just had progressive damage to their underlying thyroid gland. This has resulted in needing further thyroid replacement-not uncommon. Increase the thyroid to keep the TSH normalized and don't worry about it.


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