maryfran33 in reply to helvella14 years ago

Thanks for your response, Rod. I am in the U.S.

Had an unplanned thyroidectomy about 7 months ago. Went in for a parathyroid adenoma. Bad surgeon.

Anyway, I was doing ok with the original Synthroid dosage except for insomnia. So, the endocrinologist started lowering the dose. Once I was down to 75 mcg., I became hypothyroid. Am now up to 100 mcg. but still have no appetite, feel nauseated, and fatigued.

Mary

helvellaAdministratorThyroid UK in reply to helvella14 years ago

Mary,

That sounds like a very bad surgeon.

Insomnia can be, and very often is, an issue with *HYPO* - not just hyper. And it can take a long period of treatment to fully resolve (possibly many months or even years) even on the optimum dose of levothyroxine. Unless there were other signs/symptoms of being overdosed and test results to back that up, I would not have lowered the dose of levothyroxine for that one issue. (Just as I would be wary about adjusting it just for decreased gastroesphageal motility.)

Without knowing your laboratory results, it is difficult to be sure where you are. Can you post them?

You may care to note that the full replacement dose for levothyroxine is estimated somewhere between 1.6 and 2.2 mcg per kilogram of body weight (depending on source of information). So 75mcg could be appropriate for someone of around 75 to 100 pounds. And 100mcg for 100 to 135 pounds. (In both cases assuming excellent absorption. The weight range is based on taking 2.2 per kg at the low end, 1.6 per kg at the top.)

Are your parathyroids OK? Have you had follow-up parathyroid hormone tests?

I too have recently had nausea (probably thyroid-related but nothing like your issues) and was prescribed Prochlorperazine (Buccastem) 3mg tablets for that. It helped me.

Do bear in mind that no-one here is likely to have any knowledge of any Synthroid-specific issues.

All the best

Rod

<b>Updated on Aug 8 2010 10:46AM:</b> For the natives of this site who are more used to Imperial weights and measures for human bodies:

75 lb is around 5 stone 5 lb

100 lb is around 7 stone 2 lb

135 lb is around 9 stone 9 lb

maryfran33 in reply to helvella14 years ago

Thanks, Rod.

My parathyroids are not ok. Supposedly I have 2 1/2 left but they have not "kicked in" yet. I take 1800 mg. calcium citrate daily as well as .25 mcg. Calcitriol (Rocatrol) 2 x per day. I also take 500 mg. magnesium daily. At my last testing on July 15, my TSH was 5.3, definitely hypo, but my free T4 was 1.1 (lab range=0.6 - 1.3). Last January I began on 112 mcg. Synthroid, then decreased to 100 mcg.; then to 88 mcg.; then 75 mcg.....way too low. According to the weight guidelines, I should be taking 100 mcg., which also kept my TSH on the low end and I felt fine. I seldom, if ever, get to talk with the actual doctor(endocrinologist). I am passed off to her assistant or nurse practictioner. There is a serious communication problem and lack of knowledge. Obviously, I am looking for a new doctor and have an appointment scheduled in two weeks. In the meantime, I'm hoping for the 100 mcg. Synthroid to start kicking in, as I felt ok previously when I was on that dosage. I have only been on the 100 mcg. for two weeks. In the past, even before any parathyroid/thyroid issues, I would occasionally have the symptoms of slow gastric emptying; but hadn't been bothered with it for a few years. I'm thinking that since I have a tendency toward this motility problem, maybe it is exaggerated now with my metabolism screwed up, so to speak. I know that gastroesophageal motility is not a typical symptom of hypothyrodism, but after doing some reasearch, i found that "hypothyroidism prominently decreases gastroesophaeal motility." I hope I haven't rambled on too much. I appreciate your comments.

Mary

helvellaAdministratorThyroid UK in reply to helvella14 years ago

Mary,

I know next to nothing about parathyroid issues - just had a funny myself where I had a low calcium level. Had a PTH test and the lab didn't get the sample within the required 30 minutes. So I have been trying to mug up - but really don't feel comfortable with my understanding yet.

Back to GO motility, have you seen this?:

ncbi.nlm.nih.gov/pubmed/711...

I would be a touch concerned that the magnesium & calcium you are taking could be knocking your stomach acidity down a bit. (Of course, I am assuming you take them at least a couple of hours away from your thyroxine.)

And I am not at all sure it isn't quite common to have some degree of reduced motility - but maybe at a level that means it does not get reported very much.

Ramble on to your heart's content.

All the best

Rod

maryfran33 in reply to helvella14 years ago

Thanks for your feedback, Rod!

Let me know how your PTH levels turn out.

I will disuss the amount of calcium/magnesium I'm taking when I have the appointment (Aug. 23) with a "new" endrocrinologist. After taking the thyroxine, I wait for 4 hours before taking the cal/mag.

Mary