Special Considerations For People With No ThyroidWithout a functioning thyroid, you don't need to be particularly concerned about soy or other goitrogenic foods (i.e., brussel sprouts, broccoli, etc.) and their ability to interfere with your thyroid function .
Those without a functioning thyroid are totally dependent on thyroid hormone replacement for all their thyroid hormone. You may find that you have less fluctuation in thyroid function and find it easier to stabilize your dose and maintain an optimal TSH level on a consistent dose, as compared to patients with autoimmune thyroid disease who still have a gland. (This is because when the gland is still present and capable of functioning, it may occasionally sputter to life and produce thyroid hormone, making regulation of thyroid levels more difficult.)
Thyroid cancer patients who have had the thyroid gland removed are in a unique situation in that they are given thyroid hormone replacement drugs at "suppressive" levels. This means that the objective is to give sufficient level of medication so as to test at a nearly undetectable TSH level close to 0. This is considered "hyperthyroid" by most lab standards, but suppression is necessary to prevent cancer recurrence in most patients. So, some thyroid cancer patients refer to themselves as "hyperthyroid," although again, the underlying condition of having no thyroid gland means that the condition is actually hypothyroidism, and so much of the advice about hypothyroidism still applies.
When You Don't Feel Your BestIf you are still experiencing hypothyroidism symptoms, you may not be receiving optimal treatment for your condition. You'll need to proactively work with your practitioner to get better treatment.
This may involve:
- Trying a different brand of levothyroxine
- Increasing the dose, so that the TSH is lower. (Some patients report feeling the best when TSH levels are between 1 and 2.) (Again, remember that thyroid cancer patients often follow a different protocol to prevent recurrence).
- Adding a T3 drug (i.e., Cytomel, or compounded T3), to the levothyroxine
- Switching to a T4/T3 synthetic drug, such as liotrix (Thyrolar)
- Switching to a natural desiccated thyroid drug, such as Armour
- Complementing your treatment with alternative, nutritional and mind-body support to help improve overall health and relieve symptoms.
Help, I'm Hypothyroid and I Still Don't Feel Well
An article to help you determine what your next steps should be
By Mary Shomon, About.com
Updated: August 31, 2005
Despite treatment for hypothyroidism, many of you continue to have symptoms that may be related to your thyroid problem. Even after you've been diagnosed and are on thyroid hormone replacement drugs, you may have persistent symptoms such as continued weight gain or difficulty losing weight, depression, brain fog or difficulty concentrating, hair loss, hand/feet/facial swelling, intolerance to heat and cold, muscle aches and joint pains, constipation, carpal tunnel or tendonitis, high cholesterol levels, difficulty getting pregnant, and more.
By way of overview, the first step for you is knowing your TSH (thyroid stimulating hormone) level, and other key thyroid levels such as T4 and T3. These levels allow you to help gauge where your doctor is in terms of treatment, and give you a common point of discussion.
More innovative doctors are beginning to believe that a TSH of around 1 - 2 --- in the low end of the normal range -- is optimal for most people to feel well and avoid having hypothyroid or hyperthyroid symptoms. I know I feel terrible at 4-5, and at .2, but pretty good at 1 - 2. (NOTE: this TSH is usually kept even lower than 1-2 for thyroid cancer survivors to help prevent recurrence.) Dr. David Derry, for example, is one doctor who believes that TSH levels aren't even relevant to diagnosing or treating hypothyroidism and its symptoms.
For some people, even if the TSH level is normal, or even in some bases, low normal, there may still be a situation where one is hypothyroid at a cellular level, due to conversion problems, inadequate T3 hormone, or other factors. Inability to properly convert T4 to T3 can also result in fluctuating TSH, as the system struggles to keep balancing an out of whack T4 and T3 level, sending TSH levels up and down to compensate.
Some people also seem to need supplemental T3 to feel well. There was published February 11, 1999 in the New England Journal of Medicine a research report that says that many patients feel better on a combination of T4 and T3, not T4 (i.e., Synthroid) alone. Many people have a normal or even LOW-normal TSH level, yet still suffer continuing hypothyroidism symptoms. In these cases, the addition of T3 helped relieve depression, brain fog, fatigue and other symptoms. This information about T3 is groundbreaking and has major implications for people who don't feel well on their current thyroid therapies!!!