Postnote to “Thyroid Wellness With Integrative Medicine”
(Number 4 in a series of thyroid columns)
By 2013 I was solidly into post menopause and not on any medications. I was feeling well and looking healthy even though I had not taken any thyroid replacement medication since October 2004.
As I mentioned in my three previous columns on thyroid, I had found a way of nourishing my thyroid — and the rest of me. I wanted to see what else I could do for this new phase of my life. My med student daughter was in support of me discussing my thyroid and health regimen with an endocrinologist.
At my first consult with the endocrinologist he took a thorough history and examined me. I mentioned that my daughter suggested I discuss having the blood test also done for Hashimoto’s thyroiditis. Several days later, after analyzing my lab results, the endocrinologist indicated I had an antibody that was elevated consistent with Hashimoto’s. This is an autoimmune disease that often results in reduced thyroid function.
All things considered — my overall good health and sense of well being, and that I was not presenting any of the typical low thyroid symptoms to him — he said it was fine if I decided not to take thyroid replacement hormone. He made it clear that I was one of those cases where he did not feel I was creating any current or long term health issues by not taking thyroid replacement hormone at that time. If I wanted to, he said, he could also write a prescription for levothyroxine, a thyroid replacement hormone that he thought would be my best option, to help give my body additional thyroid hormone, and bring down my elevated TSH (thyroid stimulating hormone).
I decided to do an experiment and asked if he would participate. I wanted to see if I would feel any better, significantly better, the same, or worse on the levothyroxine. I had told him since I had never been 56 years old, I really didn’t know how 56 should or could feel. He laughed. He also agreed with my experiment, so I began a dose of .075 mg a day of levothyroxine.
It was a disaster. For three days I felt so oddly weird, so not myself. Each of the three days I hung with it, determined to give it a solid try thinking I should ride out my body’s adjustment to the medication. The negative side effects at .075 mg had severely decreased my sense of well being. I called the endocrinologist and he agreed the .075 mg was too high a dose for me.
He cut it to .05 mg a day and after trying that — and then trying several other variations through 2013 with blood tests to check my levels after every tweak to the dosing — in late November 2013 I was eventually able to settle into alternating days of .05 mg and .075 mg. That’s because there is no levothyroxine dosed pill at .0625 mg (the average of .05 and .075).
After a few months being on this alternating regimen, at those doses, I knew my vitality had increased.
On April 1, 2014 I was due for a physical and again had a full blood panel done. My physician’s report confirmed my sense of “healthy” self as the lab results were even better than last fall. All of my cholesterol levels, including LDL were in normal range. So were the other important indicators, as well as my blood pressure, pulse, and weight. The best news was my TSH is 5.24, meaning my thyroid function is borderline low. As a result, my physician is in agreement with my approach so I won’t deviate from it at this point.
Part of the reason I believe I am having such success is because I changed when I take the levothyroxine. I tend to awaken around 4 a.m. so I take the pill then with 8 or 10 ounces of water and go back to sleep. This gives it a chance for full absorption since there is no food interfering, as my stomach has long been empty and I usually don’t eat breakfast until at least 9 a.m.
There are other reasons. For a few years I have been living in southern California so I have gotten consistent sunshine which I know really helps my thyroid function better. I also get daily doses of it and of nature with my outdoor exercise. The farmer’s markets here provide the freshest organic produce. Plus my stress is also greatly reduced; in a few days my daughter graduates from medical school and marries a wonderful man on the same day.
What I know for sure is since 2004 my supplementation with vitamins, minerals and herbs, whole foods and regular exercise enabled me to be medication-free. But loving my thyroid to wellness at 57 — soon to be 58 — now also includes a support boost from a low dose of levothyroxine. This integrative medicine approach is one I feel may work for many others. Until I feel differently or some other health consideration presents itself, this remains my path.
May the information in all of my thyroid columns be helpful to you or someone you know. These columns are not intended as a replacement for the expertise of medical doctors or other health care professionals. Anyone wishing to make changes to their nutritional or exercise program for any reason is advised to first consult with their physician.
— Giselle M. Massi copyright May 4, 2014
UPDATE Nov. 5, 2015 … In May 2015 I connected with a new endocrinologist as I had moved from California to North Carolina. I wanted to see if my TSH of just over 5 could be further improved with the addition of cytomel, the T3 hormone. I added cytomel to my alternating daily dose of .05 mg and .075 mg of levothyroxine, which is the T4 thyroid hormone. (T3 is the active thyroid hormone; T4 has to be converted in the body to T3. Cytomel has a shorter half life than either levothyroxine or synthroid.) Taking a 5 mcg dose of cytomel made me feel uncomfortable so for just over 5 months I have been cutting the pill in half and only taking 2.5 mcg of cytomel with my 4 a.m. levothyroxine dose. Then right before I go to bed I take another 2.5 mcg of cytomel. As a result of this regimen both my TSH and my T4(Free) are within the normal range and I feel a more consistent level of energy throughout the day. I am confident this is the appropriate dosing for me, now age 59. Again, I am thankful to have another endocrinologist who supported my experiment so I might discover a new optimal. My hope is by sharing my thyroid journey and these columns that others will be able to achieve their optimal.