Hypothyroidism needs interpretation and Adivses please?

Hypothyroidism needs interpretation and Adivses please?

Hypothyroidism needs interpretation and advise

I am 60 y old/smoker ( about 40 cigarets/ day and cannot stop it ) hypertensive (controlled under Amilodepine Besylate ( Norvasc) 7.5 mg ( one and half tablet) with Nebevolol ( Nebilit) 2.5 mg ( half tablet) both taken as a single dose / day and my blood pressure is controlled / I had hypertension since 25 years. Also I had hyperlipedemia ( both cholesterol and triglycerides) since about 20 or 25 years ago and I think it is familiar and it was controlled through diet restriction and sim astatine drugs ( which I used it occasionally and stop it for a period when I see the tests within normal .

Since 1 year I discovered that I have hypothyroidism accident my my tests were :

T3: 0.4

T4: 0.7

TSH: 57.5. 27-11-2013

So I start levothyroxine tablets till I found the suitable dose for me to control the case is 175Mg / day although I am complaining of palpitation and Tachycardia occasionally in which I take Propranolol ( Inderal) 10 mg on need .

The last tests for my thyroid gland ( since 2 weeks) were:

T3= 0.85

T4= 7.3

TSH= 1.15 ( this is done since one month ago . And accidentally I checked my lipid profile to find high cholesterol, triglycerides and LDH and low HDL with high VLDL so I started rescol( atrovostatine ( 20 mg / day ) but little diet restriction ( I am near the overweight but not fatty )on checking fasting lipid profile it was :

So I read about hypothyroidism ( as I am a Physician) and surprised that they said it is not recommended to use simvastatine with hypothyroidism / and as I found the major increas in lipid is of triglycerides and according to advise of one of friends in healthYnlocked , he advise me to use fenifibrat ( Lipanthyl 200mg once daily after meal . By the way I started the last drug since 4 days .

I like to add that I am continuously use Omega 3,6,9 once daily , mulivitamine( Centrum) and Vitamin D as antioxidant and prophylactic treatments .

Also I am suffered from insomnia and use Lorazebam 2 mg or Alaorozalam(XANax ) 0.5 mg at night when there is insomnia ( occasionally) .

My question is : Am I right in my treatment ? Or is there any comment/s or advise to me from the good ,scientific and practical people in the HealthUnlocked group?

I will highly appreciate any good opinion and advise .

Looking forward to receive your early reply, I remain . With my best regards and thanks.

Dr. Adnan F. Alnajar

13 Replies

  • I am only going to comment on your smoking.Are you wrong in your head.Cant stop!,! Don't want to stop more like it.I am a 79 year old woman. I lost my sister when she was 69, her son 59.,her granddaughter 33. Who left 3 young children.I stopped when I was 29. It was hell at first,no Nicorette in those days,just willpower.I managed it.I would also have been dead if I hadn't stopped.I used to wake up every morning and cough,cough,cough.I have now got fibrosed right lung.Emphasema

    Don't be a B idiot.My son,who is 56 stopped 6 months ago .He was the same as you.today has been to a funeral of a mates wife who wouldn't stop smoking.She was 54. Wake up man up and stop.End of rant.

  • Hello adnanalnajjar30,

    Welcome to our forum and sorry to hear you are not feeling well.

    It is difficult to comment on your thyroid test results without lab ranges (numbers in brackets).

    However, as a doctor you will be fully aware of the devastating effects smoking has not only on the thyroid but also in inhibiting hormone synthesis.

    High blood pressure and cholesterol can be caused by hypothyroidism or other thyroid issues but also smoking. Your medications could be further activating problems.

    I would suggest you have your Vit B12, Vit D, Folate and Ferritin checked as these are common deficiencies in people with thyroid problems.

    As you have been ill for a number of years, I would also suggest having your cortisol levels checked as high/low cortisol can indirectly effect how medications are absorbed into the body.

    You will need to repost all test results including ranges in a new question for members to comment.


  • Sorry but smoking 40 cigarettes a day is not beneficial

  • I cant give you any advice re medication, but you CAN !! stop smoking ....I did, and thousands of others do it.....DO IT ! all of your health issues will improve. Good luck ...

  • Adnan, we really need a range for that T3. It looks like it could be low but impossible to tell without the range. The TSH looks ok, but as I'm sure you no, it's meaningless once you are on thyroid hormone replacemant, and the ft4 is the important one.

    if the ft3 is low, then that would account for your high cholesterol and blood pressure. I believe that smoking can also raise these. But whatever the cause, taking statins is not the answer, they will probably cause more problems than they solve. Besides, cholesterol is irrelevant. It has been proved over and over that it doesn't cause heart attacks, and is necessary to make hormones.

    Your insomnia is probably also due to your low thyroid, and all these drugs your taking could be making things worse rather than better. Sorry, not on my PC, so can't look them up. But it seems to me that your priority should be your thyroid because if your levels are optimised, the rest will probably fall into line.

    And, belive it or not, your smoking is more than likely a symptom of your low thyroid, and you'll find it much easier to give up once your thyroid levels are optmised. :)

  • I am so impressed that you, as a physician, are asking us on this forum how to treat your own hypothyroidism. Thank you for the respect that shows to the knowledge built up in this forum.

    One thing you will read repeatedly here is that people with hypothyroidism become very low on certain nutrients, particularly ferritin, B12, Vit D. Getting these checked and supplementing until you have at least mid-range figures for these may well help your health situation generally. I have heard that smoking can deplete certain nutrients too, so it could be even more important for you.

    Your high cholesterol reading may mean that you could take a little more Thyroxine. Palpitations can be a symptom of too much or too little thyroxine. Without the ranges for your T3 and T4 results I don't know, but you should be trying to get these figures into the top quartile of their ranges. A TSH of 1.15 is not too low. If you get the thyroid right you may find your cholesterol and palpitations are resolved and you can stop some of your medication.

  • I, like you, never believed I could ever give up my 20 cigarettes a day (even in spite of my own dad dying of lung cancer!) until I was given a book by Allen Carr called 'The Easy Way to Stop Smoking' by my daughter and, I kid you not, stopped within ONE DAY and have never looked back since. Although the author has since died of lung cancer (he had a 60-a-day habit!) his methodology is brilliant. The cravings literally stopped within 24 hours and I have never felt like lighting up since 1 May 2004! Don't rely on patches, chewing gum, mouth spray or any other substitute nicotine source. Nicotine is a deadly substance which, if 1 cigarette's worth were injected directly into a vein would kill you, and all you're doing is using an alternative delivery system, not getting rid of the killer. Try it... you never know, you might be as surprised as I was at how easy it was.

  • A lot of people only feel well with a lower or suppressed TSH, as I did and it was only then that my blood pressure and cholesterol returned to normal.

    'Understanding Thyroid Disorders', written by Dr A. Toft, gives good advice and it is published in association with the BMA. An extract :

    "Typical results would be a fT of 24 pmol/l or TT4 of 140 nmol/l, and a TSH of 0.2 mU/l. In some patients, a sense of well being is achieved only when fT4 or TT4 is raised, for example 30 pmol/l or 170 nmol/1 and TSH low or undetectable. In this circumstance, it is essential that the T3 level in the blood is unequivocally normal in order to avoid hyperthyroidism."

    I agree with Flower007 and eeng 's comments above about further testing as drugs may have depleted B12.

    For heart etc., the book, 'The H Factor - Homocysteine the Biggest Health Breakthrough of the Century', by Patrick Holford and Dr James Braly, gives good information on lowering homocysteine levels.

    Good luck with reducing smoking.

  • Personally-I wouldn't take simvastatine.And- I won't preach-like doctors and non-smokers yap at ya-cos I smoke. Oy Vey! I think smoking,,pain pills and estrogen (premarin) ,has a tendency to suppress your thyroid more.(and prolly sedatives and sleeping pills too if taken regularly) I don't always eat correctly--and was amazed that my glucose and cholesterol came back normal! I take Biotin.,a fish oil pill,,vit B 12 and C and D really helps! My trigs are high ---but I guess I don't process carbs and sugar too well. Some things-I can't give up! Was on generic Synthroid for years--was undermedicated..had a crash--like my adrenals pooped out!! I had a low TSH--and low T3 and T4 too! Had a lot of pain and depression. Gotta watch stress/anxiety in your life-makes everything worse! I was then switched to Armour..I can really feel it kick in-in about 4 hours after taken. In the beginning-felt hyper-heart pounded and raced--scared me! (I notice that smoking-makes my heartbeat faster.) It's leveled out now and could prolly handle more thyroid. I also take Cytomel in afternoon.I have a higher temp.and feeling better. I guess you gotta find what works for you--everybody has a different body/blood chemistry. Doctors are always handing out more and more pills to take! I think the less the better-if you can manage- cos of the all the side effects--and one working against another...and messing with my energy level! I don't know if I helped you at all...good luck thou...

  • Adnan, we really can't interpret FT4 and FT3 without the lab ref ranges. They vary widely across the world and from region to region in the UK. TSH level looks ok though.

  • And whether that is Free T3 or Total T3!

  • This explains why you need your cholesterol.

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