Quit Cigarettes, Thyroid took a Dump!

[Andyb1205]

Long story short after finally seeing progress on 100mcg Synthroid I made the terrible mistake of quitting smoking!

Now I’m such a fool I decided to quit cigarettes, been two weeks clean now. And I can feel that my thyroid just took a big dump on me, as if I just went down a dose or two! I found a new family doctor and will see him second time this Friday. Did general labs today though I was too anxious to say, “can you add T4/T3 as well” last meet when he gave me the lab requisition paper. Still waiting but labs will only run T4 if TSH is out of range so unlikely.

Any who, I am trying to muster the courage to demand the doctor raise my dose to 112mcg while we investigate central Hypothyroidism to make a long term plan for treatment. The scientific consensus is pretty clear on how smoking can artificially raise metabolism and hence how raising the dose helps when quitting. I was finally seeing progress but now old memories are coming back and there is no way I will go through the horrors again.

Either the doctor will need to raise my dose to 112mcg, or at least promise to call the labs so they can run the T4/T3 (they hold the sample for a few days) so I can see him the next day. Or I am back to smoking while I spend future meetings to educate the doctor so he can cooperate or worse, go doctor shopping again. Crossing my fingers, will see the doctor this Friday.

I hope he doesn’t just say I’m being anxious because of nicotine withdrawal. I’ve been smoking for the past 9 years and in the past year I’ve been able to track and link the progress of my moods directly to the thyroid doses hence increased thyroid hormones.

[Clutter]

Andyb1205,

Tobacco smoking can suppress TSH so your TSH may be higher and your GP willing to increase dose.

You've cracked the hardest part of quitting smoking to have managed 2 weeks without tobacco. It would be a shame if you restarted to try and prove some sort of point to your GP.

[SlowDragon Administrator]

Your GP should be aware of link between stopping smoking and changes in thyroid levels

You may need dose increase

Suggest you also ask GP to retest thyroid antibodies

verywell.com/does-smoking-c...

ncbi.nlm.nih.gov/pmc/articl...

stopthethyroidmadness.com/2...

[Andyb1205]

So my results came in, TSH barely changed and is at 0.54 (0.32-5.04). Perhaps two weeks wasn’t enough to affect the TSH much. A month

A month and half ago it was 0.44. In fact my TSH on 75mcg, 88mcg and 100mcg has stayed pretty much the same, very low-normal.

I will share the article from the medical journal with the doctor. Btw my two previous doctors weren’t aware of any link between smoking and thyroid (I had only casually asked). Most doctors are uneducated about this in fact I think, practice lagging behind the science.

Any who wish me the best of luck, I will be sure to share the update after the meeting this Friday. Worst case, if need be I can muscle a few more days after that, hunting down doctors at walk-ins. But otherwise I will have no choice but to go back to smoking while continuing to find a doctor that knows what they’re doing. I take ADHD medication and the metabolism greatly affects its efficacy. It also costs me $45 a week so walking around not just physically but mentally exhausted is simply not an option.

In the long term I would like to get all of this sorted out. It is just so frustrating when I’m trying to quit smoking only to struggle with this thyroid stuff. Mind you, I haven’t had a drink in 8 months and had ended my marijuana addiction 2 years ago, all this after almost a decade of self medicating. Just the cigarettes are left!

[eeng]

Well done for taking your habits in hand and beating them. I have enormous respect for what you have achieved. If you can get your doctor to check your nutrient levels - Iron, Ferritin, Folate, Vitamin B12 and D, you may find that you are low on some or all of these. People with thyroid problems very often become low in these because they don't absorb them properly from their food. If you find you are low in any of them taking supplements may well help your body use the Levothyroxine you take to better effect so that you don't need a higher dose. However I sympathise - your doctor should get your FT4 tested at least. You may have to consider a private blood test, which lots of people on this forum have done.

[Andyb1205 in reply to eeng]

I appreciate the kind words! I am currently awaiting my Vitamin D result, should be available tomorrow. I’ve been supplementing ever since I was found to be deficient almost a couple years ago. 8 months ago it was 80 in range of 75-150 so I increased my 10,000/week dose to 12,000, hoping to hit at least 100. B12 was slightly above range (650ish) a month and half ago. Ferritin was run and is at 100 ug/L. I believe the lab doesn’t even run Folate so never got that checked. Magnesium and Phosphate came back good as well.

I think I will try to stick to the basics this Friday with the doctor and go from there. For example, my TSH has been the same on three different doses while I felt different on each one. It is safe to assume that decreased metabolism after quitting smoking would lead to decreased absorption of the Synthroid, hence why I feel like my dose has gone down! This way I can push him to get the thyroid hormones run so he can be comfortable knowing I am far from hyper. Also I’ve already had TPOab run a few months ago, has been in range for years. As well as TGab.

Will also print governmental guidelines where the algorithm clearly states I am not hyper and my case needs to be investigated by gathering my medical history. I am crossing my fingers!

[Andyb1205]

So I appreciate that the doctor had written T4 and T3 on the lab requisition paper. However the lab refused to run the tests because of governmental protocol, they are very strict. The doctor had to write hypothyroidism under diagnosis heading on the paper for the T4 and T3 to be covered. The alternative is to write self-pay so the patient pays out of pocket to the lab. In retrospect I should have written in self pay myself. Any who as they hold the sample for a few days the doctor can call the lab to order additional tests.

I called the doctor today and asked the receptionist to give him a message,to call the lab so they can run the T4 and T3. Will call again tomorrow morning to remind him as my appointment with him is later in the afternoon. I have a bad feeling he won't. If he does but the results aren't in by time of appointment I can hold out for another day. But I need a dose increase ASAP. I'm not exaggerating, it feels more like I went down 3 doses than 2! I can't go out in public with the digestive problems (hypo with flatulence and frequent stools, funny since this is before the set point dose where constipation begins for me!), feel like I have a chronic cold, tired, muscle and chest aches, and my ADHD medication is barely working! Mind you it costs me $45 a week!

Will see what happens tomorrow. But considering it took me almost 2 years to finally see progress I simply cannot continue to put my life on hold. It's not about proving a point to the doctor but about weighing the pros and cons at this point. Clean for 18 days now, don't even have mental cravings anymore. Just feel too damn hypo.

[Andyb1205]

Here are my previous results, in order, on 75mcg, and 88mcg and the recent one on *100mcg Synthroid where I was off cigarettes for 18 days. I wish I had done labs on 100mcg before quitting smoking but oh well, this much will have to suffice. Antibodies have been in range for years, I personally suspect central Hypothyroidism.

TSH 0.44/0.54/*0.43 (0.32-5.04)

FT4 13.3/14.5/*13.8 (10.6-19.7)

FT3 4.24/3.94/*3.91 (3.00-5.90)

Should note, I take ADHD medication and noticed that my first lab on it saw a big jump in TSH from 2.19 to these very-low normal figures above. Funnily enough, 75mcg with TSH 2.19 had FT4 14.1 compared to 75mcg + Adderall with TSH 0.44 FT4 13.3! As if the increased metabolism made the pituitary send a signal to raise thyroid hormones only to get the middle finger from the thyroid!

Will see the doctor tomorrow. Assuming things go smooth and he agrees to raise the dose by monitoring FT4 what is recommended? FT4 levels stabilize much quicker than TSH, so should I get an 12.5mcg increase with labs in 3 weeks? Or go right for a 25mcg increase with labs in 4 weeks.

Thanks! If it helps, I weigh around 100kg.