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Thyroid (Expert Forum)
dry mouth, spiking BP, difficulty breathing
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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dry mouth, spiking BP, difficulty breathing
by wyoming2, May 10, 2007 12:00AM
7 years ago I was diagnosed with Graves. I was allergic to PTU family so RAI was done. Difficulty with thyroid drugs and have been on a multitude. T4 the worst. The last 2 years been on Cytomel 25 mg and Thyrolar 60 mg split 1/2 in the AM and 1/2 in PM. Due to weight gain, hair loss,puffy eyes, and good/bad days new endocronologist perscribed Synthroid 137 mcg. After a week started having chest tightness, dry mouth, difficulty breathing. Called the doc. He reported nothing to do with thyroid med. Symptoms intermittant at first.In 3 months endo prescribed-Synthroid 100, 88 and 75 mcg, then Lovyxl 88 and 75, then Unithyroid 75 mcg. Symptoms increased and more frequent. I requested to put me back on Thyrolar 60 mg 3 weeks ago. Thyrolar backordered so starting Armour 60 mg today. Presently 3 ER visits and 1 hospital stay later. Heart stress, scans all fine. O2 consistently 98-99. MRI fine. Episodes lasting up to 4 hours. Always come down (systolic 200) w/o intervention. Have bilateral mastoid mucositis infection (1st time). Amacocillian did not work. Another 10 ten of Levaquin. Last day today and appears helpful. Hospital results 4/28-5/1. TSH 4/26, 1.61, 4/28, 1.53 and 9.8 4/28 recheck. 4/22 TSH 5.12. T3 uptake 33, T4 uptake 6.6. Always healthy, active other than thyroid. This is becoming dibilitating-loosing work, in hospital for daughter's wedding.Is any of this related? Would appreciate any insight and help. Thank you.
Doctor's Answer
by Mark Lupo, M.D., May 11, 2007 12:00AM
, May 11, 2007 12:00AM
The TSh levels have been a little off -- it is hard to interpret response to treatment when it changes so frequently. I try to ask patients to stick with a new T4 dose for 3-4 weeks at least before we judge it in terms of symptoms.
If T4/T3 works best for you then combo of T4-only product and Cytomel gives the best control. In your case Synthroid/Levoxyl 100mcg and Cytomel 5mcg (am and 2pm) may work well assuming the synthroid 137mcg dose lead to the reported TSH of 1.61.
Also, always look into other causes of symptoms besided thyroid. you've had the heart tests, consider rheumatologic evaluation.
If T4/T3 works best for you then combo of T4-only product and Cytomel gives the best control. In your case Synthroid/Levoxyl 100mcg and Cytomel 5mcg (am and 2pm) may work well assuming the synthroid 137mcg dose lead to the reported TSH of 1.61.
Also, always look into other causes of symptoms besided thyroid. you've had the heart tests, consider rheumatologic evaluation.
Member Comments (5)
by thyroid man, May 10, 2007 12:00AM
Switching brands causes bp to go up in me and heart racing. I have proven this to myself over and over.Once i get adjusted to a brand my bp is great.then i switch brand and my bp gets high and goes back down after switching back to the brand I'm used to.And if i stick out long enough on the new brand the bp will get normal again.My whole body goes through some kind of adjustment on a new brand even though the levesls are normal.So I decided to give Armour a try and I ended feeling like I was going to die. So I went to the ER and my levels were perfect.Cat scan was fine too.BLood pressure was Hi and high pulse.So I didn't take any pills for a couple of days and went back to synthroid after that episode and the same feelings came.It's the switching back and forth that's bad. For some reason the body gets used to one type of thyroid and it messes things up when u change.It gets red around my eyes when I switch brands and I sweat more, a lot of things happen.The worst thing u can do is to constantly switch brands and switching to Armour and then back to Synthroid.U need to stick it on one brand or type and eventually your body will calm down.It's a quicker route to go back to what youv'e taken the longest.This does'nt make any sense but it's the way it is. I'm 100% about this Iv'e done it over and over.
by thyroid man, May 10, 2007 12:00AM
For me i'm better off not taking anything for a few days if the pharmacy is out of my brand.I too had those bad episodes lasting for hours and then feeling better. And theyr'e really bad.I don't know if there exactly the same as yours but there extremely uncomfortable.Extreme tension.Switching brands wasn't as big of a deal but switching to a totally different type of thyroid like Armour was.I think it was just the CHANGE not the Armour.Because the same thing happened when i switched back to synthroid.But the episode are slowly phasing out as i stick with the synthroid.Switching back and forth is the worst thing a person can do.I had the dry mouth too.I also had restless leg syndrome during those episodes.
by thyroid man, May 10, 2007 12:00AM
For me i'm better off not taking anything for a few days if the pharmacy is out of my brand.I too had those bad episodes lasting for hours and then feeling better. And theyr'e really bad.I don't know if there exactly the same as yours but there extremely uncomfortable.Extreme tension.Switching brands wasn't as big of a deal but switching to a totally different type of thyroid like Armour was.I think it was just the CHANGE not the Armour.Because the same thing happened when i switched back to synthroid.But the episode are slowly phasing out as i stick with the synthroid.Switching back and forth is the worst thing a person can do.I had the dry mouth too.I also had restless leg syndrome during those episodes.
by DLA, May 11, 2007 12:00AM
Also had all of these problems. Finally found endo who knows what she's talking about. She said to NEVER change brands! Most important! Also when changing dosage you have to go slowly instead of drastically. Had RAI for Graves in 2003, and have had horrible recurring problems since until I found this endocrinologist. Hang in there and find one who knows what they're doing. Trust me when I tell you it will all be worth it. Also on synthetic thyroid it is my understanding that the TSH level is the most important level to regulate. Hope it helps it will all get better.
