hypothyroidism medication

what is the best medication for hypothyroidism? does this often happen due to thal?

The medicine for hypothyroidism is thyroxine, also known as synthroid and levo-thyroxine. Hypothyroidism can be genetic, but is also common in thalassemia. Iron overload can damage the thyroid gland, but this can also be a result of damage caused by the unmatched alpha globin chains produced in beta thal, so even patients with no iron load can be affected. Treatment for hypothyroidism is one tiny pill every morning. I take it daily. 

thank you Andy...

What is your feeling regarding natural vs. synthetic replacement therapy ?
 
 
 

Joanne,

I am going to do a post on hormones and thalassemia.  I am also going to suggest a book that can be helpful to all people, especially thalassemia majors and minors.  Hormones can have a great impact on the quality of life of thalassemia patients.  We need to have balanced serotonin, insulin, growth hormone etc. in order to be healthy.  In the mean time, synthroid can be life changing and worth taking. 

Once I have created that post I will cross reference it here,

Best,

Sharmin

Will wait to read it. I have suffered hormonal issues for as long as i can remember, though the possibility of thal minor has come up only in the last 3 years or so.

One note- my hypothyroid medication gives me problems when i'm on a normal dose based on my reports. Now we are going by symptoms and well being, and it works for now.

Problems with adrenal glands and hormonal issues are very common in society in general these days - possibly due to hormones in our food, the use of plastics and various other reasons.  In thalassemia these problems are magnified by affects on the adrenal glands - likely caused by iron overload in these glands.  In some cases, medications required in thalassemia may cause these problems as well.  In some cases steroids can magnify the problem.  

We plan to participate in a study of adrenal glands this summer and are hopeful that this study will be helpful in understanding adrenal gland issues in thalassemia.  

Again, chelation will help in pituitary and adrenal function which will in turn lead to better organ function because hormonal imbalances wreak havoc in the body in many ways.  Healthy adrenal function leads to healthy growth, development and well being in general.  

I am writing a very tedious paper for school today.  Once I submit it tomorrow I will have some time to write at length about what I know about this topic.  Hopefully it will be helpful.  In the meantime, eating at regular intervals, chelating, taking antioxidant supplements and trying to eat organic will help.  The use of plastics should be limited when possible (very difficult in today's world) but at least avoid microwaving food in plastic containers may be helpful.  Eliminating pesticides, antibiotics and hormone additives in food will be helpful - that is why organic animal products - meats, milk products and eggs - is very important for healthy hormone balance and function. 

Sharmin

Hallo Andy Sir
                        Please reply.  I need your valuable advice about my mild hypothyroidism.
   I visit to Dr every 4-5 weeks and he gives 2-3 minutes at that time I able to ask him only 2-3 questions. Also I live in a village and no other doctor is available in my area.   So Please reply of my queries .

5 months ago at 07.08.15 my blood reports are
    Serum Ferritin  3767 ng/dl  , Free T4 = 0.89 ng/100 ml , Serum TSH = 10.79 micro IU/ml

Since then I am taking Sodium Thyroxine 25 mcg per day and start to chelating iron by defarasirox tablets 1000 mg/day.
Last month at 09.12.15 when my ferritin reaches to 900 then I stop chelation as per doctor's advice but I am continuing to take thyroxine. I am not done any thyroid test after starting of the medicine till now as doctor also don't suggest me to done these tests.

I want to know how long take this medicine to reach normal thyroid level  ?
Pathological tests related to thyroid should be done in how much time duration while taking thyroxine  ?

Please advice    .

Abyaya Jyoty,

I have serious hypothyroid. I will take thyroxine every day of my life. Yours depends on the reason yours is hypo. If it was caused by your iron load, correction of the iron load may cause the thyroid to return to normal. If your thyroid is just a little slow and not related to iron, then you may have to take thyroxine for the rest of your life. Your dose is very low and not worrisome. Normally, the thyroid is tested once a year, but if you have only recently started thyroxine, then it should be checked again within a few months to make sure the dosage is correct.

So many many thanks to you Sir.
 
I am awaiting for your reply.  I am sorry because I posted three long posts at a time.  But you read all the posts carefully and reply to all these in such a well manner,  it's amazing. Thank you so much Sir.

I am worried because if my hypothyroidism is due to iron load then lower the iron load ( SF 900 one month ago ) thyroid level  may be normalised . As thyroid level is unchecked and I take thyroxine at a level which may be normal. And it may be harmful.

If my hypothyroidism is due to iron load then a recent thyroid test should be done within couple of days to make sure the level is normal or not 
OR   there is no need for emergency and anxious about it and it takes time to be normalised  ( although it is iron related )      ??

I am very sorry for repeating the queries and bad sentence construction.
     Please advice.

Your thyroxine dose is minimal and it is no cause for concern. You will do no harm with that dosage. When using thyroxine, a dose is usually tried for at least 3 months before testing is done again. With a ferritin of 900, you are still carrying some iron load, so you may not see an improvement in thyroid function unless you continue the thyroxine. I think the chelator could be continued until the ferritin gets into the 300-500 range. It would be best if at some time you can arrange to get a liver MRI to check your true iron load. And drink tea with meals, as it helps inhibit iron absorption from non-meat foods.

Your thyroxine dose is minimal and it is no cause for concern. You will do no harm with that dosage.

Thank you Sir.  Your words removes all the anxiety from my mind in just a  minute.  Thank you very much.

I think the chelator could be continued until the ferritin gets into the 300-500 range.

Please guide about this issue.
I read some posts about chelation should be start in low dose at low ferritin level.
2.5 months ago I have done LFT.  All the parameters was normal except Bilirubin  (2.9)
       SGOT = 45  ,
       SGPT = 54  ,
       SERUM ALKALINE PHOSPHATASE = 117 ,
       SERUM PROTEIN  = 7.9 ,
       SERUM ALBUMIN = 4.2 ,
       SERUM GLOBULIN = 3.7
This test was done after 80 days from starting chelation.

I was chelating for 4 months from SF = 3700 to SF = 900 by 1000 mg (20 mg/kg ) defarasirox tablets /day and in this period I never transfuse. I am skeptical about this result as it was my first time chelation and I am not experience dealing with chelation. Is it possible  to decrease SF by 700 unit /month.  ?

Stop chelating 40  days ago and in this period transfuse by 1 unit ( 200 ml  ) pack cell.
As a whole I take total 18 units blood till now. In future I must done liver MRI but that is not possible recently.

Please suggest me about the low dose and it will be continue how many days  ?
Please advice.

Bilirubin is always high in thals due to the high turnover of red blood cells which creates bilirubin. This can cause issues with the gallbladder and many thals eventually have them removed.

I would suggest another ferritin check. Ferritin can drop rather quickly if the iron load in the organs is not high. If most free iron is bound in ferritin, good chelation will clean it out quickly. I think you need another check of ferritin before making any decision about continuing chelation. Since you occasionally transfuse, you will need to chelate at least on a temporary basis when needed.

You need to stay on the thyroxine dose until your doctor says you don't need it. Your thyroid should be cheched again after a few months. If it turns out that you do have a slow thyroid, you will probably need thyroxine for the rest of your life. I've taken it for 20 years, but a much higher dose.

Thank you Sir.
I'll follow your advice.

At this point you have to repeatedly monitor S.Ferritin & TSH at an interval of 1 month.
If you dont have any Endocrinologist for Thyroid checkup, let me know i will try to find out Endo near Kolkatta.

Thank you Dharmesh Ji for replying.
Sorry for late reply. I had an exam. I was busy for preparing in last few days.

Is it better to go to an endocrinologist instead of a  Hematologist treat thyroid  ?
I never go to an endo till now. May be 2-3 endo are available in my area , I have to enquire about them.

Yesterday I have taken the appointment to Dr Ramanan in 1st week of March. At this purpose I will contact with you recently.