thyroid
OK, I wasn't able to find anything in a search in the medical literature but it sure seems like there's a connection between chemo or is it just BC and hypothyroidism. Does anyone know anything about this? My TSH is creeping up and I feel crappy. Probably ought to do antibody testing, maybe subclinical. Maybe I'll just have to wait until the TSH hits the magic "4". Have to make an appt with my PCP.
Comments
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Jorf, I think chemo can do a sucker-punch to the thyroid. I felt crappy too after chemo, then instant menopause, then the bone-chills followed by hot flashes, then the extreme exhaustion with muscle soreness and stiffness. I kept complaining about exhaustion and it took a long time for the lightbulb to go on in one of my practitioner's head...oh! it was after I complained of being dizzy almost all the time. These are all symptoms of thyroid problems...My MD figures I had thyroiditis post-chemo, then it went back to normal for a few months and then cacked out completely, like a poor old car engine. Now that I'm on synthyroid, and slowly adjusting the doseage upward, I feel much better. Somehow it only makes sense that the chemo would cause problems for this gland...it's such a sucker-punch! Push for regular testing, and good luck!
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Hi Jorf
I don't know how connected bc and thyroid issues are but I had hyper before bc. I had several nodules that were causing me to be hyper. Now my TSH is also creeping up (and nodules are just as small/unchanged) and my endo thinks the thyroid will eventually burn out and then they will put me on Synthroid. But for me it is a wait until the numbers move thing. I would get the whole work up, not just the TSH. If you have antibodies then that would indicate Hashimotos (I think). I have antibodies but so far am pretty asymptomatic. I hate that they wait until you feel crappy before they will do anything. Maybe going to an endocrinologist instead of a PCP would be better? But, probably depends on the PCP.
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I had been taking thyroid medication for hypothyroid for years before my chemo, but about 6 moths after finishing, my TSH went way up & I changed medications. I don't know if you'll find anything written on the subject, but definitely request a TSH blood test. I got my pills from my PCP - this is another one of those guessing games the doctors do - a PCP can be just as helpful as an endocrinologist if they get the dosage right. They'll make you wait about 3 months to see how you do.
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If you start reading about iodine, you'll find volumes of information asserting a connection between iodine deficiency and thyroid dysfunction and even some who claim sufficient iodine levels can prevent bc. Both the thyroid and breasts are particularly affected by iodine deficiencies. Iodine used to be in our bread products, but that practice ceased decades ago. Table salt is often avoided by people for heart health reasons. This situation is made worse, imo, by the RDA (recommended daily allowance) being set at 150 mcg/day. Japanese people typically consume 13 mg per day and have a much lower rate of bc than the US. Furthermore, the US guidelines say iodine starts being toxic at 1100 mcg/day. There's a lot of information about iodine on the web as it relates to hypothyroidism. One good place to start is breastcancerchoices.org. I get my iodine supplements from there and take 50 mg/day.
You should also be aware that most women feel their best when their TSH results are 1.0. The association of endocrinologists revised the 'normal' range in 2002 to be anything between .3 to 3.0. The old range was .03 to 5.5. My gyn, internist, and oncologist are all using the old range, and even at that, I had a TSH of 6.4 way back in august of 06. I have been complaining of fatigue since 05 and not one single doctor has helped me with my thyroid, except for my friend's chiropractor who suggested I take iodine supplements.
My personal list of hypothyroid symptoms include: body temperature 1 degree too low at 97.6; low grade depression, poor stamina, low energy, hard stools, high cholesterol, brain fog, digestive problems, brittle nails, difficulty losing weight. Other common symptoms include dry itchy skin, thinning hair, especially the outer third of eyebrows.
If it turns out you're hypothyroid and you're fortunate enough to have a doctor who will dx it, you might want to investigate Armour Thyroid. All the others are made synthetically and have a list of side effects that armour does not.
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Thanks for the replies. I actually am an endocrinology nurse practitioner but when it comes to myself or my husband it's a whole 'nother story, right? I was the one who just went ahead and added the TSH to my last lab test and now need to talk to my PCP because I'll let her prescribe.
Also, I know well enough that all the symptoms that look like thyroid aren't necessarily. Tho with a TSH of 3.89 I would likely give someone a 6 month trial with an aim of low normal TSH and resolution of symptoms. So, I'll be a good doo-bee and discuss it with my PCP and if she hems and haws, with my medical director....
I've also decided to wait on the switchover from tamoxifen to arimidex given how cruddy I feel.
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I was borderline hypo in my 20's and had to wear eyebrow pencil from the time I was 14, to fill in.
My pcp (dh) would always get the TSH and say I was just borderline low, and wouldn't put me on thyroid. I had multiple other sx as well. About 4 years ago, my NEW pcp who I hired after diagnosis, put me on synthroid. He explained that in his opinion, borderline labs demonstrated that the gland was working too hard and and that synthroid was needed.
Just looked up my TSH, and I was 17.9 last year and down to 9.8 this year. Wish I'd been asked to return to f/u with blood work with the med increase last year. Guess he expected me to know to do that. Grrr---I'm sure going back in a few weeks to ck it again.
My cholesterol bounced way us this last eval, too. I believe hypothyroid has to do with that as well as a bunch of other symptoms.
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