Synthroid and Calcium AGAIN
http://www.thyroid-info.com/articles/osteoporosis.htm
"BE CAREFUL WHEN AND HOW YOU'RE TAKING YOUR CALCIUM
According to research reported on in the June 7 issue of the "Journal of the American Medical Association," calcium supplements may interfere with the absorption of thyroid hormone medications. Taking calcium carbonate supplements at the same time as thyroid hormone can reduce T4 absorption, which results in elevated TSH levels and hypothyroidism. Given that many thyroid patients are women in their 40s and beyond, who take calcium to help prevent osteoporosis, there may be concerns over how to take your calcium? Doctors suggest taking your thyroid hormone first thing in the morning, an hour before breakfast, and take calcium supplements 12 hours later, to help prevent any absorption problems. Also, remember, don't take thyroid hormone medicine wiht calcium-fortified orange or other fruit juices, as the calcium in the juice can cause the same absorption problems."
If this is true, how in the world could we take all the calcium we're trying to put into our bodies? Doesn't it say on the Synthroid insert that to take the calcium four hours after?
I'm gonna stop looking for stuff to worry about! 
Shirley
Comments
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Shirley...I hope that Rosemary checks in on this because I too am concerned. What does comfort me is the fact that my body is quite sensitive to my thyroid levels and nothing is amiss. In fact, my blood tests verify this as well. So I'm thinking that taking calcium 4 hours after the med hasn't inhibited absorbtion at all. So, really, who cares about the research if you know that your levels are doing fine, right? Anyway, Rosemary knows alot about this stuff and may have some input.
Also, btw, I thought that it was Rosemary who also told me to take calcium citrate instead of calcium carbonate due to thyroid hormone conflicting with the carbonate..?
~Marin
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Hi Shirley and Marin,
Little Goody Two-Shoes here has the answer.
I take my synthroid first thing in the day, alone.I then take my do Woody out for his first tinkle of the day.Elevators etc, it's at least 15 minutes before we are back.
Then I make his breakfast.
Then I make my breakfast.
Then I take the rest of my AM suppliments.
Mostly antioxidents.
I do NOT take calcium in AM at all.(Although I do take 1K Vitamin D.)
I take my calcium at lunchtime, and before bed.My calcium sups contain 400 vitamin D, and 400 Magnesium.(Should anyone want to discuss calcium absorbtion, which we're not.)
Simple!
Especially for those who take sups 3 or 4 times a day, like I do.(I should write it on forms as my occupation:"buying and taking suppliments")
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Hi Shirley and Marin,
Little Goody Two-Shoes here has the answer.
I take my synthroid first thing in the day, alone.I then take my do Woody out for his first tinkle of the day.Elevators etc, it's at least 15 minutes before we are back.
Then I make his breakfast.
Then I make my breakfast.
Then I take the rest of my AM suppliments.
Mostly antioxidents.
I do NOT take calcium in AM at all.(Although I do take 1K Vitamin D.)
I take my calcium at lunchtime, and before bed.My calcium sups contain 400 vitamin D, and 400 Magnesium.(Should anyone want to discuss calcium absorbtion, which we're not.)
Simple!
Especially for those who take sups 3 or 4 times a day, like I do.(I should write it on forms as my occupation:"buying and taking suppliments")
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So, really, who cares about the research if you know that your levels are doing fine, right?
That's what my doc said - take the calcium when it's convenient for you, and if your thyroid levels are thrown off, we'll adjust your synthroid. But I don't want to take more meds than necessary, so I do like Joan - take synthroid and arimidex first thing in the morning, multivitamin/extra calcium/extra D after lunch, and more calcium at bedtime (supposed to help with sleep, hahaha).
Of course I get caught up in work and forget the lunchtime dose a lot.
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Marin, Joan and Towanda....help me out here PLEASE. I had my labs done with pcp July 3. According to the lab where he sends my blood (LabCorp) here's how my thyroid reads:
TSH-Free T4 Results Limits
> TSH 0.197L uIU/mL 0.350 - 5.500
T4 Free (Direct) 1.62 ng/dL .061 - 1.76
(something like that
can't read)
He circled the two readings. I was told it was within normal range. My question, if the TSH is low, does that mean I'm getting too much Synthroid?
I believe we talked about this SOMEWHERE earlier, but I can't remember. I've been feeling nervous lately. Now, that could just be me. And, if I'm getting too much, how much is too much with the combination of both numbers? Does that make sense?
I feel so dumb.
Shirley
Oh, Marin, about the calcium. I do know that citrate absorbs more easily as we AGE. No, I didn't say, as we get OLD. As I say, I'm not getting old, I'm just getting oldER.
And, you can take it on an empty stomach.Shirley
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And, Joan, you're not "Little Goody Two-Shoes." You know we love you and value your input.
Shirley
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Shirley
I'm going to put in my two cents here. I am not an expert on thyroid issues, but I know quite a bit, only because I had idiots for endocrinologists, who didn't know anything, so I had to research everything. My dh says I know more than my dr. on thyroid matters.
.197 IS very low for your TSH! It is supposed to be between .5 - 5.5, but I see your lab shows normal as .35 - 5.5... Some endocrinologists are even saying that slightly lower is "normal". ..
Let's see.... something like .35 - 3.5 , I think. It is so hard to keep up with all this stuff, because they keep changing it all the time!
I wonder why our drs. don't routinely test for FREE T3, because that is also important. If I remember correctly, I think that the FREE T3 is important, because our bodies convert that into T4, which we use.
I would ask my dr. about the TSH, because that seems low to me.
Good Luck!
Harley
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Here's what I found. I haven't searched to far. However, it appears to me that with my TSH being low that I am hyPERthyroid. My T4 was within the normal range..a little on the high side of normal. So, if it were higher than 1.76 that would indicate that I am hyper. However, I do not know with him circling those two values if that means HE thinks I'm normal.
Here's what I found. This all gets confusing to me.
How to Tell If You Are Hyperthyroid
http://thyroid.about.com/library/howto/hthyperthyroidism.htm
Here's How:
- List your risk factors, including: family history, previous treated/untreated problems (nodules, hyperthyroidism, goiter, hypothyroidism, thyroid cancer), previous thyroid surgery, another autoimmune disease.
- Note symptoms including: weight loss, anxiety, insomnia, fatigue, hair loss, palpitations, rapid heartbeat, sweating, diarrhea, weakness, eye/vision changes.
- Note related conditions, including: atrial fibrillation, recurrent pregnancy loss, panic disorder, attention deficit disorder, depression.
- Meet with your doctor for a thyroid examination and blood test.
- Request a TSH (thyroid stimulating hormone) blood test, along with T4, T3, Free T4 and Free T3 tests.
- Review your test results with the doctor.
- At most labs in the U.S., up until late 2002, the normal range is from around 0.5 to 5.5. That range changed to .3 to 3 as of early 2003. If the TSH level is at the lower end of the range, or below the range, your doctor may determine that you are hyperthyroid (overactive thyroid.)
- If your doctor ran a test called Total T4 or Total Thyroxine, normal range is approximately 4.5 to 12.5. If you had a high reading and a low TSH, your doctor might consider that indicative of hyperthyroidism.
- If your doctor ran a test called Total T4 or Total Thyroxine, normal range is approximately 4.5 to 12.5. If you had a high reading, and a high TSH, your doctor might look into a possible pituitary problem.
- If your doctor ran a test called Free T4, or Free Thyroxine, normal range is approximately 0.7 to 2.0. If your result was greater than 2.0, your doctor might consider that indicative of hyperthyroidism.
- If your doctor ran a test called Total T3, normal range is approximately 80 to 220. If your result was greater than 220, your doctor might consider that indicative of hyperthyroidism.
- If your doctor ran a test called Free T3, normal range is approximately 2.3 to 4.2. If your result was greater than 4.2, your doctor might consider that indicative of hyperthyroidism.
- If your test results come back "normal" but you have many of the symptoms or risk factors for thyroid disease, make sure you ask for an antibodies test for Graves' Disease.
- If your test results come back "normal" but you have many of the symptoms or risk factors for thyroid disease, consider going to a reputable holistic M.D. or alternative physician for further interpretation and diagnosis.
Tips:
- Keep in mind that laboratory normal values vary somewhat from lab to lab. Make sure you find out your lab's normal ranges and review these with your doctor.
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Shirley,
Yes, with a TSH value as low are yours is, I would say that you are Hyperthyroid, and you are being OVER medicated, and need a dose change.
BUT, your FREE T4 is Normal... so WTH?
Sorry I can't be of more help than this. I guess these thyroid problems can be very complicated at times.
Harley
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Good Golly Ms Shirley! That is one incredible set of instructions! I took one looked at How to Tell If You're HyperThyroid and my eyes rolled back in my head on the second point. Initially, I thought perhaps someone had made that up. Then I realized that it's for real. Hmm, I may have posted a few like that! Geezz...
If medicine ever gets that complicated, I'd punt and call my doctor and let them decide.
Looks like maybe you're taking too much Synthroid, and are oversuppressed (low TSH).
Joan, I loved your posting! I always look for them. I think I might rearrange I take my lineup.
Harley, you're hilarious!
Tender -
Thanks for your input.
I can say (and it's not in my head...well maybe it is cuz that's were it's coming from
) that I have been quite nervous lately. I can't concentrate. My oldest daughter is coming in tomorrow and I do not know how I'm going to get this house ready for her. Not that she'll be hanging out with me. She's got a 20th high school reunion....DID I SAY 20? I'll change my oldER to getting OLD!I sweat like a pig most of the time, but who doesn't around here on HTs. Depressed, yep. A little vision problem..yep. But some of those things like anxiety, depression..stuff like that, I've had in the past. So, it's hard to know just what's what.
I think I should see an endocrinologist. I just HATE seeing ANOTHER doctor!
If that doesn't work I'm going to put myself in the looney bin.
Shirley
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Shirley,
I just read Blundin's summary of her challenge with such and use of Magnesium for both mood improvement and muscle ache resolution. It's in the hormone threads under Aromosin etc..
Maybe some Mag 2 would help you out some?
Sorry for your troubles,
Tender -
Shirley,
I hear you! I am tired of seeing so many different drs.! I think I am going to eventually have to see an endocrinologist, because that seems to be the way all the drs. here operate... they don't want to discuss anything if it's not their area of expertise! But, in the past, I have gotten NO HELP whatsoever from the endocrinolgists!
Good Luck!
Harley -
Tender, I take mag citrate. Right now I'm taking about 570 mg.
Harley, if I find a go endo here I'll let you know. My pcp doesn't mind one bit doing the thyroid check. However, I wonder if he knows exactly what he's doing. LOL I've been going to him for twenty some years. I do like him. However, doctors can't keep up with everything.
Shirley
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Ciao Shirley,
So sorry to hear you are struggling with the thyroid issue. It is a struggle and very complicated. We can read about it until the cows come home and still not know enough because it's only one puzzle piece to a big picture. Don't fret about the research. And, after twenty years with your GP, I'm certain he is looking out for your best interests.
If you are thinking about seeing an endocrinologist, maybe a university might be a good resource....one that includes oncology research? There is an advantage to work with the young, eager students who have the most recent education and the energy to stay on top of it. Where they may be lacking in Marcus Welby bedside manner, they can make up with "the right stuff". It's always a balance issue. It might be a little inconvenient for an appointment (long waits), but you can take good reading material with you while you are waiting. Just a thought.
I just returned from my visit today. Probably we should have split the fee as I left as much information with her as she gave to me....(Rosemary's info on magnesium). I asked her about the calcium carbonate (thanks to Rosemary again!)....she said that a little bit wouldn't hurt....(hummmm?) but I think that was her way to say that she didn't have information on it....sometimes, the ego gets in our way. And I didn't help the matter with rapid fire questions....but....her advise was to take minimal calcium and vit D....take long walks in the sunshine to activate both in my body. It seems just taking the suppliments arent' enough...the body needs to move in the environment to move the benefits through the system....too much calcium creates pain in the joints. She agreed too with the magnesium. She's taking a few more of my questions to the oncology docs at her hospital.
When the thyroid values aren't balanced, even deep breathing and meditation are difficult to achieve. I can tell when the meds are too much or too little...I feel it in my mood, nervous, etc. I adjust it down or up only 1/8 and it's enough to make a differnce for me....but we are all different....really.
About your daughter's visit...she's a big girl now...let her worry about the cleaning the house for you. Take it easy on yourself....you're a very nice lady.
tanti auguri! -
Thanks, Marilyn.
I go to Duke, a university hospital that's a little over two hours away. My gyn is there and that's where I always got my mammos (which didn't catch my cancer). I saw an endo there years ago for high cholesterol. It was amazing what the two labs reported..one from here in Wilmington, and the other at Duke. My cholesterol was lower at Duke. The endo found that I need thyroid meds..hypo.
I don't think it would take long for me to see an endo with a referral from either my gyn, who I see next month, or my onc. I also know that when it comes to "bone matters" they are the most knowledgeable.
I don't know if you read the link that Longshot posted. It was a small study on calcium and vitamin D. I believe more doctors are now doing the vitamin D tests. I will continue taking my D, calcium and magnesium.
When I spoke with my GP here in Wilmington he didn't know anything about the "D" subject. He said his patients teach him a lot. LOL I plan on taking some things that I have read to his office in Dec for him and the girls to read that work there. He did do a vitamin D level on me. I had been taking 1200 IUs of D. My value was 34. So, for now I am increasing it hoping to get it up more.
I've been reading about the importance of vitamin D long before I got bc.
Too late. I cleaned before my daughter got here. Poor thing didn't get home til almost 12 AM. It was a good excuse to clean and I NEED an excuse. LOL Then next month the kids and grandkids will come in for Thanksgiving. However, I will have help in the kitchen (you can bet on that!).
Shirley
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Shirley,
Please DO let me know if you find a good endocrinologist... I think I may end up seeing the endo. that is next door to my onc., because they are the same organization... New Hanover Regional MC.... I don't remember what it stands for, and I'm blaming EVERYTHING on chemo brain these days! lol But, I think that my onc will most likely give me a referral to see one of those endos. at that place. I know I'll be going there soon for a bone density test...I hear you, about the GP not knowing very much, even if you have been seeing him for a long time. I'm looking for a new Primary Care dr... Mine was about 79 yrs old, and now he's left that office and working ONLY in Loris, SC. My insurance won't allow me to go into SC for my health care....Even though I live THREE miles from the SC border!
I am also very sensitive to thyroid hormone, and I usually know when it's not balanced right.
Good Luck... let me know how it goes! I'll be thinking about you and praying that you get some answers.
Harley
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Hey, Harley. I definitely will let you know. Like I said, I just hate seeing ANOTHER doctor. A friend of mine mentioned one that her friend likes. I forgot his name, of course.
Shirley
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Harley and Shirley, I have to butt in.
I SAW an endocrinologist.I was having hypo-thyroid-SEEMING problems last winter.
Actually my ONC thought maybe I was half dead and could sleep 20 out or 24 because my thyroid was low.(Anything but admit it was Femara).
He raised my thyroid dose.
I saw an endo.
NO, she did NOT know more than my doc, my regular internist!In fact she knew LESS!She was very full of herself, saying she'd raise my thyroid dose as high as I wanted!
I said my PPO said too much thyroid can cause bone loss.
My PPO had carefully invented a perfect dose for me-150 one day, 175 the next.
My THS was PERFECT!
The moronic endo, when I told her what my doc said about too much thyroid causing bone loss (weakness, too), said "I've never heard such a thing in my life!"
That was when I knew I HADNT found an endo for me at all.
I never went to complete her stupid battery of tests :cortisol and lots of boring stuff.
The last time I saw my onc, August, he said (guess what?)my THS is too high.Not by much, but he'd like to lower my dose.
All this to say a good PPO is a great thing and really cant be beat!
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Joan, I really like my doctor. And I don't plan on changing. I've been with him for tooooooo, toooooo many years. And he also "takes care" of my dh.
I was reading about too much synthroid and bone loss. What I have found so far is that there is no proof it causes bone loss. Now, don't take MY word on that. That's just what I REMEMBER, if you know what I mean.
And, I don't know if all docs agree with that.There are really some good endos at Duke. However, as I have mentioned, I HATE seeing ANOTHER doctor, and I hate the travel. I'm not as young as I used to be. Yep, that's right. A few years ago it didn't bother me (that was when I was younger and before bc and AIs).
I don't sleep that much during the day. I may snooze. However, when I don't get a decent night's sleep I feel horrible the next day. But that could just BE ME. I'm kinda weird. Also, the nervous thing, I've had that prior to all of this. But, I was doing pretty well until recently. So, some days I skip the synthroid just to see if it makes a difference. I think I've skipped it three days now. I'm going to skip one more day. Then, I'm going back on it and perhaps to stay because I see my pcp in Dec. and want the bloodwork to show the true values.
Just consider me CRAZY! I think I'll change my screen name. LOL
Shirley
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Oh, I forgot to say Joan. I can't believe she said she'd raise your meds as high as you wanted. I'd run away from her so fast and never go back. Oh, you did that! LOL
Half the battle is having a good doctor who will at least listen to our complaints without poo-pooing (sp..LOL) them.
Shirley
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Shirley, I'd say you're over-replaced - both b/c your TSH is low and due to your symptoms. Remember that the TSH (thyroid stimulating hormone) is the most sensitive test for thyroid function - it doesn't matter if your serum T4 (or T3) for that matter is normal if your TSH is off.
Think about the TSH as the thermostat noticing that the room is too cool and telling the radiator (thyroid) to put out more heat. You might not have even noticed yet that the room is cool (T4) but your pituitary (that puts out TSH) has.
Jorf
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Thanks, Jorf.
Well, I took my synthroid this morning. Call me crazy, but I have noticed that I'm not as nervous. I'm wondering if I should call my pcp and discuss this with him.
Okay, I told you what I think I might do. WHAT SHOUD I DO? I feel like such a big baby!
Shirley
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Yes, Joan, I don't trust too many drs... and I had trouble with endos before...
But I think that Shirley is being OVER medicated, and needs a dose REDUCTION... some of our GPs don't really know much about thyroid problems, so that may be what will send me to an endo...
Just another dr., yes, that is true, Shirley...
Let me know if you remember the drs. name....
Harley
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...... Or, you can be like me who GAINS weight with an overactive thyroid! I gained 50, count'em, 50 pounds with an overactive (hyper) thyroid while in college.
Seems only about 5% of people gain weight, lucky me.........
:-)
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MAMHOP, after messing around with my Synthroid on and off for six months, but going back on it every day for about 5 - 6 weeks before my blood test it came back normal. So, for now I'm on the .125 everyday.
cayennblue, the Synthroid does not help with my weight.
Of course eating doesn't either. Shirley
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I'm in a learning curve for thyroid issues and what I'm seeing contradictions in this thread to what I think I've learned this week. First of all, my TSH last month came back with a 6.4. I've been blaming tamoxifen for my fatigue and feeling like death warmed over. Now I suspect my thyroid.
I've read anecdotal reports that most women feel their best with a TSH around 1. So comments in this thread that Shirley's 1.97 is too low has me confused.
I was reading at the AACE (American Association of Clinical Endocrinologists) site that the range for normal was revised in 2002. Old range was .035 to 5.5. New range is .3 to 3.0. The labs I use, my internist, my oncologist, and my gynecologist are all using the old standard. I know there's a mountain of information for doctors to learn and it's constantly shifting, but I still get frustrated when I come across information that seems to me like the professionals should already know.
Now I'm having trouble even remembering the basics on this. OK, a TSH result with a high number means the thyroid is UNDERactive, right? And that means hyPOthyroid?
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Right, Althea. I'm thinking that a good endo would be the one to see. However, one more GOOD doctor to find and to visit....hate the thought of that!
Shirley
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Althea,
Shirley's labs showed a TSH of .197, not 1.97 The difference is in where the decimal point is placed....Shirley,
So...the .125 dose you are on, is that a new dose or the same one you've been on? I am afraid to go see my pcp on Monday... I will have to tell her that maybe she is right, and the .75 dose is TOO much for me.... why isn't anything ever easy? I guess I'll go back on the .50 dose she wanted me to take, but I saw her partner, and he agreed to give me the .75 ....
I'm not sleeping very well, and some times, when I have these "hot flashes", or "warm flashes", my pcp thinks it could be my thyroid...
Harley
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>>Shirley's labs showed a TSH of .197, not 1.97<<
duh! Well don't I feel smart now! LOL
At this point I feel hopeful that my internist will give me a scrip that gives me some relief from this awful fatigue. I've seen 3 doctors already since last month and that's more than plenty in my book.
And to pile on more questions since my previous post, I started wondering who has the final authority on deciding what the defined normal range is for TSH? I was reading at the AACE site, but there's the AMA and a group for endocrine surgeons, and probably other groups involved with thyroid matters also. Could it be that the AACE revised guidelines but another group above them makes the final call?
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