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Questions for Dr. Kennedy
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Hypothyroidism
Posted by: Julie
Date: July 30, 2000 2:58 PM

I have been treated with thyroxine for 4 years now, during that time my daily dose has increased from 150 mcg to 325 mcg. I am still gaining weight, 14 pounds since April, my ankles regularly swell and leave an imprint if pressed and I have pains in my heels, wrists and occasionally my hips. I sometimes wake up with numb fingers and have to take my ring off. I have mornings/days when I feel mentally and physically exhausted. I am 42. Is this an unusually high dose? Am I suffering from side effects of thyroxine (are there any?).

RE: Hypothyroidism
Posted by: Ron Kennedy, MD
Date: July 30, 2000 4:12 PM

What you have described is called pitting edema. It occurs when there is retention of water which in turn happens when metabolism slows down. Slowed metabolism can have a variety of causes including toxicity and hormone deficiency, including and especially deficiency of thyroid hormone. T4 must be converted to T3 (the active form) and this is often difficult for people over 40. I prefer to use time release T3 (a compounded item - i.e. made by a "compounding pharmacy") in my older patients. Certainly one can have effects from being overdosed on thyroid. Both hypothyroidism and hyperthyroidism can cause fatigue. Lab tests are important in managing thyroid replacement. The best tests to regulate the dose of thyroid are the "free T3" and the "TSH."



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