Some myths debunked, learned a lot @ doc
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| Fri, 08-27-2004 - 11:12pm |
First of all, my second blood test revealed Hashimotos. Normal levels are <2 and my levels were >70, so the Hashimotos was unequivocal.
He said that Hashimotos sometimes resolves itself spontaneously over time, so I'm keeping my fingers crossed that I won't be needing thyroid meds the rest of my life.
He also laid to rest my concerns over eating brocoli and other fruits and vegetables I had learned on the internet that might suppress thyroid function. He said that there is a rare food alergy that some people have that causes consumption of those fruits and vegetables to suppress thyroid. But that's something that is usually discovered at a very very young age, since it's a biological genetic problem. It's also extremely rare. So he said I can eat brocoli and peaches with gusto! Yay!
Also, my HDL and LDL cholesterol levels were excellent, but my triglycerides were through the roof: over 350. He thinks that might be related to the thyroid problem. Anyone have any more details on that?
He also said I can take my thyroid meds and BCP at the same time in the morning. I'm relieved to hear that because that way I won't mess up.
He said that it's nearly impossible for people who are hypothyroid to lose weight. In fact, I lost 2 lbs during the 4 weeks I was on thyroid meds...and if anything, I've been eating more! I'm so psyched!
The most interesting thing I learned, however, was regarding Synthroid versus generic "equivilants". He said that generic meds don't have to be exactly the same as the brand name: they just have to meet a tolerance range of 80%-120%. That's fine for certain drugs, but since thyroid medication is measured in such tiny doses, taking a generic can be risky. He's insisting that I go on the brand name.
Anyway, that's all the news from me! I realize that this is just one doctor's opinion so I wouldn't be surprised at all if any of you have been told some things differently. If you have, please let me know! I'd love a virtual second opinion on these.
Thanks so much!
Karen

Eric
Most weight issues should be controlled with diet and exercise.
I know, it's easier said than done!
"Generic Levothyroxine -- Low-Cost Versions of Synthroid and Levoxyl -- Approved
June 24, 2004 -- On June 23, the U.S. Food and Drug Administration (FDA) denied a Citizen Petition that Abbott -- maker of Synthroid -- had filed in August 2003 regarding bioequivalence of levothyroxine sodium products. The company was arguing that the methods for designating bioequivalence were subject to error, and could potentially mean that products of varying potencies would be deemed bioequivalent. The FDA, however, turned down this request, which has opened the door for generic levothyroxine products.
Many manufacturers were waiting in the wings, as 3 separate companies announced on June 24, 2004 that they had received FDA approval for their generic levothyroxine products, including:
Mylan Laboratories -- which received approval for levothyroxine sodium tablets in a variety of popular strengths, generic versions of Synthroid.
Sandoz Inc. -- AB-rated (bioequivalent) levothyroxine to both Synthroid and Levoxyl.
Lannett Company -- approval of the levothyroxine made by Jerome Stevens Pharmaceutical, Inc. (JSP), Lannett's exclusive supplier, bioequivalent to Levoxyl. Note: The product made by Jerome Stevens and distributed by Lannett, which is also sold under the brand name "Unithroid," was the first levothyroxine approved by the FDA.
As can be expected, the two top brand name levothyroxine manufacturers, Abbott and King, are scrambling to defend their products Synthroid and Levoxyl against this new onslaught of lower-priced competition.
With all three companies starting to ship their generic levothyroxine drugs immediately, both Abbott and King saw drops in stock prices on anticipation of lost market share.
What Can You Expect?
First, the Abbott army of PR and drug reps is already out in force, inundating journalists with press materials, and contacting pharmacies and doctors to continue attempting to position Synthroid, the second-most-prescribed drug in the United States, and the source of $818 million in sales in 2003, as the "better" levothyroxine. Even though there is no research to establish this, and the FDA has declared these bioequivalent drugs, expect the sales pitch to press, docs and pharmacies to tout Synthroid and disaparage the generics. This message will in turn will be voiced by your own doctor, who is likely to tell you that "the new generics aren't as good as Synthroid."
Second -- question any claims that one brand is better than another, or that brands are better than generics. Until peer-reviewed, double-blind research is published that compares the effectiveness and/or superiority of particular brands vs. the generics, there is no evidence that one brand of levothyroxine is better than another, or that the new generics won't perform equally as well as the brand name levothyroxine drugs.
Third, expect your insurance companies and HMO's to attempt to shift you over to a lower-cost generic levothyroxine. There are so many people on these drugs that even a few dollars a month savings, when multipled by many thousands of patients, would be a significant cost savings that these groups will likely attempt to recoup.
What Does It Mean for You?
The question is whether or not this is good or bad news for consumers who take levothyroxine drugs. Only you and your doctor can know for sure, but here are some considerations.
First, if you are on Synthroid or Levoxyl, and you get a generic, you may find that you absorb or process it somewhat differently. If you are stabilized on a brand name levothyroxine, but want to try a lower-cost generic, or don't have a choice and must switch to a generic at the direction of your insurance or HMO, be sure to discuss it with your doctor. If you do switch, monitor your symptoms carefully (Note: the "Hypothyroidism Symptoms Checklist in my book Living Well With Hypothyroidism is a good way to monitor symptom changes and severity.) Plan to have your thyroid levels rechecked about six weeks after the switch, to ensure that you are not having fluctuations in key thyroid blood levels.
Second, the key challenge with generics, and a valid complaint by doctors, is that when you have a prescription for generic levothyroxine, every time you get a refill, you may get a levothyroxine made by a different company. This means that every time you get a refill, you may have a product that has slightly different potency, which could have an impact on your TSH levels. This is particularly a concern for thyroid cancer survivors, who require careful dosing in order to suppress TSH as a way to prevent cancer recurrence. One way to minimize this fluctuation is to get a supply that will last for some time. Consider getting your doctor to write you a prescription for a six-month supply, for example. But when you get this prescription filled, make sure you get a fresh batch, one that will not expire unti long after you will have used up the six-months' worth of drugs.
Third, if you and your doctor determine that you should not try a generic, or if you have tried a generic and determined that you prefer a brand name, be sure to have your physician write your prescription along with the special designation "DAW" or "dispense as written" along with "no generic substitution." This way you have a better chance of having your insurance company or HMO fill the brand name prescription as written, without attempting to substitute the lower-cost generic."
Me again: I think the second to last paragraph is most inportant since it shows that each time you get a refill, you may not get the same strength and/or quality in the dose. But you won'e be taking them anyway so it won't affect you.
On the broccoli and other foods to avoid - these are called goiterogens. These are not foods that have anything to do with an allergy. They contain anti-thyroid compounds that suppress thyroid function. It isn't a rare condition or anything. It can happen to anyone. But the key here is that the foods shouldn't be eaten raw. If they are cooked, it kills the compound and renders the food safe. I want to check out the allergy connection because that isn't anything I've ever seen before!!
It is NOT impossible to lose weight when you are hypothyroid. Or did he mean if you are unmedicated? Because then it can be very difficult if not impossible. But once you are on the right dose of medication, it's not any more difficult to lose weight than the average person. It doesn't do anyone any good when doctors are so defeatist about this. I've lost alot of weight over the past 2 years and often during that time, I needed my medication increased and wasn't able to get it. And I still lost weight. Congrats on those 2 pounds lost. I won't rant anymore on this topic but I could go on and on!! LOL!
Hypothyroidism can cause high cholesterol. That's why it's so critical to get it into the normal range andkeep it there. Not only because it helps us feel better and lose weight easier etc but because of the serious health risks associated with a higher TSH level. That should come down for you once you're on the meds for awhile longer.
I would NOPT take your thyroid medication with your BCP. Anything I've ever read says to take it alone, on an empty stomach and not to take any other medications or supplements for at least an hour - 4 hours for iron and calcium. If you start to hinder the absorption of one of the other, neither is going to be as effective as it is supposed to be. Just my opinion based on everything I've read.
Hashimoto's is an autoimmune condition. It's a genetic condition that is very complex in terms of it being autoimmune and connected with all other autoimmune conditions. It's unlikely that it would resolve itself on its own. It is often triggered by a stressful condition or event. I'll check that out further. I know that hypothyroidism can go away on it's own, if it is not caused by hashi's. Or if it is pregnancy related. But the other - that would be great news!!! I'll let you know what I find.
I hope you don't think it is obnoxious for me to be contradicting your doctor!! I just have your best health in mind and don't want to see you do anything that will cause you to take a step backward in feeling 100 percent. This is hard enough as it is but it is even harder when there is so much misinformation out there. I hope you don't mind!! Cathy :)