Understanding Your Thyroid (Continued)

Treating Your Thyroid

Regardless of the exact cause of your lazy thyroid, the treatment is the same. The bottom line is that if you don't have enough T-4 in your system for your body to run the way it's designed to run, the solution is to supplement it. Thus my grey pill: Levothyroxine Sodium, which is nothing more than man-made T-4.

That's the generic name of course; it also comes under the brand names Synthroid, Levoxyl, Levothroid, Unithroid, and Terosint. There's also an alternative to the synthetic hormone called "desiccated thyroid" sold under the names Armour Thyroid, Nature-Throid, and Westhroid. These are made up of chopped up and ground up pig and cow thyroid glands, much like first-gen insulins were made. Your doc will choose the best solution for your particular flavor of thyroid trouble.

Once you start on a thyroid med you might start feeling better in as little as three to five days, (what we call "seeing clinical benefit"), but it will take fully 4-6 weeks to stabilize your out-of-whack system. That assumes your doc's first-guess dose is right. Sometimes getting the thyroid medication dose nailed down is a bit of a tightrope act. Once stabilized (unless a return of symptoms is seen), the status of the hormone levels is normally checked annually to ensure that everything stays in balance.

When I reviewed the prescribing data for thyroid meds I noticed that the info sheets say that you might lose some hair in the first few months you take them, but this will pass and seems to be the only significant side effect. So don't pull your hair out about it.

Oh, wait. There is one other biggie. If you are already on a blood thinner, like Warfarin, the thyroid meds can super-size it. Your medical team will get it all balanced out, because both are critical to your health, but I thought it worth mentioning.

Like diabetes, hypothyroidism is life-long and you'll be taking your little grey (or yellow, or green, or pink—each dose is a different color) pill for the rest of your life. So you might as well take it right.

Artificial thyroid hormone turns out to be a delicate little flower. A sensitive soul that doesn't play well with others. The official advice is to take the pill on an empty stomach in the morning with no other meds. Off the record, I've had a number of endocrinologists tell me that really, it's consistency that matters more. So long as you do it the same every day, even if you do it "wrong," the dose can be adjusted to do the job.

So my advice is to be consistent.

If You Opt for Generics

Oh, and speaking of consistent, there's also the problem of generics when it comes to thyroid meds. There's nothing wrong with generic thyroid meds. I take a generic, but I always take the same brand. Remember that I told you that thyroid hormone is delicate little flower? Yeah, I wasn't quite kidding. It's a hard hormone to produce accurately. So 125 micrograms of Brand A probably won't have the same punch as 125 micrograms of Band B. Does this matter? Yes. Your body needs a steady "infusion" of T-4 daily to function properly. If your pills vary every month, you'll never get your thyroid tamed. Our problem comes from the fact some pharmacies change brands each month depending on what company is offering the best price. Talk to your pharmacist to make sure that you can always get the same brand. If you always take the same brand, and always take it the same way each day, your doc can adjust the dosage and all you'll have to worry about is your blood sugar control.

Oh. Right. Speaking of blood sugar control…

Yes, as you probably suspected, there's a connection between how well your thyroid is working and how hard it is to keep your blood sugar in check. If your body's T-4 is low, your insulin resistance will be high. That means if your medical team diagnoses you with hypothyroidism and starts a thyroid med, you need to be on the lookout for low blood sugars, because as the thyroid issue is fixed, your insulin resistance will drop and you'll need less diabetes medication.

So what is the diabetes thyroid connection? Can thyroid problems cause diabetes? Can diabetes cause thyroid problems? Did the chicken or the egg come first? They are both diseases of the endocrine system, right?

Frankly nobody knows for sure, but it seems unlikely that either one causes the other. They are just things that co-exist, like ice cream and apple pie. Sorry. I wish I had a better answer for you on those questions, but it's one of life's many mysteries.

Meanwhile, back in my bathroom, as the sun brightens the sky, all I can do is be pissed-off staring at my day-off pill box, with yesterday's little grey pill laughing at me. It's too late to take it now. Doubling up is as bad as skipping it.

I'll never really understand the connection between my stupid thyroid and my frickin' diabetes, but I do know one thing for sure: I feel better when I take my damn thyroid pill.

Wil Dubois is the author of four multi-award-winning books about diabetes. He is a PWD type 1, and is the diabetes coordinator for a rural non-profit clinic. Visit his blog, LifeAfterDX.

Read Wil's bio here.

Read more of Wil Dubois' columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

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Last Modified Date: July 01, 2014

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