Tuesday, March 27, 2012

My Thyroid

(Sorry in advance, the end of this post got a little science-y)

Last week, I went back to the endocrinologist to see about my thyroid. I had gotten my blood drawn the day before and went and picked up the results myself so that I wouldn't be shocked at the appointment time with bad results.

My thyroid was at 2.74. This is good, this is very good!

Ideally for TTC it should be down about 2.5, but at the appointment he told me that he was hesitant to change my dosage as my levels seemed to be steadily decreasing on essentially the same dosage and that he feels I will plateau around 2.5 anyway.

It had been 4 months since I last saw him and I followed his directions to the "T".

1. Get my thyroid rechecked every 2 months
2. Change to brand name medication for better absorption and more consistent dosage (upon my request mind you)
3. No more fertility treatments until my thyroid is under control for 6 months (RE appt is right about 6 months and what are the odds of it happening naturally at this point?)
4. If I should happen to get pregnant take 2 extra pills per week and call him (this wasn't necessary, obviously)
5. Take my thyroid pill last thing at night, several hours after dinner if possible
6. Spread my thyroid pill and all vitamins out as far as possible, so take vitamins mid morning

And because of all of this direction-following, the stars seem to be aligning! I am free to see an RE and my scheduled appointment falls at just the right time.

Extended Side note:

Did you know that the generic brand of a medication is not regulated as strictly in it's dosage as is the brand name? I didn't know why I should to take the brand name, but it had been recommended to me by many medical providers that I consider it given my fluctuating levels. See the example below as to why you should sometimes consider the brand name rather than the generic. I'm glad I made the change even without all of the information my endocrinologist gave me after the fact.

Example:

My Synthro.id dosage is labeled 88 mcg, Synt.hroid (brand name) is very likely to be that exact dosage or extremely close to that labeled dosage or at least consistent dosage over time as it's always made my the same manufacturer in the same place. Whereas Levothy.roixine (generic) might be labeled 88 mcg but actually be as low as 75 mcg or as high as 95 mcg. All of these levels must be within a certain level of error (my example my not be totally accurate in the range), but all are allowable as long as they are within the limits (Shit...I just looked this up and it looks like the confidence interval is 85-125%, that's a huge interval!!!!). So I might be prescribed 88 mcg, but actually receiving 75 mcg (and not know it). Because it is all about the blood levels rather than the dosage of medication, none of this matters if your pharmacy continues to get the medication from the same manufacturing facility and gets all of it's different dosages from that same manufacturing facility. If they all come from the same facility, the error will be about the same for each different dosage and you will continue to receive the same dosage and a predictable increase if your dosage should change. However, if you were on 75 mcg and upped to 88 mcg and they came from different manufacturing facilities you may actually be going from say 65 mcg to 95 mcg and not know it...gah!

Essentially this is a good reason to go with a brand name of a medication if your levels are varying and creating a mind-fuck situation.

I believe this to be true for nearly all medications. It really compounds the idea of variability in medical treatment, doesn't it?

6 comments:

  1. Wonderful news :)) Great that you're on track to see your RE again... FXd for you xoxo

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  2. This is great news Michele! And thanks for sharing the info about brand names, I didn't know that!

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  3. Yeah on your levels! Awesome news!

    My sister takes many medications for a variety of reasons, and she has often had problems with generic drugs. The bases and trace ingredients that the medication is in, even the form it takes (liquid vrs pill form) can make a huge difference in the effectiveness of a medication.

    I wish you the best of luck moving forward. :)

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  4. Wow, that's great info about the generic meds. Kind of scary!

    Glad you're heading back to normal-ville! :)

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  5. That is awesome news!
    I used to work for an endo and he never prescribed generic. If a patient asked for it he would advise them not to and would only give it to them if they obsessed over it. Then he just knew he had to keep an extra eye on them.

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  6. Wow, That's great info. I'm on the generic dosage, now I'm definately going to switch!

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