Often found to simultaneously exist, hypothyroidism and fibromyalgia share many symptoms. Extreme fatigue, depression, muscle pain, cold body temperature and foggy thinking are the primary symptoms shared between these two conditions.
While experts have not yet agreed on the cause of fibromyalgia, some believe that like many cases of hypothyroidism, it is an autoimmune disorder. An underactive metabolism is a commonly suggested link between fibromyalgia and hypothyroidism.
Many people with fibromyalgia take thyroid medication for metabolism regulation. The difference between feeling good and not feeling good can be found in the following thyroid medication variables:
Taking the right prescription
Maximizing your medication’s effectiveness
Taking the Right Prescription
The testing involved in thyroid evaluation and their subsequent prescriptions can vary greatly, depending on your doctor. The thyroid hormones identified by the medical community for most cases of thyroid dysfunction are thyroid stimulating hormone (TSH), T3 and T4. The relationship between these substances is complex and continually being looked at and challenged. The “gold standard” of assessing thyroid function is measuring TSH. If this test is returned with a normal lab value, many physicians will cross hypothyroidism off the list of possible diagnoses.
If a TSH level is normal, yet all of the classic signs of hypothyroidism are established (hair falling out, headaches, weight gain, brittle nails, fatigue, cold body temperature, etc.), some informed doctors will probe further. According to respected integrative medicine specialist, Eric Gordon, MD, the most accurate way to comprehensively assess thyroid health is to test TSH, free T3 and free T4 levels. It is typical for doctors to bypass the testing of free (not currently bound) T3 levels because the body converts it to T4. However, Gordon advises that without including the free T3 evaluation, there is no way to know if the body is doing this conversion properly. According to Gordon, “If you are exhibiting signs of low thyroid, your free T3 will be low despite your TSH being ‘normal.’ The TSH only shows what is going on in your hypothalamus, not in your liver or elsewhere in your body.”
In times of stress, our bodies naturally manufacture reverse T3. In a healthy, properly-functioning body, once the stressor ends, the body stops making the reverse T3 and normal T4 conversion to T3 continues. However, some experts have observed individuals that continue to make reverse T3, initiating the symptoms of hypothyroidism.
With the possible variability involved in hypothyroidism, receiving the correct prescription is crucial to the person’s recovery. Most people convert T3 into T4 effortlessly. These people may simply need to supplement with T4 (Synthroid). However, certain individuals may need both T4 with T3 or only T3 to achieve the ideal balance of thyroid hormone. Finding the right medication at the best dosage often requires repeat doctor visits and blood tests to refine your prescription. Working with your doctor to explore all of these options will help assure that you are taking the right medication at the best possible dosage.
Maximizing Your Medication’s Effectiveness
A majority of us take daily supplements in conjunction with prescribed medications to sustain our health. A typical morning for people with fibromyalgia consists not just of breakfast, but also of vitamins, minerals, herbs and any prescribed medications. Remembering what to take and when to take it can overwhelm anybody taking a variety of pills, especially if that person struggles with fibro fog. A majority of us take daily supplements in conjunction with prescribed medications to sustain our health. A typical morning for people with fibromyalgia consists not just of breakfast, but also of vitamins, minerals, herbs and any prescribed medications. Remembering what to take and when to take it can overwhelm anybody taking a variety of pills, especially if that person struggles with fibro fog.
The highly respected patient advocate and writer Mary Shomon, shares the following suggestions for taking thyroid medication:
1. Always check the prescription against what you receive. Don’t allow generic substitutions, as their ingredients may slightly vary.
2. Most doctors advise taking thyroid hormones on an empty stomach to allow for maximum absorption.
3. Many practitioners advise taking thyroid hormones at least one hour before eating, to allow for maximum absorption.
4. Be consistent about a high-fiber diet. If you start or stop eating foods high in fiber, get your thyroid rechecked, as it may change your absorption.
5. Many experts recommend taking vitamins or supplements with iron at least two to three hours apart from thyroid hormones. Iron can interfere with thyroid hormone absorption if taken too close together.
6. Be careful about taking anything with calcium, including calcium-fortified orange juice, at the same time as thyroid hormones. Allow at least two to three hours apart, so absorption is not affected.
7. Don’t take antacids within two hours of thyroid hormones. Allow at least two to three hours apart, so absorption is not affected.
8. Always check with your physician or pharmacist regarding any potential interactions of prescription drugs, herbs and supplements with your thyroid drugs. Some of the better known drug interactions with thyroid medication include antidepressants, insulin, cholesterol-lowering drugs and blood thinners. These interactions could result in making the thyroid medication more or less effective and/or make the other medication more or less effective.
9. Don’t stop taking thyroid hormone during pregnancy or while breastfeeding. It’s necessary for you and your baby’s health. Talk to your doctor about adjusting to the right dosage.
Deanna Couras Goodson from http://www.suite101.com/ adds some more valuable suggestions for taking thyroid medication. During a hypothyroidism or fibromyalgia flare-up, struggling with memory is a very real and present issue. Because it is important to be consistent with your thyroid medication dosing, Goodson advises to:
1. Write down a reminder for yourself to take the thyroid medication on a calendar, to-do list or other location you visit frequently.
2. Take advantage of modern technology for reminding you to take the thyroid medication. Examples include creating a screen saver or scheduling pop-up reminders on your computer or Personal Digital Assistant (PDA).
3. Take your medication the same time each day and keep it in a place that will remind you to take it. An example of this is storing the medication next to your tooth brush, so it is automatically included in your morning routine.
Since finding the right balance of thyroid medication is so critical to recovering from hypothyroidism, anything affecting that balance must be stabilized. Making sure you are taking the right medication at the appropriate dosage can significantly improve one’s quality of life. For the many individuals with both fibromyalgia and hypothyroidism, properly medicating with thyroid medication can make living with both of these conditions enjoyable by warming the body and increasing energy levels, while reducing muscular pain and fibro fog.
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