In my 38 years' experience of having a thyroid destroyed by Hashimoto's
disease, I've been hyper on thyroid replacement (both Armour and Levoxyl)
and I've been hypo on thyroid replacement medication.  The problem is one
has to have an alarming constellation of symptoms to get one's thyroid
actually tested outside the testing schedule of 1/year or 1/2years.  My
weight was usually what changed to effect my thyroid status.  In this case
on external hormones, a weight loss in my case caused the existing thyroid
dose to be to high and precipitated thyrotoxicity.  Weight gain needs
slightly more thyroid medication, which by the way is a narrow therapeutic
window drug.  A small amount too much brings on toxicity and a small amount
too little brings about hypothyroidism.  It's a slippery slope with this
drug.

It's totally baffling why the health management organizations do not test
more frequently in thyroid patients when clinical symptoms appear, even
though they are soft signs.  But it's "turn the crank" medicine at it's
worst.  (A rapid pulse rate can come from a number of sources.  Sweating can
come from several sources, etc.  Same with muscle weakness, panting, atrial
fibrillation, etc.  Probably the softest of signs are intermittant
palpitatations, which can even be considered to be normal, but annoying).
Think of how many times the conjecture diagnosis you receive has made money
for the health management organization at your expense.  To solve this
problem, between the thyroid checks I alter the amount of medication up or
down never beyond 10% and usually 5%.  If you are on beta blockers for any
reason (there are many different brands), for say, performance anxiety,
hypertension, to slow down one's atrial fibrillation, etc. etc., many of the
thyrotoxicity symptoms will be masked.  In this case a thyroid patient on
replacement therapy + beta blockers should have more frequent checks (than
1/yr or 1/2yr) of thyroid function, so that one will not permanently lose
bone density.  (The health management organizations seem only to focus on
one thing at a time without regard for other medications or other
conditions.)




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