In a message dated 8/4/2009 10:54:02 P.M. Eastern Daylight Time,  
[log in to unmask] writes:

Hi:

I've been on 37.5 of Synthroid for a year now.  My  TSH doubled recently 
and 
my endo put me on 50 of Synthroid.  I had a  cardiology appt two weeks 
later 
and my heart rate was between 119 and 130  range.  The cardiologist was 
alarmed and immediately sent me for a  stress test and further cardiac 
testing.   >>>>>>>>>
IMHO (In my humble opinion), something else is  wrong.  In a situation like 
this, I would suspect Adrenal Insufficiency or  another metabolic  problem.
 
About 200 mcg is an average full replacement dose for an adult. If you use  
anything less than this when you don't need it, a normally functioning 
thyroid  will decrease its output to allow the total amount of hormone to be 
correct. If  you are getting overdose symptoms on such a small change in dose, 
your doctor  needs to do better. 
 
TSH, used in isolation, is worse than useless in  assessing the adequacy of 
thyroid replacement.
 
It is  very important to remember that 85% of any diagnosis, from pregnancy 
  
to gunshot wound, is purely History (What's been happening to the patient  
before  they came to the office?); The Examination (How do they appear  to 
the, 
hopefully,  well trained eye?) is worth about 10% and Labs are  only good 
for about 
5%.

Most docs use the clinical lab, instead of  clinical acumen, to tell 
whether  
their patient has a thyroid problem.  This guarantees that a lot of thyroid 
problems  are missed  and the host of resulting problems helps make ours 
the most  
expensive,  but not best, medical system in the world. 
 
Likewise, it seems that no one is bothering to look at the rest of  the 
clinical picture to really give you the help you.
 
A prayer that you get what you need to get well.
 
Doc Don
 
(AKA D. Michael, MD, PC)
 
 





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