A Thai Doctor Saved My Life

[SoiGirlHunter]

Well a couple years back I started getting bad asthma-like symptoms. I went to a bunch of good US doctors and they could not

control it. I started getting more severe symptoms and seeked out different doctors and was given battery after battery of

tests and they basically gave up. (I told the doctors all the symtoms that matched hypothyroidism, one doctor even pointed

out my thyroid levels were "off" but then completely either forgot or brushed it off and never mentioned it again) Also my

temperature was low and the doctors would mention it but never link it to anything. One time they took it 10 times thinking

the thermometer was broken. Idiots.

Then i moved to Thailand and when my asthma inhaler ran out I went to the local low cost clinic and asked the Thai doctor there which inhaler

I should use in Thailand. He started questioning my symptoms and said he wanted to give me 2 tests, one for diabetes and one for thyroid.

Well the tests came back and no diabetes but the TSH level of my thyroid was high at 11.5 - normal range is 1-5. He told me to take 200mcg

of thyroxin every morning. I went on the net and read as much literature as i could find and got the thyroxin and started taking about

5 days ago. BTW I paid cash all this cost me less than the co-pay of 1 office visit in the USA.

So basically if i carried on like this just thinking it was just asthma it would have killed me eventually and i dont think i was that far away.

------------------------------------------------------------------------------------------------------------------------------

Anyways I was wondering if there is anyone out there being treated for this here in Thailand?

I just had a few questions, some of the answers are out there in the literature, i am just looking for personal experiences.

-I started the thyroxin and i getting major fatigue! I mean wiped out. Is this normal? I read fatigue could be one of the side effects.

I started taking the thyroxin before sleep to help this. The good news is other symptoms have improved a little in just these 5 days.

-How long til the thyroxin kicks in and i feel better? I still feel terrible.

-Is there something better than Thyroxin?

-Should I also take Armour? If so where could i find in Pattaya or BKK?

-Is there any groups out there that meet about this?

I'd love to talk to anyone out there with experience in this, at least for my own sanity, please PM me if you could.

well take care

thanks

SGH

[Jingthing]

I have hypothyroidism. In fact I don't really have any thyroid anymore.

I take Euthyrox to replace the hormone (about the same dose as you). There are different brand names, they are all replacements for the hormone which you take for life. You need occasional blood tests to maintain the proper dose. Have you tested your blood to make sure you are now at the proper level? If the hormone replacement therapy isn't working for you (either can't get the proper levels or you are not feeling better) you had best see a specialist, an endocrinologist:

http://www.endocrineweb.com/hypo1.html

Edited April 1, 2009 by Jingthing

[SoiGirlHunter]

OK thanks for that Jingthing

Well i have been taking the thyroxin for 5 days and the Dr said come back in 30 days to get tested again as it takes that long to adjust

Do u remember how many days it took before u felt better?

thanks again

SGH

[Jingthing]

You were lucky to find a doctor that found it. It is quite common and very under-diagnosed. For some reason, it is more common in women. I found out when I visited a salty old Kaiser HMO doctor in the US. He took one look at me and said I am testing your thyroid. This was long ago and I don't remember how long it took to feel better, sorry. But keep on it and good luck. BTW, I also have asthma but I didn't realize there was any connection between to two conditions (except both allergy/immunity issues). Thyroid hormone does not cure asthma, if you are asthmatic you still need to treat the asthma.

Edited April 1, 2009 by Jingthing

[SoiGirlHunter]

Well 2 of the symptoms of hypothyroidism is shortness of breath and panic attack, combine both and it looks like an asthma attack.

Basically your body cools and organs start having problems functioning, even your brain - from what i read.

Jing when you started on the medication did u feel very fatigued?

I notice one thing, if i can somehow do a hard 1 hour of excercise i better, maybe it brings my temp up, i need to get a thermometer.

thanks again

appreciate

[eek]

Hi sgh.

I have Hashimoto Thyroiditis. I went through a nightmare getting my diagnosis and my IeveIs normaI again. (Had major side-effects from swinging from Hypo to Hyper.) I made a coupIe of threads on this some time back that may be of interest/heIpfuI:

First: http://www.thaivisa.com/forum/Subacute-Thy...is-t124529.html

second: http://www.thaivisa.com/forum/Hypothyroidi...;hl=hypothyroid

Third: http://www.thaivisa.com/forum/Hashimoto-s-...is-t211661.html

At present my Thyroid IeveIs are better and my goiter has nearIy aII gone. Im on 75ug/mcg of Euthyrox. But, after nearIy two years, im stiII Iearning about how my body is affected. I think it takes time if its a Iong term probIem to reguIate and understand the changes in your body. I am more aware now if my IeveIs are not normaI due to how my body responds. I know what to recognise. If its a permanent thyroid probIem you have, then give yourseIf time to Iearn about what is happening to your body. Make sure you get your IeveIs tested reguIarIy. Once you are more stabIe, you shouId onIy need a test every six months or when you feeI something is wrong.

Im no expert on this though...stiII Iearning myseIf.

-I started the thyroxin and i getting major fatigue! I mean wiped out. Is this normal? I read fatigue could be one of the side effects.

I started taking the thyroxin before sleep to help this. The good news is other symptoms have improved a little in just these 5 days. - Your body wiII take time to adjust. At one point, i recaII sIeeping way too much. But..get a good diagnosis and check. SIow steady improvement is best. 20mcg sounds Iike a heII of a Iot to take for a first dose..(SheryI, or anyone eIse who has better knowIedge..what do you think?) If you take too much hormone it can make you hyper.

-How long til the thyroxin kicks in and i feel better? I still feel terrible. - Sorry, I have no idea..but weeks/months reaIIy. Depends on your own body..but wiII most IikeIy take a bit time to reguIate and find the right dosage.

-Is there something better than Thyroxin? - I did take Thyroxin before. Im on Euthyrox now. I cannot recommend which is better for you. I advice seeking a good doc/getting a second opinion.

-Should I also take Armour? If so where could i find in Pattaya or BKK? - Whats Armour?

-Is there any groups out there that meet about this?

I'd love to talk to anyone out there with experience in this, at least for my own sanity, please PM me if you could.

well take care

thanks

SGH

FeeI free to ask anything, if it can heIp.

Most of aII, dont worry. Get a good doc, get good testing, then give yourseIf time to get weII. This is not quick fix (at Ieast in my experience and what ive read up on), but, with the correct dosage, you wiII feeI much much better.

[Jingthing]

Jing when you started on the medication did u feel very fatigued?

I didn't. But my symptoms were different than yours from my point of view, weight gain, hair loss, rough skin. As far as the dose, the doc gave you a dose based on your blood levels. There is no reason to ease you into it if the numbers indicated you needed a lot of hormone, the correct therapy is to give you a lot of hormone, in my non-medical opinion. However if you think you are experiencing bad symptoms from the meds, you need to go in sooner. In my case, the dose I got many years ago is the same dose I take now (also high) and tests have always showed good levels since I started taking it.

[Sheryl]

1. Euthyrox and thyroxine are one and the same, euthyrox is just one of many brand names for it.

2. The thyroid gland produces 2 natural hormones: T3 and T4. Hypothyroidism must, obviously, be treated with hormone replacement. It is most commonly treated with levothyroxine (thyroxine for short, many different brand names). which is a synthetic form of L-thyroxine (T4). The rationale for treating with this alone is that T3 is very short-acting, while T4 is longer acting and the body naturally converts it to T3 as needed, hence T4 alone is usually given to correct low levels of both T3 and T4. However sometimes both a form of T3 and T4 are given together. T3 is never given alone, too short acting.

A third option (vs synthetic T4 alone or synthetic T4 + synthetic T3) is the use of dessicated thyroid extract, which will contain both T3 and T4. This is what Armour is; there are other preparations as well. In Thailand the available brand is "Thyroid-S".

Synthetic T4 (thyroxine) thus far remains the mainstream treatment preference based on previous studies which showed it to have fewer side effects than desiccated thyroid, provide a more reliable dosage (the T3 and T4 content of desiccated thyroid preparations was found to be quite variable, although this was some years back and thus did not include the newer preparations) and because desiccated thyroid was found to produce wider flunctuations in hormone levels throughout the day while thyroxine gave a steadier state.

However some newer desiccated thyroid products are anecdotally reported by some patients as providing better results than treatment with synthetic thyroxine and there are groups actively promoting its use, some but by no means all of them affiliated with the companies which produce Armour. This has set in motion a controversy which, from a scientific point of view, has not yt been settled. In short, there is no definitive answer to whether or not you would be better off taking the synthetic preparation your doctor has prescribed or Thyroid-S (Armour equivalent). However it does, for certain, have to be one or the other; do not take both!

Regardless of whether treated with a synthetic form of thyroid hormone or desiccated thyroid extract, tretament should always begin at a low dosage (which is what you were given) followed by repeat blood test after 4-6 weeks and that process may need to be repeated several times until optimal blood levels are obtained. Expect it to take at least 4 weeks to see the full effects of the medication (and any dosage change).

Indications that you are getting too much thyroid hormone replacement would be a feeling similiar to an overdose of caffeine: jitteriness, insomnia. palpitations, trembling hands etc. If that happens return to the doctor at once as overdosage can cause heart problems.

3. Many patients with hypothyroidism are also anemic which will add to the fatigue. If it was not already done you should have a complete blood count to rule this out.

4. Your doctor as described is providing treatment in accordance with interntationalkly accepted standards. If however at any point you want a more expert opinion, the following doctor is AFAIK the top specialist in Thailand for thyroid problems (at least among those with private practice), she is at Bumrungrad:

Dr. Rosanee Valyasevi

Speciality: Medicine, Endocrinology (Diabetes)

Language: Spoken: English,Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine, Siriraj Hospital, Mahidol University (First Degree Honor),Thailand, 1988

Board Certifications:

- Diplomate of The American Board of Internal Medicine, 2003

- Diplomate of The American Board of Endocrinology, Diabetes and Metabolism,2004

- Diplomate of The Thai Board of Internal Medicine, 1992

Fellowships:

- Endocrinology, Howard University Hospital, USA, 1995

- Endocrinology, Mayo Clinic, USA, 2000

Special Clinical Interests:

- Thyroid Diseases, Parathyroid and Calcium disorders

Day Time Location

Tue 09:00 - 15:00 NS 16A (Endocrine/Neuro)

Wed 09:00 - 15:00 NS 16A (Endocrine/Neuro)

Thu 09:00 - 15:00 NS 16A (Endocrine/Neuro)

Fri 09:00 - 15:00 NS 16A (Endocrine/Neuro)

Sun 09:00 - 15:00 NS 16A (Endocrine/Neuro)

[qualtrough]

I had a similar thing happen to me. Had a complaint that no doctors in the US could pin down. Final doctor allegedly diagnosed it and told me I would just have to live with it. Went to Thailand on holiday, visited a good walk-in clinic, diagnosed and cured in a matter of days for about $10, including visit and medicine. I stiffed the doctor back in the US when he sent me his $700 bill, with a nice letter explaining why I was not paying him. I find my dealings with the system here vastly preferable to the ones back home (USA), especially the bedside manner and other little things that can make a big difference. Try just walking in to visit a specialist in the USA without making an appt first, possibly weeks or even months in advance. Or getting while-you-wait test results. Or letting the family camp out in a hospital room when someone is sick, or....

[Jingthing]

Regardless of whether treated with a synthetic form of thyroid hormone or desiccated thyroid extract, tretament should always begin at a low dosage (which is what you were given) followed by repeat blood test after 4-6 weeks and that process may need to be repeated several times until optimal blood levels are obtained. Expect it to take at least 4 weeks to see the full effects of the medication (and any dosage change).

Thanks for that. It does sound reasonable. However, my memory about my experience (which was long ago and may be wrong) was that my doc started me on the dose which he thought would be close to the actual full dose I would need. It may have been that he did that to save on too many future blood tests as he worked for a cost conscious HMO.

Final doctor allegedly diagnosed it and told me I would just have to live with it.

That is so outrageous. If it was the most common thyroid problem, a problem that can be solved with simple and cheap hormone replacement, this is one of the easiest and cheapest serious chronic medical conditions that exist and you sure don't have to live with it (more like die with it if you don't treat it).

Edited April 2, 2009 by Jingthing

[piiguy]

Regardless of whether treated with a synthetic form of thyroid hormone or desiccated thyroid extract, tretament should always begin at a low dosage (which is what you were given) followed by repeat blood test after 4-6 weeks and that process may need to be repeated several times until optimal blood levels are obtained. Expect it to take at least 4 weeks to see the full effects of the medication (and any dosage change).

Thanks for that. It does sound reasonable. However, my memory about my experience (which was long ago and may be wrong) was that my doc started me on the dose which he thought would be close to the actual full dose I would need. It may have been that he did that to save on too many future blood tests as he worked for a cost conscious HMO.

Final doctor allegedly diagnosed it and told me I would just have to live with it.

That is so outrageous. If it was the most common thyroid problem, a problem that can be solved with simple and cheap hormone replacement, this is one of the easiest and cheapest serious chronic medical conditions that exist and you sure don't have to live with it (more like die with it if you don't treat it).

You can buy an Armour equivalent, ThyroidS at a pharmacy in Soi Thonglor, If you get off the BTS at Thonglor, the pharmacy is on the right, 50 to 100 meters into the soi. You might like to check the function of your adrenal glands too. See this site re thyroid and adrenals - stopthethyroidmadness. I had terrible sinus problems and severe fatigue for several years until I started

taking bovine adrenal gland extract.

[SoiGirlHunter]

I thank you all for the wealth of information provided!

I am glad i posted this here! i appreciate!

[SoiGirlHunter]

Update and more help needed! and hopefully this helps someone else who goes down treacherous road later.... this s#cks!

its one helll of a ride..

OK so about a week ago I got on Thyroxine, I went to my small local pill shop and just blindly asked for thyroxine and voila

she pulls out a bottle named Thyroxine but i didnt see a brand name. I assume they are all Synthroid-S (T4 only).

So I started taking it and I felt better, my panic attacks subsided, the numbness in in my feet went away etc etc, didnt feel

perfect but better. But then I started getting bad nausea, diahea, some abdominal pain and ALOT more fatigue than what i was experiencing

with just the hypothyroidism. So i searched "Thyroxin nausea" and behold it is a side effect. This nauseated feeling is worse

than the normal Hypothyroid symtoms, if it was minor i would just deal with it.

So my question is - from what I read on the net its not clear whether a different brand of any Sythoid-S product will not cause this

nausea etc. I did read about purified forms that were supposedly better but what brand name is a purified form?

Or maybe I should just try the Thyroid-S (Armour equivalent) ??? Any idea where i can buy this in Pattaya?

Any thoughts?

Thanks again

SGH

[piiguy]

Update and more help needed! and hopefully this helps someone else who goes down treacherous road later.... this s#cks!

its one helll of a ride..

OK so about a week ago I got on Thyroxine, I went to my small local pill shop and just blindly asked for thyroxine and voila

she pulls out a bottle named Thyroxine but i didnt see a brand name. I assume they are all Synthroid-S (T4 only).

So I started taking it and I felt better, my panic attacks subsided, the numbness in in my feet went away etc etc, didnt feel

perfect but better. But then I started getting bad nausea, diahea, some abdominal pain and ALOT more fatigue than what i was experiencing

with just the hypothyroidism. So i searched "Thyroxin nausea" and behold it is a side effect. This nauseated feeling is worse

than the normal Hypothyroid symtoms, if it was minor i would just deal with it.

So my question is - from what I read on the net its not clear whether a different brand of any Sythoid-S product will not cause this

nausea etc. I did read about purified forms that were supposedly better but what brand name is a purified form?

Or maybe I should just try the Thyroid-S (Armour equivalent) ??? Any idea where i can buy this in Pattaya?

Any thoughts?

Thanks again

SGH

Contact Sriprasit Pharma, the manufacturers of Thyroid-S, on 02 4370343 and they can tell you which pharmacies

in Pattaya sell Thyroid-S. As I mentioned in my previous post, you may want to check your adrenal function, as cortisol

is necessary for thyroid hormones to pass from the blood into the cells where they are utilized. Many people with

thyroid problems have poor adrenal function and may initially improve when taking thyroid hormones, but then get

worse because the adrenals are not producing sufficient cortisol. There is more info on this at stopthethyroidmadness,

Mary Shomon ,Dr Bruce Rind or ThyroidUK.

Good Luck,

Piiguy.

[eek]

As im no expert, i can only give a humble opinion.

Personally I would (just initially) pay out money to see a good specialist (which is what i eventually did after my own treatments got messed up..just wish i had done it sooner). I couple of appointments to get you on the right track. I would also ask the specialist who they would recommend in your area.

I personally recommend a couple of visits to Dr.Rosanee at Bumrungrad (the doctors details Sheryl posted above). She also put me in touch with a doctor here in Chiang Mai (at the local University Hospital..so very low fees).

Edited April 8, 2009 by eek

[unforgiven]

Well a couple years back I started getting bad asthma-like symptoms. I went to a bunch of good US doctors and they could not

control it. I started getting more severe symptoms and seeked out different doctors and was given battery after battery of

tests and they basically gave up. (I told the doctors all the symtoms that matched hypothyroidism, one doctor even pointed

out my thyroid levels were "off" but then completely either forgot or brushed it off and never mentioned it again) Also my

temperature was low and the doctors would mention it but never link it to anything. One time they took it 10 times thinking

the thermometer was broken. Idiots.

Then i moved to Thailand and when my asthma inhaler ran out I went to the local low cost clinic and asked the Thai doctor there which inhaler

I should use in Thailand. He started questioning my symptoms and said he wanted to give me 2 tests, one for diabetes and one for thyroid.

Well the tests came back and no diabetes but the TSH level of my thyroid was high at 11.5 - normal range is 1-5. He told me to take 200mcg

of thyroxin every morning. I went on the net and read as much literature as i could find and got the thyroxin and started taking about

5 days ago. BTW I paid cash all this cost me less than the co-pay of 1 office visit in the USA.

So basically if i carried on like this just thinking it was just asthma it would have killed me eventually and i dont think i was that far away.

------------------------------------------------------------------------------------------------------------------------------

Anyways I was wondering if there is anyone out there being treated for this here in Thailand?

I just had a few questions, some of the answers are out there in the literature, i am just looking for personal experiences.

-I started the thyroxin and i getting major fatigue! I mean wiped out. Is this normal? I read fatigue could be one of the side effects.

I started taking the thyroxin before sleep to help this. The good news is other symptoms have improved a little in just these 5 days.

-How long til the thyroxin kicks in and i feel better? I still feel terrible.

-Is there something better than Thyroxin?

-Should I also take Armour? If so where could i find in Pattaya or BKK?

-Is there any groups out there that meet about this?

I'd love to talk to anyone out there with experience in this, at least for my own sanity, please PM me if you could.

well take care

thanks

SGH

for most conditions you'll get better treatment in thailand than in america

[Sheryl]

Synthroid (with no "-S") is a brand name for synthetic thyroxine (T4) which AFAIK is not distributed in Thailand. Numerous other brand names are. Presumably you have some brand of levothyroxine (same thing as synthyroid) beause that is what a pharmacy asked for thyroxine will dispense.

If you want Thyroid-S (thyroid extract) you need to ask for that specifically. For sure you can get it at Fascino's. In addition to brand name "Thyroid-S" made by Sriprasit Pharma I believe there is at least one other generic brand of thyroid extract available. Any fully trained pharmacist should understand the difference between levothyroxine and thyroid extract and will know that "Thyroid-S"refers to the latter. (Not everyone working in pharmacies is a real pharamcist, though. Stick to Fascino's or other large pharmacy with a white coated person wearing a name tag that says Pharmacist.)

Whether or not it is a good idea for you to switch yourself from levothyroxine to thyroid extract on your own without professional supervision is another matter.

I would recommend you first see a specialist in thyroid disorders (see prior post). If you like, you can specify to her that you prefer to use natural thyroid extract.

If you do decide to self-treat (and I am not recommending it) the closest equivalent to 200 mcg of levothyroxine would be 120 mg (two 60mg tabs) of natural thyroid extract. However, the fact that you are feeling so unwell on the 200mcg raises the question of whether in fact you need this much, hence the value of getting a specialist opinion.

If you have Hashimoto's disease you may be alternating between hypo and hyper thyroid states...

[SoiGirlHunter]

OK thanks all, I will go see a specialist soon.

Today I think I have gone hyperthyroid, racing heartbeat, tons of energy, feel great actually.

But yes I am playing with fire going this alone.

I will record how things go here.

take care

SGH

[Beachbunny]

Jing when you started on the medication did u feel very fatigued?

I notice one thing, if i can somehow do a hard 1 hour of excercise i better, maybe it brings my temp up, i need to get a thermometer.

thanks again

appreciate

I have hypothyroidism. Fatigue is not a side affect of the medication, it is a side affect of hypothyroidism, as is dry skin and hair loss. You probably

won't notice much of a difference until about 30 days, that's one of the reasons the doctor wants to see you back then. Exercise will probably help if

you feel up to it.

I use Euthyrox....mainly because it's similar to synthroid and the tablets are easy to divide as my doasage is .125....not available here.

Beachbunny

P.S. I'd listen to Sheryl. She knows what she's talking about.

Edited April 8, 2009 by Beachbunny

[SoiGirlHunter]

>>>>I have hypothyroidism. Fatigue is not a side affect of the medication, it is a side affect of hypothyroidism

Hi Bunny,

Well for me taking Thyroxin is like taking a sleeping pill, it would knock me out cold into a super deep sleep, it was wierd.

I havent taken any thyroxin for 24 hours now as i feel i am hyperthyroid now and will hold off on taking more. I feel like i am

on 2 pots of coffee lol. Also my extreme nausea and diarhea has VANISHED thank God.

I just found Thyroid - S here right in my local small pill-hut also called a pharmacy here, the witch-doctor i mean pharmacist said

i will do much better on these.

If u dont here from me again, u know what happened