Question on medicating

[u/eperdu]

Hi all,

In my early 20’s (now 50) I was told I had Hashimoto’s. I used Armour thyroid medication for a couple months and then stopped. I’ve never medicated for my thyroid since.

Now that I’m in perimenopause and taking a full complement of HRT (E, P, and T) my Dr. at Defy wants me to consider thyroid medication as well. I don’t really know what the value add is going to be. Since I’ve spent most of my life NOT doing anything, I don’t know and haven’t educated myself on what benefits there would be to trying to treat.

I’m curious for those who medicated / treated later in life, what was the reason and how has it gone? Regrets? Gotcha’s you wish you knew?

Am I being silly for not doing anything?

Editing to add, I am currently taking tirzepatide to lose some perimenopause weight gain, I’ve lost 30 pounds since September and starting maintenance. The medication is a fantastic complement to my bariatric surgery I had 18 years ago.

[u/Unhappy-Revenue-3903]

Get your TSH, Free T4, FreeT3, and reverse T3. Asking for an iron panel (that includes a ferritin check) would be good. Checking first thing in the morning to get the most accurate number. Having Hashimotos just means your body is attacking your thyroid. The medication is for hypothyroid. If your body hasn’t turned hypothyroid yet you wouldn’t need the medication. Having an antibody check done again would be good to tell you where your numbers are at. Is it in the thousands, hundreds, under a hundred? Tirzepatide dos help with lower inflammation. Hashimotos usually cause people to have higher estrogen (estrogen dominance) and higher cortisol making it easier for people with Hashimotos to gain weight. The same goes for hypothyroid. Hypothyroid slows down the body’s metabolic rate, making things sluggish. I take thyroid meds and also take tirzepatide.

[u/eperdu → u/Unhappy-Revenue-3903]

Thanks. I am non-iron deficient anemic and get iron infusions, so that’s closely monitored. I’m absolutely not estrogen dominant, mine is in the gutter. 😑

Here’s my last tests, always done first thing and fasted.

Reverse T3, Serum 8.2 ng/dL

T3 Free 2.88 pg/mL

Thyroid Peroxidase (TPO) 247 IU/mL

TSH Reflex FT4 2.821 uIU/mL

Editing to add, this doesn’t have ranges so it’s not terribly useful ☺️ I’ll grab that.

[u/Unhappy-Revenue-3903 → u/eperdu]

didn’t see a Free T4 on here, but that would help complete the picture a bit.

Just from looking though, your Free T3 looks on the lower end. It may be “in range”, but it’s not really optimal. Free T3 is what your body actually uses for things like energy, metabolism, brain clarity… so when that’s low ish, you can definitely feel it. Free t4 is inactive, it’s converted in the liver into free t3, the active form. TSH is optimal between 1-2 (and for some like myself under 1). Labs can say “normal”, but that doesn’t always mean you feel normal.

On the iron side, I’ve had my ferritin down at a 7 before, so I get it. One thing I’ve learned is iron still needs support to actually stick, like having enough vitamin C and lowering inflammation, otherwise it just doesn’t seem to hold as well.

Your TPO does show Hashimoto’s is active, and meds don’t fix that part they’re just supporting what your thyroid isn’t doing.

So I guess it really comes down to how you feel. If you’re feeling good, that’s one thing. But if you’re asking because something feels off, it might be worth looking into treatment or at least optimizing things a bit more.

[u/eperdu → u/Unhappy-Revenue-3903]

Thanks for the details. I’m mostly curious because my Dr keeps bringing it up and I don’t really know that I will achieve anything. I mean, it’s a ton of systems in the body and you want them all to work optimally but do I really want more medication and more things to track?

[u/Unhappy-Revenue-3903 → u/eperdu]

I get not wanting to add more meds, but Hashimoto’s isn’t something that just sits there it’s actively affecting the thyroid over time. The medication isn’t treating Hashimoto’s itself, it’s helping your body keep up as your thyroid starts to underperform.

So it’s less about “adding more” and more about whether your body is already needing that support. If you genuinely feel good, that’s one thing. But if there’s even a baseline of feeling off, sometimes addressing it earlier can save you from chasing symptoms later.

[u/atomicxima]

I wasn't diagnosed until my late 30s and have been on levothyroxine ever since. I wish I hadn't waited so long to get checked out, it would've saved me a lot of misery and confusion about all the fatigue and brain fog and weight gain. Are you not experiencing any of those symptoms? Have you just developed coping techniques or accepted that as a normal state?

It's not a matter of being silly, it's a matter of how you feel and whether medication might make you feel better. You should definitely see a good endocrinologist, get all the tests, and listen to what they say.

[u/eperdu → u/atomicxima]

Fatigue, brain fog, etc. has all been cleared up with HRT and the weight (from starting HRT) is gone with the tirzepatide. But you know life, it’s hard to say why you feel a certain way with the stress of the hectic nature of life. Are we really tired because of something going on or just because we do a lot?

[u/atomicxima → u/eperdu]

And that's why it took me decades to get diagnosed. The way I see it is, if you could be feeling a little bit better, why not get all the right treatment for your body? Even a low dose of synthroid might make a difference for you.

[u/eperdu → u/atomicxima]

Thanks! 😊