Split personality?

[Blossom234]

Ok. I'm now a week in since starting my increased T4. I'm now on 50mcg up from 25mcg. First few times I've chickened out of taking the whole 50mcg tablet by pulling a fast one and taking two 25mcg ones instead - simply because they dissolve in my mouth where the stronger ones don't. After much faffing about I now take a 50mcg a day and throw it in some water so it all comes apart, which works ok.

Lately I've been getting more mood problems - whether it's from the hypo or not I'm not sure, but it always happens when it's outside and it happens to be cold, wet, windy or damp. When it's warm with just a small breeze, not a problem, but then put me back in the indoors where it IS warm and then, as if by magic, I'm back to normal. It takes a couple of minutes or so before this happens but it's almost as if I've got some split personality thing going on and it's been worrying me and my boyfriend. It's been worrying him as he thinks most of the time I'm getting annoyed about him and it's worrying me as I know full well it isn't about him yet I get this impulse to fly off into some sort of outburst.

I went to church for the first time in seven months this morning. I'm not a religious person but the people who are, are people I went to school with and grew up with and although I am right in saying I do have friends other than those who attend church, they have their own sets of friends I don't know and interests that I don't have. Also, feeling too tired to go when I needed to go out and have fun (which I don't do very often!) left me feeling guilty for not catching up with any of the guys I usually see. Funnily enough, one of the girls at the church I used to speak to now and again also has a thyroid condition and she had radioactive treatment for it which has left her hypothyroid. She now takes thyroxine and goes through having her blood tested more regularly, and it's so nice to know that there's someone I can relate to and understands what I'm going through within my home community.

Before in my daily life I felt alone especially whilst I still had my job, because although I looked well enough I didn't feel very well within myself and one particular person in my team (I won't say who) although has a relative with hypothyroidism did not take my word for it until a blood test I had gone for would prove I was suffering from it.

During this time there was one occasion where my left leg completely seized up and felt so heavy I couldn't use it to get up the stairs. Going downstairs was fine but the problem was when it came to lifting it up. I told this person and they suggested I use a lift whenever I wanted to go between floors. I wished I had the nerve to tell them that I also have steps going into my flat, maybe I should get the local council to fit in a lift for that as well?

This whole thing really did get my back up and after I left my job and I was looking for work elsewhere it played on my mind so much that it made me want to talk about it, out loud, over and over again, whilst I was on my own. If something annoys me enough I feel as though I have to vent it more than once to get it out of my system until I do eventually say to someone in person what it is that's bothering me. I think telling myself out loud about it over and over prepares me for what I have to say until the time I can say it to someone in person. I don't know. I feel like I'm going mad as I write this and I don't want anyone to think I am.

The mood swings just happen. They get out of control within a few minutes of me being in the cold or wet or damp and it's almost as if I've lost the ability to stop the irritability/anger I feel. The self-control I have is somewhat blunted - that's right! Yes, blunted.

My family thinks maybe I should be on more thyroid hormone and I have my doubts as I've only been on the 50mcg for a little over a week. (I started the increased dose on 15/06/2013.) Weight's been better however. I look more filled out - before I weighed 45.8 kg and now I weigh 49.9 kg! I've been eating more food that I know will bulk me out but I'm also eating more fruit and veg, whereas before I'd be lucky to finish what I was given due to the difficulty swallowing. So yes, things are better for me in that respect and my eyes are nowhere near as puffy/baggy as they were before. Tiredness isn't as bad but the mood swings I can't help but feel embarrassed about.

[Duchy82]

The mood swings sort of come with the territory I'm afraid and it indicates to me that you should be on more thyroid hormone. 50mcg is a very low dose (i'm on 200mcg myself). Make sure that the doc retests your homone levels after about 6 weeks on your current dose you will find you will probably end up being given more and with that the mood swings should also improve.

[Blossom234 in reply to Duchy82]

Hi there thanks for your response.

The first dose of thyroid hormone I was on was 25mcg and that was started on the 1st of June. That was for two weeks. The doc then wanted me to take 50mcg once those two weeks were up and to take the 50mcg until the 29 June. (that's when my two weeks for the 50 is up). He then wants me to start on 75 from the 30 June and I'm scheduled to have the blood test which he wanted me to have done before the time gets up to three months. (blood test is on 23 August). Should I be concerned that he's modified the dose every two weeks? I'm not sure how long thyroxine takes to work but to me two weeks between the increase in dose isn't very long.

Thanks!!

[Hidden in reply to Blossom234]

Hi

When you go to the GP for blood tests ask for Vit D , B12, Iron, Folate /ferritin as these also play a big part if not optimal. I would maybe speak to her about adrenals also. I know how you feel about the cold and damp it makes me extremely miserable also. I don't have the patience I used to either especially when feeling so so miserable.

It seems like you have a pretty good GP

The dosage normally gets increased gradually.

Ask for a copy of your next blood tests with ranges as there are some amazing people on here that will interpret them for you.

Don't forget to ask for your Vit levels to be checked.

xxx

[Blossom234 in reply to Hidden]

Hi there Jacaranda thanks for your response.

With the blood test I just had which confirmed the hypothyroidism I asked for a copy of the bloods which they did (free of charge and hand delivered!!) and although the print says "complete blood test" this did not include Vit D, B12, Iron or Folate/Ferritin. I thought if it were a complete blood test things like these do get tested?

Anyway, yes, I'm with a very good GP - when they sent me the copy of the blood test I had last they wrote explanations of the normal ranges and what my results meant.

Thanks!! xx

[Duchy82 in reply to Blossom234]

Two weeks between dose increases to begin with is quite normal, i started on 25mcg for first to weeks and then up to 50etc. Be patient it can take a long time before you will get back to some sort of normality it took me 2years. And quite a few blood tests if your tsh is back in the normal range on your next blood test but only just and you still have symptoms dont take no for an answer and get another increase your aiming for a tsh of 1 or less before you will feel better on thyroxine

[Duchy82 in reply to Duchy82]

Oops should've replied to your response to me thats what i get for using my phone

[Blossom234 in reply to Duchy82]

Hi there MCoates thanks for your response.

Wow - 2 years? It might take me some time then as when I was diagnosed my TSH was 22! I mean my GP is pretty good as although my FT4 was in range but only just he recommended he start me onb the thyroxine.

xx

[Duchy82 in reply to Blossom234]

Wow thats a high TSH, not sure what mine was when diagnosed but now it is 0.02 (below range) and my T4 is 25 (top of the range).

It doesn't surprise me that you feel so unwel with T4 at the bottom of the range and such a hight TSH. Most people if they respond well to Levothyroxine will feel better with a TSH below 1 and T4 at the top or slightly over the top of the range so you have plenty room for improvement.

The up side is I'm now losing weight (16kg in a year),My hair hasn't been this thick in years and my skin is miles better, still dry but i don't think it will completely go, i no longer look like death warmed up and slowly but surely all the other medical problems I was having are going.

I baffled my heamotologist as all of a sudden my reactive neutrophillia (high neutrophil count) has gone, his theory was because i smoked mine was because of the hypothyroidism. lets put it this way i haven't managed to quit smoking yet so who was right.

one less specialist to go to as I no longer need to see him whohoo!

[Blossom234 in reply to Duchy82]

Good news with the weight loss!

I'm gaining weight but I needed it as before my clothes would hang on me. I now weigh nearly 8 stone whereas before I was around 7 stone 3. I've filled out where I've needed to luckily enough which was on my waist. Whether that's due to the hypothyroidism I'm not sure but I'm a lot happier that I'm more huggable.

[nostoneunturned]

This is from Dr Toft's "Understanding Thyroid Disorders", BMA publication, about £5 from Amazon/chemists, Dr Toft past president of the British thyroid association.

"Normally thyroxine treatment is begun slowly and you will be prescribed a daily dose of 50 mcg for 3 to 4 weeks, increasing to 100mcg daily for a further 3 to 4 weeks and then to 150mcg daily.

You'll then have another blood test some three months after starting treatment to assess whether any further minor adjustment of dose is necessary. The aim is to restore levels of T4 and TSH in the blood to normal."

It does seem your doctor is increasing the dose rather rapidly: this would not matter while you are on these comparatively low doses, 25mcg and now 50mcg. 50mcg is regarded as the standard starting dose and, as Dr Toft indicates, patients normally are on 50mcg for 3-4 weeks as is the case for subsequent increases.. This gives the body time to adjust to the increased doses.

As Jacaranda says, there is always help/advice here.

[Blossom234 in reply to nostoneunturned]

Hi there thanks for your response.

What I've read up about when looking into typical thyroxine doses from other sites is that adults (whether young adults or much older I'm not sure) are given small doses, mainly 25mcg, if they have cardiac problems. So far as I know I don't have a cardiac problem, although my family has a rife history of diabetes, high blood pressure, stroke, angina and both grandparents have had heart bypass surgery so whether having a genetic predisposition has meant I need to be on a low dose for a shorter time I really don't know. One thing I do have is Raynaud's and a high plasma viscosity which might've determined the small starting dose - or even the TSH level. I still don't feel a huge difference has changed. My eyes look better, but that's about it!

Thanks!! xx

[nostoneunturned in reply to Blossom234]

You have only been on thyroxine for a matter of what - 4 weeks? maybe 5 by now? If your eyes look better then things are changing for you already for the better.

It is striking that you say that you have Raynaud's, this often crops up in connection with hypothyroidism, and as for the high plasma viscosity, it would not surprise me if that might be related to the lowered blood volume also associated with hypothyroidism, but I have never done any research in connection with this, just surmising at the moment, no time for research, alas.

[Blossom234 in reply to nostoneunturned]

Hi nostoneunturned!!

Yes, my eyes look better but that's about it. Nothing else has changed as of yet.

I didn't realise I had lowered blood volume, but when looking more into it I'm a bit low. I used an online calculator which said that my blood volume is 3 litres. I am short however (5ft 3) and most people have 2 more litres of blood than me! Unfortunately I'm 28 so I do get mistaken for a teenager still.

xx