Blood results all "normal" - still feeling hypo - any ideas??

[chloemcm]

I've still got hypo symptoms - excessive fatigue, cold intolerance, arm and leg muscle and joint pain, brain fog, lack of concentration, itchy scalp, hair loss, constipation/diarrhoea, abdominal pain. Diagnosed with primary hypothyroidism one year ago Over the last 6 - 8 weeks I've developed a fast pulse. Resting pulse varying between 85 - 130. Had ECG which showed sinus tachycardia and T wave abnormality (which Dr said was perfectly normal!! ) Any ideas about this?? Heart scan and chest xray normal too! Recent blood results as follows:

Progesterone 1.1 nmol/l

FSH 4.4 (1.7-21.5)

LH 14.5

Testosterone 1.1 (0.278-1.73)

Oestradiol 2735 pmol/l

SHBG 48 (32.4-128)

Free androgen index 2.3 ratio (0.34 - 3.87)

Cortisol 349 nmol/l

Sodium 141 (133-146)

Potassium 4.6 (3.5-5.3)

chloride 105 (95-108)

CO2 25 (22-29)

Urea 3.9 (2.5-7.8)

Creat 87 (45-84) High

Serum total protein 73 (60-80)

GFR 60ml/min

Vit B12 424 (191-663)

Folate 12.5 (4.6-18.7)

Calcium 2.27 (2.2-2.6)

Free T4 14.4 (12-22)

TSH 1.12 (0.27-4.2)

Vit D 39 (<50 deficiency) Deficient

Iron 15 (13-30)

Transferrin 2.1 (1.8-3.8)

Ferritin 58 (13-150)

Transferrin saturation index 29

Thyroid peroxidase antibody level 15 (<34)

Daily Cortisol Saliva test 31.1 (21-41)

DHEA Cortisol Ratio 1.17 (1.0-4.0)

DHEA Mean 0.37 (0.30 - 1.00)

I'm on Eltroxin 50mcg daily and now started on Vit D 800 x 4 daily for one month and then 2 daily for a month for maintenance. So tired and sore I can hardly think straight or get around. All the Dr and Endo will say is everything is normal, yet I feel far from normal! Any advice or opinions would be gratefully appreciated.

[waveylines]

Hi Chloemum,

Am so sorry to hear that you are feeling so poorly.

A couple of things that I noticed is that your Ft4 is at the lower end of the range -ideally you want to be in the top third or towards the top of the Ft4 range. Your TSH is also a little high for someone on treatment. I would suggest that your doctor increases your dose of Eltroxin -and tiltrates it slowly up every 6-8 weeks until your FT4 is in the top third and your symptoms go. 75mcg would be the next step most docs would recommend. 50mcg is really a starter dose normally.

Your vitamin D is indeed low -800iu of vitamin D3 twice daily for a month may not bring you up to the best levels -around 80. Many people need 2-5000 iu of D3 daily to maintain a good level. For more information on vitamin D do look at the Vitamin D Council website - this has loads of useful information as well as info on supplementing which you could show your doctor.

vitamindcouncil.org/about-v...

Your B12 level is a little low - this commonly occurs in hypothyroidism and unless you know of any known causes -such as does b12 deficiency run in your family....you might want to get this checked out with tests like the Intrinsic factor. If all is clear you could try supplementing with b12 methyl -look at the B12 Deficiency Website. B12 deficiency mimics many symptoms like fatigue, aches and pains but also has some separate symptoms such as pins and needles, numbness,

b12d.org/

Am sure someone else will comment on your iron and ferritin -am not very good on this area- but yours again seems a little low....and is common in under treated hypothyroidism... and in b12 deficiency. Am sure other s will comment on whether you would be wise to supplement.

[chloemcm in reply to waveylines]

Thanks, for reply. I asked Dr to increase Eltroxin and she said no because of my current pulse rate. I'm confused - GP and Endo said resting pulse of 113 is too high, yet cardiac assessment unit says resting pulse of 130 is perfectly normal despite ECG showing sinus tachycardia. Any ideas??

When I have tightness in my chest with fast pulse I do get pins and needles down my arm into my fingertips so you may well have a point with the B12. What is the Intrinsic Factor?? Will have to google.

[Hidden]

50mcg is not a large dose - but your TSH seems to be at a number most GPs assume is fine. However, I think it's likely those blood tests aren't revealing the full picture and you might need more thyroxine to feel better.

Did you by chance happen to take your thyroid meds on the day of your blood test? And what time of day did you have the blood taken?

[chloemcm in reply to Hidden]

No didn't take thyroid tablet on day of test and had test done in the morning. I asked Dr to increase Eltroxin and she said no because of my current pulse rate. I'm confused - GP and Endo said resting pulse of 113 is too high, yet cardiac assessment unit says resting pulse of 130 is perfectly normal despite ECG showing sinus tachycardia. Any ideas??

[Riverfrog]

chloemcm, How long have you been on Eltroxin,? some of your problems could be side effects of the drug, if you search Eltroxin people have complained that it presents problems and switch to Levothyroxine.

Whether side effects or not they should be looking at your pulse rate, 130 a minute is not normal and will indeed make you feel very tired, exhausted even. I can't think why they say it is normal.

Whether it is because you are still hypo or a side effect of the drug they need to change your medication.

Sometimes an ST abnormality is considered OK but not always, ask your doctor why yours is considered normal.

Have you any previous ECG readings to compare?

[helvella Administrator in reply to Riverfrog]

Riverfrog,

Not sure what you are saying about Eltroxin.

Eltroxin is simply a brand name for levothyroxine.

In the UK and Ireland, the Eltroxin brand is owned by Mercury Pharma (Amdipharm). In other countries it is owned by other companies. (The products vary in formulation.)

A prescription for levothyroxine could be fulfilled with Eltroxin.

(Currently Eltroxin is still unavailable in the UK.)

Rod

[Riverfrog in reply to helvella]

Thanks Helvella, It is just that although they are both levothyroxine the brand names are different. I have read this when researching for myself so that I could understand it better.

Perhaps really it is the company making it that causes the difference!

I am not happy on my levothyroxine made in france for other reasons and the dose is probably too low. However I do not get side effects with it.

[helvella Administrator in reply to Riverfrog]

We have both Mercury Pharma Eltroxin and Mercury Pharma Eltroxin. As of this month, they are supposedly changing the formulation of the 50mcg Levothyroxine to be identical to the 50mcg Eltroxin. The 25 and 100mcg tablets already were.

I *know* people find differences, but I am never sure whether those differences would have occurred in Eltroxin as well, but as it is unavailable, we cannot tell!

Rod

[chloemcm]

I was originally on levothyroxine 50 and switched to eltroxin 50 to see if it would make a difference but unfortunately not - symptoms still the same Both drugs still available in Ireland.