Thyroid UK
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Hello All,

I am new to this and have recently been diagnosed as Hypothyroidism although my symptoms have been all over the place. The only symptoms prior to this have been brain fog, stiff neck / shoulders, and memory loss. This hypo diagnosis resulted from an ER visti 2 months ago for bad heart palpitations / racing and found my TSH level to be at 14. Since then I have had numerous symtoms of Hyper and Hypo. Latley I have been having these episodes where I get a pressure feeling in the front top of my head with stiff neck followed by a rush feeling causing my pressure feeling to go away but making me feel very alert and loosing all stiffness in my neck leaving a numbness / muscle weakness feeling. The muscle weakness ocasionally spreads to half of my body as well. My neck stiffness will change from the whole neck to random sides as well (never front of neck though) and this change happens in a matter of seconds lasting 2 minutes to 5 hours. If I drink alcohol these get very extreme the next day and the muscle weakness changes from side to side of my body and lasts for days.

I have tried taking Levothyroxine and have had bad side effects (tried 2 different brands). I started on 50 mcg for a week and it set me feeling hyper and made my finger nails all crack / look dead. I tried stepping down to 25 mcg and same thing. I am now on 12.5 mcg for the last 10 days and am having very bad side effects today.

I am sensitive to caffeine among many other things but I am a 190 lb. 5' 11" male so 12.5 mcg of levo should no be an issue I would think.

My lab results from the last couple months are:

AM Cortisol 14 mcg/dL 16-Apr

Creatine Kinase(S) 178 u/l 16-Apr

Thyroxine, Free (FT4), S1.3 ng/dL 13-Apr

TSH, S. 8.8 mIU/L 13-Apr

TSH, S. 4.4 mIU/L 23-Mar

TSH, S. 10.2 mIU/L 10-Mar

TSH, S.1 4.4 mIU/L 5-Mar

TPO Antibodies 0.9 IU/mL 23-Mar

Triiodothyronine (T3), Total, S 116 ng/d 23-Mar

Glucose, Random, S87 mg/dl 10-Mar

Glucose, Random, S144 mg/dl 5-Mar

Erythrocytes 4.25 x10(12)/L 5-Mar

Hematocrit 36.5% 5-Mar

Thanks for any help you may have on the symptoms!!

3 Replies

Those symptoms sound horrendous and must be quite debilitating!

Do you have the reference ranges for these results? It is difficult to interpret them without the ranges as they can vary from lab to lab.

I think (but not sure without the range) that your haematocrit is on the low side. This indicates anaemia. Anaemia/low iron can make it very difficult for your body to convert and use thyroxine. This can cause horrible side effects from even a small dose of thyroxine. This would be worth looking into. You will need at least a serum iron and ferritin test and you want the results to be well within the reference ranges. A low-normal result at the bottom end of the range is not optimal.

Is your thyroid enlarged? I wonder if it is pressing on something that is causing the symptoms in your neck and head. It would be a good idea to get all this checked out.

I don't know if your t4 and t3 are normal or not without the reference range.

As I suspect your iron may be low and is possibly the reason you are not tolerating thyroxine, it would also be a good idea to get your folate, vitamin b12 and vitamin d checked as these may be low too.

I'm sorry I couldn't be more help. If you can post the lab ranges for the tests, particularly the thyroid tests and haematocrit, I may be able to provide more information :)

Carolyn x

1 like

Thank you for the reply Carolyn! I spoke with the endo over the phone today as well and he said all my side effects cannot be from the levo and I am not aneimic nor would a deficiency cause these symptoms with Levo... So I took some vitamins with B12, D, Iron, and folic acid as soon as I read your post. Hopefully after a few days of vitamins I will be able to tolerate the Levo. Also have an appt with Neuro but of course that takes over a month to get in.

Thanks again for you help, much appreciated!

Chloride, S/P 101 mmol/L 98 - 107 mmol/L

Creatinine (w/eGFR 1.1 mg/dL 0.8 - 1.3 mg/dL

eGFR-African American >60 mL/min/BSA >60 mL/min/BSA

eGFR-Non African American >60 mL/min/BSA >60 mL/min/BSA

Eosinophils... 0.15 x10(9)/L 0.05 - 0.50 x10(9)/L

Erythrocytes4.25 x10(12)/L 4.32 - 5.72 x10(12)/L

Hematocrit36.50%38.8 - 50.0 %

Hemoglobin 13.5 g/dL 13.5 - 17.5 g/dL

INR... 10.8-1.2

Leukocytes 6.8 x10(9)/L 3.5 - 10.5 x10(9)/L

Lymphocytes.. 1.8 x10(9)/L 0.90 - 2.90 x10(9)/L

Magnesium(S) 1.9 mg/dL 1.7 - 2.3 mg/dL

MCV 85.9 fL 81.2 - 95.1 fL

Monocytes.. 0.49 x10(9)/L 0.30 - 0.90 x10(9)/L

Neutrophils... 4.37 x10(9)/L 1.70 - 7.00 x10(9)/L

Platelet Count 221 x10(9)/L 150 - 450 x10(9)/L

Potassium, P 3.6 mmol/L 3.6 - 5.2 mmol/L

Prothrombin Time(P) 11.4 sec 9.5 - 13.8 sec

RBC Distrib Width.. 12%11.8 - 15.6 %

Sodium, P 138 mmol/L 135 - 145 mmol/L


Yes, looking at these results your iron is definitely on the lower side. Your haemaglobin is right at the bottom and your haematocrit is below range.

It is a good idea to take iron away from your levothyroxine. Also take the iron with vitamin c to aid absorption and minimise digestive issues. It is a good idea to get enough vitamin b2 (riboflavin) to aid with storage of iron. This is found in several foods such as Marmite.

If you are taking vitamin d (it needs to be D3, not D2) you should make sure you are getting enough vitamin K2. This is often found in multivitamin preparations but also in fermented foods like sauerkraut. You will also need to make sure you are getting enough magnesium. Yours is currently in range but you need to keep an eye on this. It may be wise to try a small supplementation while you are taking the vitamin D. Look into the best forms of magnesium before buying anything. I find magnesium citrate works well for me but others find magnesium creams or oils that you apply to the skin work best for them. Sunshine is a good way to get some vitamin D but, depending on where you live, you may not be able to get enough this way.

It will likely take longer than a few days to notice improvements in your iron levels. There may also not be enough iron in a multivitamin. You would need to check exactly what is in it.

Make sure you take supplements containing iron, calcium or magnesium well away from your levothyroxine. Levothyroxine should be taken at least an hour or two before these supplements or at least 4 hours afterwards.

I hope you start to feel better soon

Carolyn x


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