I was diagnosed with Hashimoto's 2 weeks ago (after feeling very tired, short of breath, choking sensation, dry skin and cold for 3 months) and started on 25 micrograms of Levothyroxine straight away. I know it's the lowest dose but given that I'm quite slim and small, it is probably appropriate. Checkup in 3 months for dose adjustment, and also to check Folate, Ferritin and B12 (I'm already on 2000 units of Vit D)
My results 2 weeks ago were:
TSH 7.14 (range 0.5 to 4.2)
T4 16 (range 12-22)
Thyroid peroxidase antibodies 318 (range <30 or something similar)
Ultrasound: no nodules ; hypervascularity (i.e. thyroid is inflamed)
CRP 0.5 (low risk of general infection is for values <0.5)
Now, after starting thyroxine at first I was suffering with feeling really hot, fast heartbeat, suddenly feeling exhausted but then feeling fine again. I seem to be past this initial stage no. I've been feeling much more energetic these last 5 days. The only symptom that's much worse, even worse than before being medicated, is this choking sensation where my thyroid is. This to me means the inflammation is getting worse.
My questions: Do you experience bouts of intense inflammation (thyroid killing) which then go away? How long to they last?
I'll be very grateful for any personal experience or scientific information (I'm a scientist so feel free to throw facts at me)
Hashimoto’s Thyroiditis is an autoimmune condition where the formation of thyroid peroxidase (TPO) and/or thyroglobulin antibodies (TGAb) attack and eventually destroy the thyroid gland leading to a decrease in thyroid hormone production. The most common form of treatment given by GP's is synthetic thyroid hormone Levothyroxine.
Levothyroxine takes 7/8 days to be absorbed before it starts working and only medicating 25mcg isn't always helpful. The pituitary produces TSH to tell the thyroid to secrete further hormone and insufficient thyroid hormone replacement can be enough to suggest to a struggling pituitary gland to rest, so secreting less hormone that before medicating Levothyroxine.
Levothyroxine takes up to 6 weeks to initially saturate the body which will only tolerate small increases at any one time. 3 months is too long to leave a new patient initially medicating thyroid hormone replacement. It is usual to retest thyroid hormone levels after 6 weeks and adjust the dose according to results. Ask your GP to do this and leave 24 hours between last dose of Levo and blood draw. Also try to have the blood drawn early in the morning when TSH is highest.
It is important to take your pill on an empty stomach with a glass of water, 1 hour before food, 2 hours before supplements and 4 hours before calcium, iron or vit D supplements as these may delay or reduce the absorption.
The goal of Levothyroxine is to restore the patient to euthyroid status and for most people that means TSH just above or below 1.0. and symptoms can lag behind good biochemistry by many weeks//months (depending on the duration of remaining undiagnosed).
During Hashi attacks you may feel hypo one day and hyper the next as stored amounts of hormone is dumped into the blood stream making you feel very unwell. Optimal thyroid hormone replacement helps to dampen the bodies auto immune response so lessening the chance of further Hashi attacks.
Your TPOAb (thyroid antibodies) are high meaning your immune system is in a heightened state. Many experience an over reaction to gluten ( and dairy) which can cause autoimmune damage to the intestines resulting in pain & poor absorption of nutrients.
Ask your GP is test Folate, ferritin and Vit B12 asap and post results complete with ranges (numbers in brackets) for members to comment. You may find "The Root Cause" by Isabella Wentz an interesting read.
Thank you very much, this is plenty of information. I'll see if I can get my next blood tests done sooner. I have very healthy eating habits, but not gluten free or dairy free. Haven't noticed dairy free to make any difference (already tried that). Could give gluten a go. I wonder if general anti-inflammatories might also help or whether it's a waste of time. I also have topical anti inflammatories, might try those too. Unlikely but just maybe... This choking sensation is quite unpleasant at times. I'll update here of there's any success with either drug strategy
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