Hi please could someone help me to understand why I continue to feel so poorly on a reasonable dose of Levo (175mcg) and T3 (10mcg) and normal results?
I was diagnosed with hypothyroid 4 years ago, blood test results below.
Jan-2017
TSH - 1.65 (0.2 - 4.2)
Free T4 - 16.1 (12 - 22)
Free T3 - 4.3 (3.1 - 6.8)
TPO antibody - 584.1 (<34)
TG antibody - 605.3 (<115)
Symptoms are
Bone pain
Dry skin
Gritty eyes
Constipation
Heavy periods
Depression
Ears ringing
Feeling cold
Looking washed out
Muscle cramps
Irregular periods
Weight gain
Loss of appetite
Anxiety
Breathlessness
Difficulty swallowing
Tightness in throat
Thank you
Written by
fiora
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Some of your symptoms are indicative of low levels of some of these. If you've been tested, please post the results with reference ranges for comment. If not, ask your GP to do them. Optimal levels of vitamins and minerals are necessary for thyroid hormone to work properly.
Also, as your antibodies are high, you are positive for autoimmune thyroid disease aka Hashimoto's. This is where antibodies attack the thyroid and gradually destroy it. You can help reduce the antibodies by adopting a strict gluten free diet. Gluten contains gliadin which is a protein thought to trigger antibody attacks.
Supplementing with Selenium L-selenomethionine 200mcg daily also helps reduce antibodies, as does keeping TSH suppressed. Selenium also helps T4 convert to T3.
So addressing all those will help. But also, most people feel best when TSH is 1 or below and your FT3 would benefit from being a lot higher in it's range, on the top quarter is where most people feel best. An increase in T3 would be a good idea.
You have many clinical symptoms and your TSH is too high. Some of us need it to be lower than 1 some even need it suppressed. The perfect dose is one that relieves symptoms and we feel well. Your FT4 and FT3 are too low. The following links may be helpful. These were by Dr John Lowe who was an Adviser to TUK before his accidental death.
Are you taking generic levothyroxine? I never really felt well when taking levothyroxine even when combined with Cytomel (T3). Recently I switched to the name brand of levothyroxine, in my case Synthroid, which made all the difference. I feel entirely normal (FINALLY) and I don't even take Cytomel at all. It's unbelievable what a difference it made. I don't understand it but I like to tell people in case it's the same for them. Even my endocrinologist admitted that many people do better on real Synthroid vs. generic levothyroxine.
In the UK we really don't have the same branded versus generic issues.
Although technically the Eltroxin make is claimed to be a brand, it is also available without the Eltroxin name! So we have four different fomulations of levothyroxine here. We see people who cannot tolerate one, doing fine on another. And the exact reverse.
In my view, it has nothing to do with whether a product is deemed "branded" or "generic" - and everything to do with whether the individual taking it gets on with it or not.
The marketing power of Synthroid is incredible. The price of Synthroid is incredible.
Interestingly, I only have to pay $40 per month for Synthroid and that's without insurance! After this month, insurance will cover it so hopefully it'll be even less. Generic costed me $18 for 3 months, but it didn't help my symptoms. It was strange how different I felt by just switching over to Synthroid. You'd think they were exactly the same but apparently there is some leeway on the amount of content for the generics in the US. I had to take T3 with generic levo (and still didn't feel quite right), but I need nothing additional when taking Synthroid.
What you call "leeway" is a defined range of 95 to 105% of declared potency. (In the UK the range is 90 to 105%. But in neither case do we expect to see any product at the extremes of those ranges - only approaching them as the product approaches and goes over expiry date.)
That range applies absolutely equally to ALL levothyroxine tablets in the USA regardless of the name on the package. That is, the same leeway for Unithroid, Lannett and Synthroid.
I do not question your feeling better on one make than another. We see that all the time. But I have most certainly seen a number of people say how much better they were when switched to, for example, Unithroid than when they were on Synthroid.
I do seriously question whether there is any specific thing that is better about Synthroid (which for those who care, contains acacia and lactose and corn) than every other make which is what seems to come from your response? (Synthroid is coloured by dose. So it also contains a wonderful range of colourants except in the 50 microgram tablet.)
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