Sudden drop in thyroid levels: reasons for feeling bad?

[Brigida]

Hi everyone,

I am a 37 year old female and have been diagnosed with Hashimoto 10 years ago. I have had some good times where I felt really normal but also ever since then some really rough times with depression, feeling low on energy etc- and also some general issues that never really went away (bloating, feeling really tired in the morning, mood swings, PMS..).

I have had a bumpy ride for more than a year now, ending up hypothyroid last December (TSH was already at 5,8), then a doctor dramatically upped my dose and I was in total overdrive..couldn't sleep, anxious, depressed, lost weight etc. A total nightmare.

I reduced the dose pretty drastically (my usual doctor told me I needed to get out of overmedication fast) and have somewhat stabilized over the summer. Felt more normal, mood was better etc. I knew at some point I would have to increase again as the dose I am on is nowhere near what I usually took.

My labs beginning of July were:

TSH 0,06 (0,3-4,0)

ft3 2,81 (1,7-4,2)

ft4 14,6 (9,4-18,0)

TSH had dropped again but since ft3 and ft4 were in the mid range, I didn't feel overmedicated or hyperthyroid I guess.

And then 5 weeks later:

TSH 2,42 (0,3 - 4,0)

ft3 2,26 1,7-4,2)

ft4 10,8 (9,4-18,0)

Suddenly a clear sign I need more Thyroxin, right?

Right at the time I got the results back, I noticed my mood dropping again and the dreaded feeling/symptoms I have had plenty of times before - and I suspect it is always a sign of Hashimoto flare up, or the dose not being right etc:

low mood, no energy and motivation, everything feels like it is too much. (When I am feeling ok I am really sociable), not much appetite, feeling like crying a lot. I also got a bad cold that lingered for almost 3 weeks at the time as well.

So long story short:

I have increased very carefully now (not making the mistake of last time again!) but am really worried why I am feeling bad again. Is the change in levels the explanation for it? And does the cold have anything to do with it as well?

Would be great to hear some feedback! I am really exhausted constantly feeling bad, improving, then feeling bad again...

Thank you!

[Nanaedake]

Do you think the ups and downs you're experiencing are related to the activity of your thyroid antibodies? This could explain the variation in your thyroid blood test results. We are often vitamin deficient due to gut problems caused by hypothyroidism and this affects absorption of crucial nutrients. Have you had your vitamin levels tested?

[Nanaedake]

Generally you should increase thyroid meds slowly, 25mcg at a time and test in 6 weeks then adjust. It can make you feel very ill taking a big 'leap'.

Always get your blood tests done fasting first thing in the morning and take your thyroid meds after, not before the test.

[Brigida in reply to Nanaedake]

Thank you, Nanaedake, for your replies.

Not sure if it (just) depends on my antibodies as I had them really low a year ago (they dont get tested regularly anyway) but was definitely on a too low dose then and feeling sluggish as well.

I am supplementing Iron (always on the lower end even when I supplement though), VitD and Vit K, Vitamin B12, Vit B6, Vit B1, Selenium, Zinc and Magnesium.

I also take Tumeric now because I read it might help inflammation/mood.

Is there anything else I should take?

It is already a tough schedule to work in all these pills in a day with what you can't take with each other etc.

I suspect though that I just haven't found the optimal hormon dose for me and I haven't had a stable dose in 1,5 years since I was constantly dosed up and down and also basically only in 25LT steps, rather than getting into the small adjustment.

I have only increased from 106,25 to 112,5 LT now because I really had a bad experience getting in overmedication last time so I want to make sure I don't miss potential "feel good" doses and go easy on my body as it had so many ups and downs the last year...

I just need confirmation sometimes that I am indeed not a mentally unstable person but that it has something to do with my Hashi and my hormon levels that I am not feeling well (physically and mentall right now), and that my symptoms can get better...

[Nanaedake in reply to Brigida]

I'm sure you're not a mentally unstable person but thyroid imbalance can temporarily change your perceptions and makes you wonder about your sanity. We've probably all experienced that to some degree. Just hang onto the fact that it's temporary and part of thyroid imbalance which will even out again soon.

With Hashimotos, the antibodies attack the thyroid gland and the dying cells release high levels of hormone which makes your TSH level drop. When the attack settles down you become hypothyroid again and possibly a little more hypothyroid and you may need to increase your levothyroxine in response. This process continues intermittently until the thyroid is destroyed.

You can help to prevent the antibodies attacks by keeping your TSH around 1.0 or slightly lower, taking selenium which you are doing and going gluten free. Apparently gluten can trigger the antibodies.

You may not be taking enough vitamin D or you may have an absorption problem. Please post your latest blood tests and vitamin results on this forum as there are very experienced people who can help you to work out what's going on. People with autoimmune thyroid conditions can be susceptible to other antibodies. If you've had B12 and folate tested then post them too.

[Brigida]

Thanks so much for your reassuring words, Nanaedake. I kind of know that it must be my hormons and the Hashi flare ups and also the instability of my LT doses (and possibly also never really having had a good dose for me over a longer period of time) that causes these periods where I feel bad. But like you said, it makes you question your sanity and stability when you suddenly become so low on energy, cry all the time and everything that you normally do on the fly/with fun/without thinking about it becomes such a drag.

Funnily (or luckily) enough, I never get the obvious physical symptoms that bother a lot of Hashi patients, such as weight gain and hair loss. But my mood and overall feeling of wellbeing is most affected.

I don't have new lab results for VitD and VitB or other lab work right now, but I should definitely get them tested again soon.

Since I always struggle with my ferritin level (despite the supplementing), maybe I am generally not absorbing vitamins/minerals well. (I have had a gastroscopy and coloscopy for that reason actually..because my ferritin is always so low, but everything was fine).

As for going glutenfree: I know that a lot of alternative practioners recommend it and a lot of patients say it helped them, but this is just a bit too drastic for me, not having any "real" scientific evidence that it helps, unless you're really gluten intolerant.

I have tried it and omitted gluten, dairy, egg and soy for 5 weeks, because I wanted to see if it helped with my bloating, but had no results whatsoever - neither bloating nor energy etc. So I decided, the stress of carrying through with such a strict diet is probably not worth the effect that I didn't really notice. Besides, I travel a lot and it would be really really difficult to stick to such a strict regimen.

I think with me, the secret in feeling better might really mostly lie in finding a good dose of LT and stick with it for long enough so my bode/system can calm down.

Like I said, I have had a rollercoaster for over a year now, jumping from hypo to hyper within two months and then back down again... so probably no wonder I am feeling that way now.

Again thank you for your kind input, Nanaedake, it helps a lot to hear from others who know the ride that it will pass and that there IS a totally logical physical explanation for it.

I still haven't found a good doctor who takes all these factors into consideration...