Hyper symptoms with hypo bloods?

[Confusedj]

Newly registered is it common to have hyper symptoms (sweats, tremors, weight loss) with hypo bloods?

TSH 10.8 (0.27 - 4.20)

Free T4 12.9 (12 - 22)

Taking 50mcg levothyroxine diagnosed 2012

Advice appreciated

Thanks

[SeasideSusie Remembering]

Yes, it can happen. Have you had thyroid antibodies tested? Were they high - Hashimoto's?

You're very undermedicated. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges.

Have you always been on 50mcg since diagnosis?

[Confusedj in reply to SeasideSusie]

I haven't been checked for antibodies and always been on 50mcg yes

[SeasideSusie Remembering in reply to Confusedj]

Have you got any other results you can post? Let's see if your results are fluctuating.

Can you remember if all your tests have been at the same time of day? And did you eat before the blood draw? Conditions need to be the same each time to compare accurately.

[Confusedj in reply to SeasideSusie]

All tests done before 9 am and I didn't eat before blood draw

[Confusedj in reply to SeasideSusie]

Mar 2017

TSH 1.69 (0.2 - 4.2)

Free T4 15.7 (12 - 22)

Free T3 4.1 (3.1 - 6.8)

Nov 2016

TSH 4.10 (0.2 - 4.2)

Free T4 17.2 (12 - 22)

Free T3 4.7 (3.1 - 6.8)

May 2016

TSH 3.86 (0.2 - 4.2)

Free T4 13.6 (12 - 22)

Free T3 4.5 (3.1 - 6.8)

Mar 2016

TSH 6.10 (0.2 - 4.2)

Free T4 12.7 (12 - 22)

Free T3 4.0 (3.1 - 6.8)

[SeasideSusie Remembering in reply to Confusedj]

I'm fairly confident that if your thyroid antibodies are tested - both types Thyroid Peroxidase and Thyroglobulin - that you would have either one or both high confirming Hashimoto's.

TSH in March 2016 - 6.10 and March 2017 - 1.69 - far too big a difference for natural fluctuation considering they've been done fasting and early a.m.

You need to ask your GP why, when your TSH has been as high as 6.10 and over range, weren't you given an increase in your dose of Levo? The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges. Your GP has been negligent not increasing your Levo when your TSH was so high, either that or he hasn't a clue how to treat hypothyroidism and he should get informed.

You desperately need an immediate increase now with a TSH of 10.8 so ask for a 25mcg increase now, with retesting every 6 weeks along with an increase of 25mcg each time, until your TSH is low in range and you feel well. In support of your request, refer to the following thyroiduk.org.uk/tuk/about_... > Treatment Options:

"Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist. You can obtain a copy of the article by emailing [e-mail] print it off and highlight question 6 to show your GP.

[SlowDragon Administrator]

Yes, when under medicated, vitamin levels likely to be terrible

Have you got recent tests for vitamin D, Folate, ferritin and B12

If these are too low then thyroid hormones can not work and we feel hyper, but are hypo

You need dose increase of 25mcg, retest after 6-8 weeks. Likely to need further increase

For full evaluation you need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

If you can't get full thyroid and vitamin testing from GP

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

See post above yours for more info too

[shaws Administrator]

I do not know how you have managed on 50mcg since 2012. It is far too low a dose and the reason why your TSH is sky high because if you were on an increased dose of 25mcg every 6 week until your TSH was 1 or lower you would probably feel better with relief of your symptoms

Your FT4 and FT3 also need to be towards the upper part of the range and I doubt they will be with such a high TSH. Your FT4 is at the bottom so I assume your FT3 will be too.

Change your doctor and hope you get someone with at least a bit of knowledge.

Blood tests to check thyroid hormones has to be the earliest possible, fasting (you can drink water) and allow a gap of 24 hours between your last dose of levo and the test and take afterwards.

Also get B12, Vit D, iron, ferritin and folate checked as well. Deficiencies in these also cause symptoms.