Fourth month of no periods.: Hi, I'm 22 years old... - Thyroid UK

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Fourth month of no periods.

Sweetlolly11 profile image
7 Replies

Hi, I'm 22 years old and I started taking levothyroxine back in July. My next period after that was 3 weeks late, and every single one after that has skipped. I checked my hormones back in September the last time, this is what showed:

TSH = 3.33 (0.38-4.31)

fT3 = 3.77 (3.2-5.9)

fT4 = 14.81 (10.6-21)

I don't remember my exact results before starting any therapy, but I know my TSH was 4.7 on this scale, and both my fT3 and fT4 were HIGHER than they are now. Why would they drop after starting therapy, they were supposed to go up?

After these results, my doctor put me on an alternating dose of 25 mcg one day and 50 mcg the next day. I don't feel any better, if anything I feel worse and I still haven't gotten a single period. I used to be EXTREMELY regular before (my periods were always early or late up to a week, but they came every single month since I started getting them when I was 13). I also started getting so much acne, it's everywhere. I don't understand what's going on.

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7 Replies
SlowDragon profile image
SlowDragonAdministrator

You are under medicated to have TSH this high. The aim of Levothyroxine is to be increased in 25mcg steps, retesting after 6-8 weeks, until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Make an appointment to see GP and ask for 25mcg dose increase

Also do you know if you have had thyroid antibodies tested? This would confirm diagnosis as Hashimoto's also called autoimmune thyroid disease

It's very common when hypo to have low vitamin levels. Ask GP to test vitamin D, folate, ferritin and B12

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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)."

You can obtain a copy of the articles from Thyroid UK email dionne.fulcher@thyroidUK.org. print it and highlight question 6 to show your doctor.

Prof Toft, also brilliant article just published

rcpe.ac.uk/sites/default/fi...

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, lowest FT4 and most consistent results

Link about antibodies

thyroiduk.org.uk/tuk/about_...

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Print this list of symptoms off, tick all that apply and take to GP

thyroiduk.org/tuk/about_the...

Sweetlolly11 profile image
Sweetlolly11 in reply to SlowDragon

Thank you for replying, I tested all that you said and I supplement vitamin D and B12 which are now optimal, and my folate and ferritin are good. I tested antibodies several times before, always come back negative but I do have a 0.6 cm nodule. They booked my appointment for February, I have to wait 2 months to get my dosage upped. I don't know what to do.

SlowDragon profile image
SlowDragonAdministrator in reply to Sweetlolly11

How long since dose was increased to 50/75?

If more than 6 weeks, See a different GP. Explain how unwell you feel and that you would like bloods retested.

Make sure to get tests as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test

What are your actual results for folate, ferritin, vitamin D and B12?

Sweetlolly11 profile image
Sweetlolly11 in reply to SlowDragon

It wasn't increased that much - the dose stayed at 25 for one day, and 50 the other, and it alternates so the dose is 25/50. It has been two months now since upping the dose. It took me 10 years to even find a doctor who wanted to give me a diagnosis and start treating - others refused to start giving me medication. I don't know where I would go after her, to be honest.

I don't remember folate, but ferritin was 54, vitamin D was 92 (I had stopped supplementing three weeks prior to testing) and B12 was 400, but I've been taking methylcobalamin for 8 months now after it was tested.

Clutter profile image
Clutter in reply to Sweetlolly11

Sweetlolly,

You are undermedicated to have TSH 3.33. Ask your GP to increase dose.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.38 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

SilverAvocado profile image
SilverAvocado

50mcg per day is a starter dose. 25mcg is only for people who are very frail. Either way you'd expect an increase after 6 weeks, and these low doses don't really make anyone feel better.

Perhaps you were started extremely low because the doctor felt you were a borderline case. This is more an issue of GP management :( it sounds like you may just have to wait the two months. When I was first sick I had to wait 3 months between dose adjustments.

Sweetlolly11 profile image
Sweetlolly11

My biggest concern right now is what I am going to do about the missing periods. Should I go to my GP and talk to her, or just let things as they are before seeing my endo?

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