First post, I think I'm under medicated but can't be sure. I was diagnosed hypothyroid in 2012 and take 50mcg since 2013 and my muscles ache, get breathless, have puffy and dry eyes. Am I likely being a hypochondriac? Thank you for feedback
TSH 5.8 (0.27 - 4.20)
Free T4 13.1 (12 - 22)
Free T3 3.2 (3.1 - 6.8)
Welcome to the forum, Polkadotti.
If you post your recent thyroid results and ranges we will tell you whether you are optimally dosed or undermedicated on 50mcg.
Hypothyroidism can cause dry eyes so ask your pharmacist for a preservatives-free eye drops.
TSH 5.8 (0.27 - 4.20)
Free T4 13.1 (12 - 22)
Free T3 3.2 (3.1 - 6.8)
You’re not a hypochondriac - you are indeed woefully undermedicated. You’re on a starter dose of levo - why hasn’t your doctor raised the dosage??
I had it reduced back in 2014 when levels were TSH 0.80 (0.2 - 4.2) Free T4 20.6 (12 - 22) Free T3 4.1 (3.1 - 6.8) and never had it adjusted or checked until recently
You probably had what we call a “Hashi’s flare”. Most hypothyroidism is caused by autoimmune disease which attacks the thyroid. When that happens, the damaged thyroid produces more thyroid hormone than usual, temporarily sending your results out of whack.
Over time, your thyroid, as it’s slowly destroyed by the autoimmune disease, just won’t work at all.
So. Definitely time to raise your dose.
Ok thanks. I'm a bit confused. I had antibodies checked but GP told me at the time they and my thyroid levels indicated hyperthyroidism?
I suspect your doctor was the confused one! Difficult to say without seeing the results, but it’s much more likely you have Hashimoto’s than Graves.
TPO ANTIBODY 604.5 (<34)
TG ANTIBODY 369.3 (<115)
TSH 5.4 (0.2 - 4.2)
FT4 15.8 (12 - 22)
Yes. Hashimoto’s for sure. As I said, it was a flare, which by their very nature are temporary.
Thanks so Hashimotos is treated the same as hypothyroidism until the thyroid is completely gone?
Yes. Eventually your thyroid just won’t produce any thyroid hormones.
Well, those results didn't show overmedication (and your free T3 was too low in range) so you shouldn't have had your dose reduced.
Polkadotti,
You are undermedicated. Ask for a dose increase.
The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 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.
Ditch your doctor, first of all for keeping you on a starting dose of 50mcg and not ensuring that you had sufficient thyroid hormones to bring your TSH to 1 or lower. Both Frees are at the bottom of the range when they should be nearer the top.
50mcg is a starting dose, insufficient thyroid hormones can cause more problems for us but our doctors are so poorly trained they think they are doing the right thing. On this form we've had to read, learn and ask questions as you are doing and most have recovered their health. I will give you a link by a top Endocrinologist and highlight the part in the link about doctors and send to your GP.
When you have a blood test for thyroid hormones it have to be at the very earliest possible, fasting (you can drink water) and allow a gap of 24 hours between your last dose and the test and take afterwards otherwise the results can be skewed.
If he's not tested B12, Vit D, iron, ferritin and folate ask for these too.
healthunlocked.com/thyroidu...
Thanks all bloods done fasting, early morning and I allow a gap of 24 hours between dose and blood test
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease). About 90% of all hypothyroidism in Uk is due to Hashimoto's
Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise
Hashimoto's affects the gut and leads to low vitamin levels
Low vitamin levels stop Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
thyroidpharmacist.com/artic...
thyroidpharmacist.com/artic...
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
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 - 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...
See Box 1. Some possible causes of persistent symptoms in euthyroid patients on L-T4
Actually, Dr Toft has told me personally that he now fears that very small initiating doses of T4 starting therapy can actually make things symptomatically worse, and he now wades in with at least 50 ug T4 to right matters as fast as possible.
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