I'm 29 years old and take 25mcg levo, never had medication increased. I have symptoms of ears ringing, goitre, dry skin, feeling cold with sweats, eyes feeling heavy, tiredness, feeling wired, aches in bones. I feel really undermedicated but with the sweats will they get worse or better if I increase? Diagnosed 2011 thankyou
TSH 6.10 (0.2 - 4.2)
FT4 12.8 (12 - 22)
FT3 2.5 (3.1 - 6.8)
TPO ANTIBODY 607.4 (<34)
TG ANTIBODY 588.3 (<115)
Welcome to our forum,
You are very undermedicated at 25mcg and yours is a long line of similar posts we've had this week with such low doses.
First of all 25mcg is an incremental dose alone. Starting dose should be 50mcg of levo with blood tests every six weeks with an increase of 25mcg every six weeks till the TSH is 1 or lower. However, many doctors like yours believe if it reaches 'somewhere' in the range you are on sufficient - no you are not on sufficient but insufficient which means you have lots of clinical symptoms.
Your TSH is above range at 6.10 but doctor is probably going by the guidelines that we should not be prescribed until it reaches 10 - but the aim is 1 or lower. Both FT4 and FT3 are bottom of the range when they should be towards the top - FT3 in particular is the only Active thyroid hormone required in our millions of T3 receptor cells. Without sufficient our body cannot function, heart and brain in particular need the most.
We have to read, learn and ask questions and we can then get on a path to recovery, which is the aim of replacement hormones - except the last people to know this are the 'professionals'.
You have an Autoimmune Thyroid Disease - called Hashimoto's and it is the commonest cause of hypothyroidism. The antibodies attack your thyroid gland and wax and wane and that's why you may at times feel 'hyper' and other 'hypo'.
Going gluten-free can reduce the antibodies and the attacks.
First of all get an immediate increase of 50mcg and blood tests every two weeks until you are symptom-free with a FT4 and FT3 in the upper part of the range.
It is disgraceful that six years have elapsed since you were diagnosed.
Your GP needs to test B12, Vit D, iron, ferritin and folate. He knows nothing about how to treat hypothyroid patients.
The aim is a TSH of 1 or lower and FT3 and FT4 in the upper part of the range.
All blood tests have to be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take afterwards.
thyroiduk.org.uk/tuk/about_...
T4 is levothyroxine which is an inactive hormone and converts to T3. T3 is the only Active thyroid hormone and it is T3 which is required in our millions of T3 receptor cells.
As shaws says, you are extremely under medicated. Ask GP for immediate 25mcg dose increase. Bloods should be retested after 6-8 weeks and dose increased repeated in 25mcg steps (retesting 6-8 weeks after each dose increase) until TSH is around one and FT4 towards top of range and FT3 at least half way in range
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
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 print it and highlight question 6 to show your doctor please email Dionne: tukadmin@thyroiduk.org
Prof Toft - article just published now saying T3 is likely essential for many
rcpe.ac.uk/sites/default/fi...
As you are so under medicated you are very likely to have very low vitamin levels
Ask GP to run blood test for coeliac disease, plus vitamin D, folate, ferritin and B12
Put up a new Post with results and ranges on vitamins once you get them
Typical low vitamin levels when under medicated
healthunlocked.com/thyroidu...
Your high antibodies confirm you have Hashimoto's
Hashimoto's affects the gut and leads to low stomach acid and then 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
Ask GP for coeliac blood test first
thyroidpharmacist.com/artic...
thyroidpharmacist.com/artic...
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
Besides the 'flares' associated with Hashimoto's, another reason for feeling 'wired' or hyper with longterm hypothyroidism is that the adrenals will produce more cortisol to compensate for physiological stress. Over time, cortisol production cannot keep up, and adrenaline is released instead, adding to these awful feelings of being physically and psychologically strung out.
This is an excerpt from the following link:-
Although starting doses are usually the same, the dose of levothyroxine you end up taking, or how quickly the dose is increased, depends on your symptoms, hormone levels, age and whether you have any other health problems.
Adults usually start with a dose between 50mcg and 100mcg taken once a day. This may be increased gradually over a few weeks to between 100mcg and 200mcg taken once a day.
Some people, such as over-50s or people with heart disease, may start on a lower dose.
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