Hi I was diagnosed with an underactive thyroid in 2013 and my GP is reluctant to increase my levothyroxine of 50mcg because of the risk of me becoming hyperthyroid. My endo has also said he believes I am suffering from some form of general anxiety disorder.
I have been on higher doses before, as much as 175mcg levothyroxine with 10mcg T3. Symptoms are currently low libido, period pain worsening the more I am into my cycle, joint pain, red blotches on skin, weight gain, tiredness, memory loss, poor concentration, sweating with exertion, hair loss, pins and needles, periods heavy, puffy eyes and black circles around eyes, feeling cold, nails flaky and splitting, eyelashes and eyebrows looking sparser.
Any help would be appreciated. Thank you.
DEC-2017 - 50mcg levothyroxine
Serum TSH *8.5 mIU/L (0.2 - 4.2)
Serum Free T4 14.7 pmol/L (12.0 - 22.0)
Serum Free T3 3.3 pmol/L (3.1 - 6.8)
OCT-2017 - 175mcg levothyroxine and 10mcg T3
Serum TSH *<0.02 mIU/L (0.2 - 4.2)
Serum Free T4 21.3 pmol/L (12 - 22)
Serum Free T3 5.2 pmol/L (3.1 - 6.8)
Thyroid peroxidase antibodies *848.1 IU/mL (<34)
Thyroglobulin antibodies *389.3 IU/mL (<115)
Written by
Jkat
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Presumably you have Hashimoto's (high thyroid antibodies)?
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect 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
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
You will need to increase Levo back up until TSH is around one and FT4 towards top of range and FT3 at least half way in range
Retesting 6-8 weeks after after each dose increase
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
Improving vitamins with significant supplements, assuming they are dire
If you have Hashimoto's then likely to need strictly gluten free diet too
If after all these FT3 remains low, like many of us with Hashimoto's, you may need to restart small dose of T3
Thyroid UK are collecting evidence of malpractice due to removing clinically needed T3
Please consider sending a brief outline of this. How T3 improved you and the subsequent disaster since it was stopped. I would include the dire vitamin levels, assuming you have them!
So there was absolutely nothing wrong with October results. Endo freaked at low TSH, but FT4 was in range (just) and FT3 actually a touch low . you were only taking 10mcg T3. Lots of us take 20-25mcg T3
You very definitely have Hashimoto's. You probably had very low vitamins in October
No doubt vitamins will be dire now
Your TSH now is way over range at 8.5
Make an urgent appointment to see a different GP, if yours won't agree to 25mcg dose increase
Insist on testing for coeliac, vitamin D, folate, ferritin and B12
Here's a typical post that is possibly like your results in October with low vitamins affecting conversion, causing high FT4 and low FT3
I still had hypo symptoms in October. I had vitamins and minerals tested in December 2017. I supplement vitamin D 9000IU (Better You oral spray 3000IU x3) because my levels did not improve on 3000IU. Have been getting an increase in pains in ribs, hips and tibia bone that I cracked 13 years ago. Thanks.
From December 2017. Complete blood count only showed MCV *80.2 (83 - 98) MCHC *375 (310 - 360) Iron was in range 7.2 (6 - 26) Transferrin saturation 13 (12 - 45) also from December 2017
Low MCV and high MCHC suggest iron deficiency anaemia plus your serum iron and trans sat way too low in range. You need to ask your GP for appropriate treatment which should be 3 X Ferrous Fumarate daily (take each tablet with 1000mg Vit C to aid absorption and help prevent constipation) and start eating liver regularly (no more than 200g per week due to it's high Vit A content).
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