Hyperthyroidism

[Anna89]

Hi all, I am new and I was diagnosed hyperthyroid recently with the following results - TSH 10.6 (0.2 - 4.2) FT4 10.3 (12 - 22) FT3 3.3 (3.1 - 6.8) Was originally diagnosed hypothyroid in 2013. My symptoms are currently things like my eyes feeling puffy and dry, sluggish bowels, losing hair, weight loss, pains in ribs and joints, low mood, feeling cold. Thanks in advance for any support.

[Clutter]

Welcome to the forum, Anna89.

You say you were diagnosed hypothyroid in 2013. Were you not taking Levothyroxine since 2013?

TSH 10.6 with FT4 below range means you have overt primary hypothyroidism not hyperthyroidism. How much Levothyroxine are you prescribed now?

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 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_...

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

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

[Anna89 in reply to Clutter]

Hi yes, that is correct. I was diagnosed hyperthyroid very recently with a TSH above range. I am not on any levothyroxine, was taking levothyroxine from 2013 - 2018. Thanks

[Clutter in reply to Anna89]

Anna89,

You are NOT hyperthyroid. If a doctor has told you that you are hyperthyroid you have been misdiagnosed.

You are hypothyroid but you are very undermedicated. How much Levothyroxine were you taking from 2013 - 2018 and why did you stop taking Levothyroxine?

[Anna89 in reply to Clutter]

Hi yes a GP diagnosed me with hyperthyroid and I was asked to stop levothyroxine. I have been on the following combinations

2013 - 50mcg, 25mcg, 75mcg, 100mcg, 125mcg (all levothyroxine)

2014 - 125mcg, no levothyroxine, 50mcg, 100mcg (all levothyroxine)

2015 - 125mcg levothyroxine, 150mcg levothyroxine, 175mcg levothyroxine, 75mcg levothyroxine and 10mcg T3

2016 - 75mcg levothyroxine and 10mcg T3, 25mcg levothyroxine, 50mcg levothyroxine, 75mcg levothyroxine and 10mcg T3, 100mcg levothyroxine and 10mcg T3, 125mcg levothyroxine and 10mcg T3, 150mcg levothyroxine and 10mcg T3, 175mcg levothyroxine and 10mcg T3

2017 - 200mcg levothyroxine and 10mcg T3, 150mcg levothyroxine, 175mcg levothyroxine, 100mcg levothyroxine

2018 - 75mcg levothyroxine

[Clutter in reply to Anna89]

Anna89,

You have been misdiagnosed. You are NOT hyperthyroid. Please see another GP. You are overtly hypothyroid and need to resume Levothyroxine.

[SeasideSusie Remembering in reply to Anna89]

Find a new doctor, run away from this one because he will make you very ill. As Clutter has said you are very definitely hypOthyroid with an over range TSH and below range/low free Ts.

Have you had thyroid antibodies tested and were they raised?

[Anna89 in reply to SeasideSusie]

They were raised, yes.

Thyroid peroxidase antibodies 504.3 (<34)

Thyroglobulin antibodies 267.5 (<115)

[SeasideSusie Remembering in reply to Anna89]

Then you have autoimmune thyroiditis aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results. I imagine your very many dose changes (plus the addition and removal of T3) is down to these fluctuations in test results and your doctor not understanding it. Most doctors dismiss antibodies as being of no importance but don't understand how Hashi's affects the patient.

However, this does not explain your GP's total ig prance and confusing hypOthyroidism with hypERthyroidism.

To help reduce the antibodies you should adopt a strict gluten free diet and supplement with selenium L-selenomethionine 200mcg daily. Keeping TSH suppressed can also help reduce antibodies.

chriskresser.com/the-gluten...

hypothyroidmom.com/hashimot...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

Hashi's and gut/absorption problems tend to go hand in hand and very often low nutrient levels or deficiencies are the result. I wouldn't be surprised if your vitamin and mineral levels are low. Have you had them tested - Vit D, B12, Folate and Ferritin?

[Anna89 in reply to SeasideSusie]

At the time I was told I have hyperthyroidism I had symptoms of sweating, so possibly that. I have had vitamins and minerals tested, yes, and I supplement. Can I post them? Thanks

[SeasideSusie Remembering in reply to Anna89]

Yes, post the vitamin and mineral results with their ranges. Say what you are supplementing with and the dose.

The fluctuations caused by Hashi's can mean that you can have hypo and hyper type symptoms. It doesn't mean that you are hypERthyroid, it's just a temporary swing caused by a 'Hashi's flare', at this time dose of levo can be adjusted then readjusted when things settle down again.

[Anna89 in reply to SeasideSusie]

Ferritin 63 (30 - 400) taking 1 iron tablet for iron deficiency

Folate 2.2 (2.3 - 19.5) restarting folic acid after first B12 injection and testing negative for intrinsic factor antibodies

Vitamin B12 283 (190 - 900)

Vitamin D total 60.2 (50 - 75 suboptimal) taking oral spray 3000iu D3 with K2 and MK7, GP monitoring every 6 months as confirmed vitamin D deficient

Thanks

[SeasideSusie Remembering in reply to Anna89]

If you have confirmed iron deficiency then the treatment is 2 or 3 times ferrous fumarate daily - see NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):

cks.nice.org.uk/anaemia-iro...

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

•Treat with oral ferrous sulphate 200 mg tablets two or three times a day.

◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

Iron tablets must be taken 4 hours away from thyroid meds and 2 hours away from other supplements and medication as it affects their absorption. You should take each iron tablet with 1000mg Vit C to aid absorption and help prevent constipation.

Ferritin needs to be at least 70 for thyroid hormone to work. You can help raise ferritin by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

**

B12 and folate are being addressed. Optimal levels are B12 - very top of range, Folate - at least half way through range. When taking B12 we should take a B Complex to balance all the B vitamins. If your B Complex contains Biotin then it should be left off for a few days before any blood tests.

**

The recommended level for Vit D, according to the Vit D Council, is 100-150nmol/L. As you have Hashi's then for best absorption you should use an oral spray such as BetterYou. Magnesium is another important cofactor of D3, it helps it to work. D3 and K2-MK7 are fat soluble so should be taken with the fattiest meal of the day, D3 4 hours away from thyroid meds and magnesium at least 4 hours away from thyroid meds.

[Fruitandnutcase in reply to Anna89]

Anna 89, I’ve got Graves Disease - hyperthyroid with antibodies. There is absolutely no way you you are hyper with a TSH as high as that. No way.

Your doctor is wrong. It’s not possible. If you were hyper your TSH would be something like < 0.03 (0.35 - 5.5 ) Below low reference limit like mine was.

To be considered hypo your TSH would have be above 5.5 - the upper limit on that lab range - although you would probably be feeling utterly dreadful long before it reached 5.5.

Have you seen an endocrinologist or is it your doctor who has said you are hyper? If it’s your endocrinologist who has said you are hyper then you need to change your endocrinologist and your doctor.

[Anna89 in reply to Fruitandnutcase]

I am under an endocrinologist but yes the GP said I was hyper

[Fruitandnutcase in reply to Fruitandnutcase]

I would ring your endocrinologist’s secretary and tell her that your results are and say that are very worried because your GP is now saying that you are hyper and you don’t think that is right.

[Angel_of_the_North in reply to Anna89]

Sweating is often caused by undermedication as the adrenal glands step in and raise adrenaline to keep you going - that causes sweating.

[Angel_of_the_North]

Those bloods show you are very UNDERactive - hypo, not OVERactive - hyper. Any doctor who says otherwise needs to be fired. TSH ABOVE range - HYPO. Free t4 an free T3 OVER range = hyper. If you were told overactive , or given a diagnosis of hyperthyroidism in writing and didn't just mis-hear, make a complaint about your doctor, s/h eis dangerous and could kill someone by giving wrong treatment