Hi I just wanted to know if what I am feeling could be related to having my thyroid removed...
I had a completion TT over a year ago, currently on 100-125mg Levothyroxine daily.
I’ve always been a sensitive/emotional person, quite insecure and self conscious, however sometimes I get so down/ sad for the littlest of reasons or no reason at all. Some days I don’t even feel myself I can be so happy one minute and then so low the next.
I just wondered if anybody felt this too? I wondered if it would be anything to do with thyroxine hormones.
Any insights would be helpful xx
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You are on quite a low dose of levo for someone who has had total thyroidectomy. What are latest blood test results? Are you undermedicated? Are you absorbing Levothyroxine adequately?
Yes, I recognise in your description the emotional rollercoaster I've been through. And that was only when my levels were stabilised...before I was only a walking mess.
At some point I have realised that that was not me, I'm also a sensitive, emotional individual but I've never before that been emotionally unstable or depressive. Only then I started to look elsewhere for solution and changed approach and treatment.
Resemblance of symptom is high but please remember that we all are different and what works for some might not work for others. But in my case it was poor treatment management.
That is the way I feel when I am undermedicated. I had a TT 22 years ago and each time I was undermedicated I felt sad and lost interest in everything When I have been overmedicated I am the complete opposite i.e. panic attacks and nervous. I find the best guide I use is how my bowels are. I become very constipated when I am undermedicated and get a very dry skin. The opposite happens with my bowels when I am taking too much.
If FT4 is high but in range it's not a problem. FT4 is best in top third of range. more important is FT3. If FT3 is over lab range then you would likely want to reduce meds slightly to bring back into range. As NHS rarely tests FT3 the doctor is hitting in the dark. FT3 is best in top third of range.
You sound undermedicated or FT3 is too low but you need a blood test to find out. Too low or too high FT3 gives indication of problem. TSH levels in NHS are based on healthy people without thyroid conditions and may not be a reliable guide to dosing for thyroid patients. There is a disconnect between thyroid hormones foe people with reduced thyroid volume. Read papers by Dr Midgeley and team. Sorry, I don't have links to hand.
Find Scientist, Diogenes' profile on this forum and read the research papers.
Do you have your most recent test results and ranges, if so can you add them
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 at
tukadmin@thyroiduk.org
Also you might request list of recommended thyroid specialists
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
(But especially after thyroidectomy likely to need TSH at lower end and probably under one)
Professor Toft recent article saying, T3 may be necessary for many. Note especially his comments on current inadequate treatment for patients following RAI or thyroidectomy
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
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. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or new prescription
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