Hi all. My hypo thyroid symptoms seem worse to me despite medication and my endo saying I'm in range. By 12pm I feel totally unmedicated?

[Shredder]

Hi I'm really struggling with my hypothyroidism since radio iodine treatment nearly two years ago. I started on Levo but found it difficult to tolerate finally giving up on it at 150mcg with itching, unbearable insomnia and huge weight gain. I went onto Naturethroid which was tolerated better and then WP which was great for me until they stopped producing . I then went to NP but I found these difficult to tolerate but did so until Naturethroid became available again. Unfortunately the current formulation made me feel unmedicated despite increasing the dose. I have finally resorted to you g back on Levo but even with Levo, feel unmedicated by 12pm plus my systems seem worse. I'm running out of hope. I'm a UK male by the way.

[SeasideSusie Remembering]

If you felt OK on NDT and you're only taking Levo now, then you are without the T3 that NDT contains. You could try adding synthetic T3 to your Levo.

It would help to see your latest test results, not only thyroid (TSH, FT4 and FT3) but vitamin and minerals as well - Vit D, B12, Folate and Ferritin.

[Scazzoh]

Hi Shredder, have you had your adrenals tested? High cortisol can impede thyroid hormone uptake. This link provides some useful information about getting tested and how cortisol affects thyroid hormones.

thyroiduk.org.uk/tuk/testin...

stopthethyroidmadness.com/a...

Don't run out of hope. There will be an answer, it's a case of working out what it is.

[SlowDragon Administrator]

You need to know if you have low vitamin D, folate, ferritin or B12

As you have had RAI you are likely to need small addition of T3

Suspect if you get full Thyroid testing you will have low FT3

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test FT3 and FT4 plus vitamins

Private tests are available

thyroiduk.org.uk/tuk/testin...

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 ideally 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. (Patient to patient tip, GP will be unaware)

Low vitamin D can be linked to insomnia

drgominak.com/sleep/vitamin...

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

[e-mail]

Also suggest you request list of recommended thyroid specialists some are T3 friendly

Professor Toft recent article saying, T3 may be necessary for many. Note especially his comments on current inadequate treatment following thyroidectomy or RAI

rcpe.ac.uk/sites/default/fi...

[Shredder in reply to SlowDragon]

Thanks very much for taking the trouble to reply.