Hello everyone. I'll try not to waffle on too much in this post but I wanted to give at least as much of the story as is needed as I'd like to ask for opinions on what to do next as I don't know what to do.
For info, I'm a 37 year old male.
About three years ago I was diagnosed with Hashimoto's hypothyroidism. Since then, I've been returning for blood tests and increasing the dose of levothyroxine by 25mg roughly every 3-6 months (NICE guidelines seem to recommend waiting 4 weeks between tests as far as I can see but my doctor seems to think every three months at least is better).
I'm now on 200mg of levo and have been for six months. After the first three months of a 200mg dose the TSH levels were still above normal and I feel as though the general levels of tiredness haven't really gone. So I was hoping that when I had another blood test and if the TSH result were high again, I might be referred to an endrocrinologist and I'd hoped to maybe start T3 treatment.
Three months ago my test results were:
Free Thyroxine: 17.3\E pmol/L 12-22
TSH: 4.8 mU/L 0.3-4.2
At my most recent test, the TSH had fallen to 3.7 bringing it into the 'normal' range.
This has complicated things somewhat for me, and left me a little confused for several reasons I'll try to organise below, sorry if it's a bit muddled.
I still feel pretty terrible. There's a general feeling of tiredness but occasionally I'll have an episode of much higher levels of tiredness. I had one of these episodes a day or two after the last blood test. Interestingly I have also had one of these episodes just before a blood test once before, and that was the only other blood test that came back with a 'normal' TSH. I wondered if there could be a possible link between episodes of high levels of tiredness and a low TSH or whether it's simply coincidence?
The other issues are that in the three years since diagnosis, I've piled on about six stone. If I'm honest, I wouldn't say it's entirely to do with the thyroid issue, but attempting to lose weight has been near impossible.
Also, my diabetes results have gone from being quite a way below normal, to being pre-diabetic.
My cholesterol level has gone from being quite a way below the upper normal threshold to being something to start worrying about (I've been a vegetarian for two decades and if anything, my diet has improved considerably this last year).
My blood pressure has also gone from being quite firmly in the middle of the normal range to being rather high. So much so, that I had to start on a blood pressure medication as soon as possible (this was started about a week before the last blood test, although I'm not sure it should affect the result?).
Whilst my blood pressure has dropped slightly, my resting heart rate has gone from about 60-70bpm to 80-90bpm which the doctor has told me I shouldn't focus on. Instead I should focus on trying to lose weight, something that's proving to be quite tricky.
I'm worried that being under-medicated for some time has started to affect other things, like the cardiac system, and I would really like to address the root cause of the issue.
I've considered ordering T3 or NDT myself, but I could just be confirming my own bias that these things are what I need, rather than going on the available evidence (which is that my TSH is now normal). So, should I just wait another six months for another blood test and see what the results might be (although should the TSH go up again I've suffered another six months worth of damage by being under medicated) or should I attempt to medicate myself and see what the results would be?
It's awfully confusing, but thank you for any assistance you could provide.