Hi I had a dose increase from 25mcg levo to 50mcg last week for hypothyroid diagnosed 2011. Is it normal to have symptoms of sweating. This has been happening even before diagnosis but I am worried it is a hyperthyroid symptom?
I made the mistake of reducing my dose of 150mcg levo and took myself off levo for 6 weeks on the advice of an endo who said the sweating was likely a thyrotoxic symptom.
Other symptoms - hyperpigmentation around eyes, disturbed sleep, reduced appetite, weight gain, tiredness, breathlessness, constipation, feeling cold. Also concentration not great. Thanks for reading
Ah, an endoknob. The world seems to be full of these jumped up diabetes specialists calling themselves endos. You most definitely weren’t thyrotoxic with a TSH over 4!
As you’ve had higher doses of levothyroxine quite recently you may be able to increase faster than if you were starting out. What’s your plan for increasing your dose?
It takes a while for levothyroxine to build up in your system. I think - but I’m going to tag in SeasideSusie for her opinion - you could probably raise to 75mcg now, then stick there for a month or so. Then ask your GP to run some blood tests to see where you’ve got to and decide whether and when to raise again. You shouldn’t have to make these decisions alone.
75mcg is really unlikely to overmedicate you, and some people are started on that dose from day one, so I think you’d be ok. I think it’s much more likely that the sweating is a symptom of undermedication than overmedication.
I empathise. I had profuse sweating. I was toxic from levothyroxine. I had got antibodies too. I did feel very unwell symptoms as you have, including hyperpigmentation.
I also suffered palpitations and trembling...
However, my tsh was <0.01 at that time.
I think you must be guided by your Endo. Let us know how you get on. I wish you luck.
Hyper-pigmentation coupled with those symptoms sounds like low adrenal function - have you been tested for Addison's or similar (MRI or CT scan, Insulin stress test, ACTH test)?
As advised in replies on your previous thread, your raised antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where the antibodies attack the thyroid and gradually destroy it.The antibody attacks cause fluctuations in symptoms and test results and this is why you have been having "hyper-type" symptoms such as sweating.
As advised on your other thread, adopting a strict gluten free diet can help reduce the antibodies, as can supplementing with selenium l-selenomethionine 200mcg daily and keeping TSH suppressed.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. Your endo is probably a diabetes specialist, most of them are, and know little to nothing about thyroid and probably even less about Hashi's. You need to read, learn, understand and help yourself where Hashi's is concerned.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies, as can be seen with your results.
Ferritin 21 (30 - 400)
What is your GP doing about this? It is below range, low enough for your to need an iron infusion. Also, low ferritin can indicate iron deficiency anaemia so you need a full blood count and an iron panel.
If given iron tablets then take each one 4 hours away from thyroid meds and 2 hours away from any other medication and supplements as it affects their absorption.
For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.You can also help raise your level 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...
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Folate 2.6 (2.5 - 19.5) folic acid since 2016
You need to ask your GP why, after 2 years of supplementing with folic acid, is your level just 0.1 over the bottom of the range. It's pretty obvious it's not working for you.
Vitamin B12 201 (190 - 900)
Were you ever checked for signs of B12 deficiency? Check now b12deficiency.info/signs-an... List any that you have then speak to your GP. You should be tested for B12 deficiency/pernicious anaemia and you may need B12 injections.
Taking folic acid can mask signs of B12 deficiency so you should stop taking it until all investigations have been carried out and any B12 supplementation in any form has started.
I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
And an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
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Vitamin D 52.2 (50 - 75 suboptimal)
I take 800iu vit D since 2013,
Again, supplementing for 5 years and you are still in the suboptimal category. What on earth is your doctor doing, certainly not looking out for you.
The Vit D Council recommends a level of 100-150nmol/L and I would suggest you buy your own D3 to help raise your level. As you have Hashi's then an oral spray gives better absorption. I would buy BetterYou 3000iu strength and take 6000iu daily for 4 weeks then reduce to 3000iu daily. Retest 3 months after starting it.
When you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3 as recommended by the Vit D Council -
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
Sweating is a symptom of both under and over medication and adrenal problems (being under medicated stresses your body) and peri menopause. Your Dec results show undermedication, but you'll need to start again at 50mcg and work up, so you'll feel rotten for a few months.
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