Swollen fingers and sore fingertips

[Jillycee]

Sorry, me again!!

Just wondering if anyone has any knowledge about swollen fingers/hands? I have Hashimotos, take 100mcg of Levo and also take B12 and B complex, Vitamin D and K2. I have been on a gluten free diet for 2 years.

All of a sudden, when I am walking, my hands have started swelling quite a lot. I have also noticed for the last two weeks my fingertips feel like I have burnt them all and are quite sore all of the time. I also have a small blister type thing appear on two fingers.

I have booked another appointment with my GP on Thursday, only to find out what I can do to stop the burning sensation.

Any advice would be greatly appreciated.

Many thanks

[SlowDragon Administrator]

Ask GP to run full Thyroid evaluation. So you need TSH, FT4, TT4, FT3. Plus vitamin D, folate, ferritin and B12.

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Have you had recent change in brand of Levo?

Or been glutened?

[Jillycee in reply to SlowDragon]

Thanks SlowDragon. My GP won't run anything other than the TSH test, so I have them done privately every 6 months. I had them done in April and have been advised on here before to stop taking my Levo until after my test, so I did do that. However, I didn't stop my B Complex, so will try that next time.

I am on the same brand of Levo as normal and I try really hard to be 100% gluten free and can guarantee I am at home, but of course I can't be 100% certain when I'm out.

Ive attached my last results at the top of the post

Many thanks

[SlowDragon Administrator in reply to Jillycee]

These results would suggest you are under medicated. Suggest you ask for 25mcg dose increase

TT4 is very near bottom of range, as is FT4. FT3 is also too low

Your folate is dire. Does your vitamin B complex contain folate or folic acid.

Vitamin D too low as well, should be nearer 100nmol

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]

Professor Toft recent article saying, T3 may be necessary for many

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

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

[Jillycee in reply to SlowDragon]

Thanks SlowDragon. I will speak to my GP about an increase. I have tried to show her the article from the pulse magazine before but she said she didn't have time to read it!! After looking at the shock on my face when she said that, she did agree to give me an increase in Levo, but said that she would put it in my notes that she didn't agree that I needed it!! That's why I'm a little nervous going to my GP about anything now.I was advised on this forum that my folate was too low, and when I looked at my B complex, It does have folate in but I was only taking one tablet a day and I should have been taking two, so I have now increased this. I do normally take Vitamin D just through the Winter. Should I continue through the Summer also? I am going away next week for some sun, so hopefully that will help.

Thank you for all of the info