Thyroid UK
90,481 members104,860 posts

Hypothyroid eyelid puffiness

Does anyone experience puffiness in your eyelid area when you've been underdosed on your hypothyroid supplement? I have spoken to one progressive M.D. and pharmacist in the US who recognized that I was still hypo (as indicated by some of my remaining symptoms) even though my T3 , T4, TSH, Free T3 and FreeT4 were all within range. The only indicator that something was amiss was my High Reverse T3 blood result and puffy (double eyelid flap), sluggishness and trouble sleeping.

12 Replies

Have you the thyroid results...what is 'in range ' for some medics, is not for us? TSH 1 or under for example? Occasionally I have puffy, itching, eyelids but don't put it down to thyroid undertreatment. What were you other symptoms? Do your medics look at Vit D, B12, folate and ferritin levels - need levels in top of range to be optimal; these plus Selenium for eg. Improve thyroid health, and help T4 conversion to active T3.


Yes, I retain all of my blood results. I suspect that I stopped converting ( on levothyroxine) . I recently learned that I need four labs at the minimum: ferritin, % saturation, serum iron, and TIBC. Even low ferritin along with optimal results in the other labs have caused problems with T3 pooling in the blood(?) I will also be taking a saliva Cortisol assessment. Just never heard 'double-eye flap' symptom from anyone else. It has always been an indicator of a hypo state for me.

1 like

I'm not sure that T3 'pooling' in the blood is an actual thing. I know they talk about it on STTM, but… And, in any case, it would have nothing to do with rT3. Yes, I know what they say about rT3 on STTM, but it's not right.

rT3 is one of those tests that tells you there's a problem, but doesn't tell you where it is. So very many things can cause high rT3 that it's really not worth doing the test. You could have a virus, or not be eating enough calories or have high/low cortisol, low nutrients. A common cause is poor conversion - having high FT4 and low FT3. But rT3 is the result of poor conversion and not the cause. However, if your FT3 is so high that you think it's pooling, it doesn't sound as if you have a conversion problem.

Perhaps it would be a good idea if you posted your latest results here, as you have them. That would give us a much better idea of what's going on. :)


T3Free 2.6 /2.0-4.4

T4Free 1.44/ 0.82-1.77

TSH 1.52/ .450-4.500

Rev T3 24.6/ 9.2-24.1

Cortisol 12.7/ 6.2-19.4

This was blood test from last month after having been on Synthroid for 2 years. Prior to that time I had been on Naturthroid for many years.


OK, so you're a poor converter, and your FT4 is high enough to explain the high-ish rT3. So, what you need to do is reduce the levo dose, and add in some T3, if you can. That will bring down your FT4 and your rT3, and increase your FT3, which is too low, and causing you symptoms. :)


Thanks for your info. :)


You're welcome. :)


I AM in need of B12! Thanks for the reminder! I've been out of it for a while and that may very well be contributing to my issue.


I had puffy eyelids and even puffy nose when I was on lower dose of levothyroxine but after increasing my dose of levothyroxine it's better than before, I still can't say it's completely gone though...


thanks for your reply. :)


I can't advise, being fairly new to this thyroid problem, so will leave that to the more experienced here. One of my main symptoms, besides being unable to concentrate, has been puffy eyelids. They especially seemed to swell up when using too much brain power, such as spending too long at the computer - especially trying to type - or being in a social situation and having to take part in conversation.

Thankfully I feel a lot better (especially after finally starting Levothyroxine). But a few weeks ago I was chatting with my neighbour and my eyelids started to swell quite suddenly. At the same time my scalp felt slightly swollen and kind of "Fizzy", especially at the back, and I was hardly able to concentrate enough to tell her how I was feeling and that I couldn't chat any more just then


Thanks for replying.


You may also like...