Thyroid UK
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Hi my name is Tisha, I am a 19 year old female and I have had a lot of physical symptoms since I was about 10.

I was diagnosed hypothyroid Christmas 2017 and I take 125mcg Levothyroxine moved up from 100mcg in April 2018 and in January 2018 was on 125mcg, so I have been on my current dose for a few more weeks than expected for me to be fitted in for blood tests. I am due my retest next week to see how I am feeling and how my levels are doing. I was told back in January 2018 my levels on 125mcg Levothyroxine were unacceptable and so a reduction by 25mcg was given.

My results done in April 2018 were I was told ok but I knew myself that I didn’t feel right as seen below. I was losing concentration, becoming anxious, getting harder stools; periods tiring me, becoming breathless, losing hair and my ankles became more prone to swelling up before my current period which has never happened before. I was tempted to ask for over the counter water pills but I am glad I didn’t since my ankles have now gone back to normal size after my period started though I do get a lot of unsteadiness and irritability during monthly bleeds and blood literally pours out of me.

I am still very slim and I have learned that being slim and hypothyroid is not as common so I would love to gain a bit more weight if possible. At the start of last year I weighed 45kg. As of 2 weeks ago I am 56.9kg but my body mass index when calculated allows me to go up to 64kg and I have been told by friends I could do with a bit more meat on my bones! Any help with this at all would be great as I feel I am destined to spend the rest of my life as a skinny Minnie! My diet isn’t exactly great as we have limited income to make anything from scratch and my partner has said he has a better feeling about what he wants to eat the same day, so we do not plan in advance what we eat. Also my digestion is very poor in the mornings and I can only have something like a cup of tea with lactose-free milk, dairy free milkshake or a small glass of water without getting any upset stomach. I get very hard stools when I eat anything early in the morning so I tend to skip breakfast. My digestion “wakes up” around about 10-10:30am which probably sounds odd. It does to me anyway!

I also have suspected oestrogen dominance, polycystic ovarian syndrome, low DHEA, low magnesium, iron deficiency, folate anaemia, low B12 which is being treated with 3-monthly injections and vitamin D deficiency. I have been on the vitamin D for 5 years; iron currently being treated with 2-yearly IV iron. I had endometriosis for a number of years after starting periods but this isn’t as frequent now, I haven’t had it since May 2017. I get a lot of hypoglycaemia and so my blood sugar spikes a lot. After I eat something very sugary and calorie dense I get sugar highs and then a crash less than hour later where I need to sleep and then wake up with pounding headaches. I think that is hypoglycaemia? I am surprised diabetes was ruled out despite a very strong family history of it (mum, gran and uncle) and my mum has Cushing’s Disease, Multiple Sclerosis and hypothyroidism. Family history is also strong for stroke, high blood pressure, high cholesterol, aneurysms and heart disease.

Any advice appreciated, thank you!

JANUARY 2018 (125mcg)

*TSH 0.03 (0.2 – 4.2)

*FREE T4 25.1 (12 – 22)

FREE T3 4.7 (3.1 – 6.8)

APRIL 2018 (100mcg)

*TSH 4.21 (0.27 – 4.20)

Free T4 17.5 (12 – 22)

Free T3 4.3 (3.1 – 6.8)

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Hi Tisha, this sounds very complicated and I don't know if I can help. You probably are hypothyroid and taking levothyroxine has brought down your TSH and really elevated your FT4 which goes into storage. Your liver, etc. converts T4 to T3 or reverse T3 but you are not getting the full amount from all the T4 your first tests show. The reduction in dose brought everything down including the active FT3 and now you have hypo symptoms. When your thyroid is being attacked (usually it's an autoimmune issue) your adrenal glands have to make up the loss of thyroid hormone.

Your adrenal glands use cholesterol to make other hormones (sex hormones and steroids) and when you mentioned the high fluid, Ray Peat is an authority on this and says:

"Even before aldosterone was identified, progesterone's role in regulating the salts, water, and energy metabolism was known, and after the functions of aldosterone were identified, progesterone was found to protect against its harmful effects, as it protects against an excess of cortisol, estrogen, or the androgens." I think this may cause low progesterone levels.

Autoimmune attacks against the thyroid are sometimes caused by gluten or dairy but taking hormone like T4 needs assistance to become active thyroid or T3. High cortisol can stop that conversion and also stop digestion. Low iron can also defeat the conversion. Your stomach may not be producing enough acid to make B12 and other minerals so it all begins in the gut. Another culprit is unsaturated fatty acids, those are vegetable fats which are cheap and plentiful and probably in most restaurant food.

This man has many really informative videos about hormones.

*THYROGLOBULIN ANTIBODY 275 (0 - 115 NEGATIVE)

*THYROIDPEROXIDASE ANTIBODY 805.5 (0 - 34)

*FERRITIN 27 (30 - 400)

*FOLATE 4.1 (4.6 - 18.7)

VITAMIN B12 242 (190 - 900)

*VITAMIN D 40.6 (<25 Severe vitamin D deficiency. Patient may need pharmacological preparations. 25 - 50 Vitamin D deficiency. Supplementation is indicated. 50 - 75 Vitamin D may be suboptimal, and long-term may lead to clinical affects. Advise on safe sun exposure and diet. Supplementation may be indicated. >75 Adequate vitamin D)

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