I take 25mcg levo

[Emerald27]

Newbie

When to feel better on this please

Diagnosed in Nov 2017 with hypothyroid

Symptoms list

Shaking

Feeling cold

Depression

Tiredness

Pins and needles in feet

Easy weight gain

Puffy ankles

Thank you for reading

[greygoose]

Hi Emerald27, welcome to the forum.

I'm sorry, but you're never going to feel well on 25 mcg levo. It's too low a dose - not even a starting dose. Have you been on 25 mcg since Nov 2017? When were you last tested?

[Emerald27 in reply to greygoose]

Thank you I was on 25mcg to start with and then 50mcg 3 weeks after that. Then my levels went a bit strange with my TSH below range in Dec and then again in Feb. I have bloods under the following dates:

OCT 2017

DEC 2017

FEB 2018

APR 2018

[Emerald27 in reply to greygoose]

OCT 2017 (DIAGNOSIS)

TSH 23 (0.2 - 4.2)

FREE T4 10.1 (12 - 22)

FREE T3 2.7 (3.1 - 6.8)

DEC 2017 25MCG LEVO)

TSH 0.03 (0.2 - 4.2)

FREE T4 20.1 (12 - 22)

FREE T3 4.2 (3.1 - 6.8)

FEB 2018 (50MCG LEVO)

TSH 0.02 (0.2 - 4.2)

FREE T4 25.6 (12 - 22)

FREE T3 4.1 (3.1 - 6.8)

APR 2018 (25MCG LEVO)

TSH 4.5 (0.2 - 4.2)

FREE T4 17.2 (12 - 22)

FREE T3 3.2 (3.1 - 6.8)

[Emerald27 in reply to greygoose]

Last tested on Monday this week

[greygoose in reply to Emerald27]

Well, in April, there, you were very under-medicated.

Is your doctor testing every four weeks? That's too soon. Better at 6-8 weeks, otherwise, it gets very confusing.

Also, you have a conversion problem. But just adding more levo is not the solution because, as you can see, the higher your FT4, the worse your conversion. What you need is some T3 added to your levo, and for your doctor to dose by the FT3, not the TSH.

[Emerald27 in reply to greygoose]

Every 8 weeks I get tested. Thanks

[Emerald27 in reply to greygoose]

Also TPO antibodies 286 (<34) were checked in Dec 2014 before diagnosis

[greygoose in reply to Emerald27]

OK, so you have Hashi's. In which case, you need to keep your TSH suppressed - how much do you know about Hashi's? Has it been explained to you?

[Emerald27 in reply to greygoose]

Hi no Hashis hasn't noticed explained to me at all. I know very little about it

[greygoose in reply to Emerald27]

OK, so Hashi's is an autoimmune disease, where the immune system attacks and slowly destroys the thyroid.

After every attack, the dying cells release their stock of thyroid hormone into the blood stream, causing the levels of the Frees to shoot up - FT4 around 30 something, FT3 around 11/12 - and the TSH therefore drops to suppressed.

There is no knowing how long these high levels will persist, but eventually, they will drop by themselves as the excess hormone is used up or excreted, and not only will you become hypo again, but slightly more hypo than before, because there is now less thyroid to make hormone.

Therefore, it's very important that your doctor does not reduce your prescription, because you’re going to need it again! If you start to feel over-medicated at that point - some do, some don't - the best thing is to stop levo for a few days, then, when you feel hypo again, start taking it again. It's very important to know one's body, and how it reacts.

There is no cure for Hashi's - which is probably one of the reasons that doctors ignore it - apart from the fact that they know nothing about it, of course! But, there are things the patient can do for him/herself.

a) adopt a 100% gluten-free diet. Hashi's people are often sensitive to gluten, even if they don't have Coeliac disease, so stopping it can make them feel much better, and can often reduce the antibodies.

b) take selenium. This not only reduces antibodies, but can also help with conversion of T4 to T3 - something that Hashi's people often find difficult.

c) the best way to even out the swings from hypo to 'hyper' (often called Hashi's Flares, but that doesn't really sum up the way it works) is to keep the TSH suppressed. This is difficult because doctors are terrified by a suppressed TSH, for various false reasons, and because they don't understand the workings of Hashi's. But, TSH - Thyroid Stimulating Hormone (a pituitary hormone) - tries to stimulate the thyroid to make more hormone, but it also stimulates the immune system to attack. So, the less gland activity there is, the less immune system activity there will be, meaning less attacks, gland destruction slowed down and less swinging from hypo to hyper and back.