Hello, I'm new here and if i'm honest i'm really struggling right now.
I'm 26 and at Christmas 2018 I was told I had hypothyroid, I have been taking 50mg every morning since January 2019 and all was fine till 3 weeks ago I needed dental work - i needed a filling. As soon as the filling was done I came out feeling really really shakey. I had some sugar (incase it was low sugar) but that didn't help. I managed to drive to work but definitely did not feel good, I spent the whole day not feeling 100% and when I got home I spoke with 111 and they said get seen as soon as possible. So the next day I went to minor injuries and they sent me to A&E, I was discharged the same day with some antibiotics (they had no idea).
The following day I went to see my GP and they said maybe its anxiety (I'm least anxious I've ever been (other than a little worried about what's wrong with me)). The next week my GP rang and said my thyroid was now alot higher than before and to reduce to 25mg (and if tremor didn't reduce to cut levothyroxine completely the following week). I've now had a week of no levothyroxine, one GP said I could have a blood test to see if its helped - a different one has said they can only check blood every 6 weeks?- does anyone know if this is true?
I'm fed up, I can cope with the constant shaking just about but I've been getting really bad brain fog and I don't know how to clear it and it's having a negative impact on my life.
I guess my questions are:
Can thyroid only be checked every 6 weeks?
Can an adrenaline shot in local anesthetic cause your thyroid to go hyperthyroid?
It may not be related to the thyroid, if it gets worse see a doctor. Hyperthyroidism causes a fine tremor in the hands if you hold them out in front of you. This is not your whole body shaking, just the hands. The idea of checking thyroid blood tests after six weeks is that it gives a change in dose time to settle down. Thyroxine has a half life of one week so after six weeks the body will have accumumlated 98% of a dose increase, which is better than the accuracy of the test. Six weeks also gives the TSH plenty of time to settle down as it doesn't react very quickly. However, there is no requirement to wait six weeks to run a blood test, especially if the new test is a bit different.
I would ask for copies of your blood test results and post them here. It could be that you have autoimmune thyroid disease and this can give erratic levels of secretion. In this case your doctor should test for TSH, fT3, fT4 and preferably antibodies. It is very important that fT3 is measured in this case. The labs often refuse to do the fT3 assay so your doctor needs to write very clearly that the fT3 must be done.
Local anaesthetics usually contain adrenaline. It is possible to have dental anaesthetics without adrenaline in (if you ask) but dentists don't like using them because they don't last as long as anaesthetics which contain adrenaline and they aren't as effective in terms of numbing the mouth.
It can be a shock to the system to have a reaction to a dental anaesthetic, because people generally aren't expecting it when it first happens. However, in future you can ask for an injection without adrenaline, or just be prepared for the shaky reaction which will wear off by itself in an hour or two.
There is a connection between adrenaline, cortisol and the thyroid. The body uses cortisol and adrenaline as "substitutes" for thyroid hormone when hypothyroidism is untreated or under-treated. When people are properly treated their cortisol and adrenaline levels should return to normal. However, if they have been untreated or under-treated for a long time the return to normal levels of cortisol and adrenaline may take a long time, or in the worst cases may never return to normal.
Another consideration is that in people who have autoimmune hypothyroidism (also known as Hashimoto's Thyroiditis) their levels of thyroid hormone will fluctuate. If your levels were found to be high this is not uncommon in the early days of the disease. Your levels may be low again in a few days or weeks. Eventually the low levels of thyroid hormones become permanent.
Just in case you weren't aware...
Hypothyroidism : High TSH, Low Free T4, Low Free T3
Hyperthyroidism : Low TSH, High Free T4, High Free T3
If a doctor ever mentions that your thyroid levels are high, make sure you ask which levels they are talking about i.e. are they talking about TSH (which is a pituitary hormone, not a thyroid hormone), or are they talking about Free T4 which is produced by the thyroid, or are they talking about Free T3 which is partly produced by the thyroid and is also created by various tissues throughout the body by converting T4 into T3.
Bloods should be retested 6-8 weeks after each dose increase
Do you have results you can add?
If left too long on low dose, body has to try to adapt and one way is start to live off adrenaline. Adrenals can get over worked and become very over sensitive.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
If vitamins are too low, TSH tends to drop regardless of how hypothyroid you may be
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Medichecks currently have an offer on until end of May - 20% off
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
NHS guidelines on Levothyroxine including that most patients need somewhere between 100mcg and 200mcg Levothyroxine. Also what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.
This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.
You are legally entitled to printed copies of your blood test results and ranges.
UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
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Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Hypo you hyper?
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Hypo or hyper?!?
Hypo to hyper...
