Hypothyroid, dizziness/ Nausea

[WeeB]

Hi,

Been on 50mg since nov 2018 which brought my tsh from 9.7 to 3.5 after 8 weeks. In beginning of may 2019 my tsh was 19.7. gp has put me to 75mg with view to see me in two weeks again, likely to put me up to 100mg. However, in may i did feel tired and had been having regular palpitations april and may . Went on medication around may 7th. my palpitations died down around may 28th. But since around may 30th i’ve had extreme exhaustion , concentration issues, constant dizziness , out of breath sometimes and waves of occasional nausea . i’m really struggling to work . in amongst this i’ve had 3 small chest pains to right side and one huge quick chest pain to the centre all on the one day . ended up at a and e with ecg , blood tests and x-ray , all came back clear . hospital told me my tsh is now 8.7. hospital planning to put heart monitor on me for 3 days just to make sure they haven’t missed anything , but the doctor said all symptoms could be related to thyroid and medication adjustment . What’s everyone else’s thoughts on my symptoms ? it’s coming up 3 weeks now of all new symptoms, a week since the chest pains , and previous palpitations have significantly calmed down 3 weeks ago so i only get mild feeling ones about once a day .

[Lynneypin]

Have you had your cortisol checked?

My adrenals were shot and it was only when I took adrenal support that the thyroid meds worked. I was always dizzy and sick. I’m not suggesting that’s your problem but without healthy adrenals your thyroid will struggle to cope with the meds.

[WeeB in reply to Lynneypin]

i don’t think they have been checked so i’ll tell go this, thanks

[Lynneypin in reply to WeeB]

I had to arrange my own cortisol test.

[Lynneypin in reply to Lynneypin]

Saliva.

[Angel_of_the_North in reply to Lynneypin]

However, NHS won't recognise saliva cortisol results

[Lynneypin in reply to Angel_of_the_North]

True. I was seeing a doc privately.

[jostafford0 in reply to Lynneypin]

Hi Lynneypin, can you please let me know what supplements you took to support your adrenals? Many thanks Jo

[Lynneypin in reply to jostafford0]

Nutri Adrenal Extra initially, now just one Nutri Adrenal a day.

[jostafford0 in reply to Lynneypin]

Thank you - Jo x

[McPammy]

Did you have your T4 and T3 tested as well your TSH level. All 3 must be checked. It’s worth having a 9am cortisol blood test to check your adrenals too. All vitamins need to be optimal B12, D, ferritin and folate.

It can take weeks even months for the thyroid medication to settle.

T3 is very important to check as you may not be converting T4 to T3 well. T3 is the only active hormone. T4 medication just sits waiting to be converted into energy T3.

[WeeB in reply to McPammy]

around january i think i got a medicheck result where t3 was 5.8 i think but nhs never test it and not sure they would even if i asked . i can’t afford regular private blood tests so need to be clever about when to check them privately so i can make the most of them. i’ll ask gp to check them but if they say no i guess now is good time to pay private. my folate was low in may so been on folate for 4 weeks or so . b12 is good as on injections , iron is good but gp won’t test vit d regularly ; i’m on vit d supplements as it’s been low in previous years but it was fine last summer .

[Newday64]

Your heart palpitations may be due to your high tsh (8.7). Your gp should increase your levo gradually, checking your bloods every 6 weeks till your tsh is sub 1. Hopefully the hospital checked your vitamins and iron levels? Check to see if your vit b12, d & iron were all above mid range.

For me, levo only made men exhausted and I experienced heart palpitations & anxiety as well. I was admitted to hospital where an endo reluctantly agreed to allow me to trial t3 only.

I had to start on a very low dose & build up gradually & it took me over a year to recover, but now I have a life & I'm very grateful!

I hope levo works for you, but if not, t3 may be the answer. Good luck x

[WeeB in reply to Newday64]

thank you , i have endo appt in august if all else fails over next few months . seeing gp in two weeks so will push for full bloods again . although i think hospital may have done full bloods so hopefully be able to speak to gp about everything sooner

[jgelliss in reply to Newday64]

Strength and Sympathy for you . It's awful to experience horrific symptoms . But I must say that hypo/hyper symptoms can over lap each other . That's why running labs is so important when one experiences and journals symptoms . BW is very helpful with symptoms .

[SlowDragon Administrator]

You will need to get thyroid levels retested 6-8 weeks after each dose increase in Levothyroxine

Make sure to stick to same brand of Levothyroxine at each prescription

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

Have you had thyroid antibodies tested ever?

If not request they are tested plus vitamin levels

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).

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that 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

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

[SlowDragon Administrator]

Just seen you have hemochromatosis and Hashimoto's

So important to regularly retest all four vitamins

Are you on strictly gluten free diet?

[WeeB in reply to SlowDragon]

i’m not yet , just a lot to manage and cutting out gluten seems such a big step , am i being daft here , is cutting out gluten a must ?

[SlowDragon Administrator in reply to WeeB]

First step is to get vitamin levels tested and make sure to get actual results and ranges

It takes 6 weeks minimum for each dose increase of levothyroxine to have effect

Gluten free diet helps thousands

You won’t know if that includes you, unless you try it

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a

diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

88% benefit from strictly gluten free diet

thyroidpharmacist.com/artic...

Going gluten free is a strategy that everyone with Hashimoto’s should try. In some cases, we see a complete remission of the condition; in other cases (88% of the time), the person feels significantly better in terms of bloating, diarrhea, energy, weight, constipation, stomach pain, reflux, hair regrowth, and anxiety.

todaysdietitian.com/newarch...

Many clinicians report that eating a gluten-free diet may help improve thyroid function in nonceliac gluten intolerance. “Getting gluten out is primary for patients with Hashimoto’s, even without celiac disease,”

If you don’t notice any improvement after 3-6 months gluten free- reintroduce and see if symptoms get worse

Ideally get coeliac test first

Retest antibodies before restarting gluten - often antibodies have dropped a lot while strictly gluten free

[WeeB in reply to SlowDragon]

thank you . better set a date to start this

[SlowDragon Administrator in reply to WeeB]

Before I went strictly gluten free I spent couple weeks assessing what I would eat instead at each meal

Then cleared out all gluten containing products out the cupboard

It seems daunting at first, but assuming you notice reduction in symptoms, as many of us do, then it's easy to stick to

[jgelliss in reply to WeeB]

I experienced personally many benefits with going gluten dairy free .

[Hidden]

Your doctor should have increased the Levo every six weeks until your TSH came down to around 1. You have been left too long on the small dose your body wonders what's going on. You can follow the advice of the others making sure your cortisol and other Vitamins and Minerals are at the correct level. Unfortunately we have to look after ourselves, shame it's a good thing that we have each other.