I had half my thyroid removed in 2014 for an inconclusive nodule and have not been on any medication since then. All results still in mid-range (TSH about 1.5 (although has gone up as far as 2.5 sometimes) FT4 15-16 and FT3 anything from 4-5.7. TSH ALWAYS 0.66-0.68 before operation.
Feeling ok generally, energy ok, no weight gain (don't want to speak TOO soon! ;-)) but main symptom seems to be persistent low mood/depression. Just not who I used to be. I think is partly due to the trauma of the operation (Was out of the blue, told I probably had cancer) and partly lower levels of thyroid hormones...?
I have been on HRT for 5 months to see if it would help (am 47 and peri-menopausal) but it hasn't, and I am going to come off it, as constant bloated tummy/bleeding (intolerant of progesterone taken orally, although could try mireena coil instead).
I have now asked my G.P for low dose thyroxine-25mg, which she has prescribed me, purely to see if it will make a difference to my depression. Realise is a low dose, but not sure a higher dose is warranted, as no other symptoms apart from depression/apathy and very ridged/brittle nails and results mid-range.
My main concern is that the 25mg might make me worse, and somehow reduce my existing half a thyroid function (i.e might make it lazy and less effective). I realise it might only really make a difference if it increases my FT3. My alternative is going back on anti-depressants, which did seem to help (although normal side effects, no libido, interrupted sleep etc) but this time for life...
Would be really grateful for your thoughts.
Thanks v much,
Sarah
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Salsa2014
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Yes you may find 25mcg helps initially.....then as you are on this tiny dose and body gets use to it....if symptoms return it's likely you need further 25mcg dose increase
Standard starter dose is 50mcg.
Bloods should be retested after 6-8 weeks on each dose of Levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
Sounds like you may have raised antibodies, if levels fluctuate. Ask GP to test thyroid antibodies and vitamins, or if they are unhelpful get private testing
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
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.
Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.
Thanks very much SlowDragon-v comprehensive answer! I know I don't have anti-bodies/hashimotos. Have been tested previously.
Is perplexing as only symptom really depression and all results mid-range. Just trying to decide whether to be on anti-depressants indefinitely or whether depression caused by lowered thyroxine levels, hence the 25mg. Don't want to make things worse with low dose, as have read somewhere better of taking nothing than v low dose.
I also considered sourcing NDT privately and just taking half a tablet daily to boost mood.
Thanks again SlowDragon-I know I was tested as I requested it but not sure both done....
What's the difference between the two and are they both linked to Hashimotos? (I had a 4cm follicular adenoma nodule on left thyroid lobe hence the hemithyroidectomy).
Thyroid levels were all in range before op though, and FT4 levels comparing both then and now seems broadly similar. (Don't know re FT3 as they never measured it before op). TSH was 0.66 prior to op and is now about 1.5 (right lobe seems to be working twice as hard, which I guess is to be expected!)
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