Spotty face

[FarmerDJ]

Does anyone else get spots appearing on their face with high TSH readings. Just started 150mcg of levo.

Current TSH 80

Current FT4 9.8

Wondering if this is related as never had spots before.

[greygoose]

It can be related, yes. Un/under-treated hypo can cause acne.

[FarmerDJ in reply to greygoose]

And theres me thinking I was becoming a teenager again 🤣

[greygoose in reply to FarmerDJ]

lol Oh, you wouldn't really want that, would you?

[FarmerDJ in reply to greygoose]

Definitely not! Lol

[NWA6]

Yes I used to get break outs. They were spots but hard and rounder than spots that eventually got a head but just so ugly 😔 I told my GP that this is one of my symptoms specific to me and she said, no I don’t think so you’d probably only relate spots to HYPERthyroidism. It was all I could do not to roll my eyes at her. We had so many ‘arguments’ because of her inane ability to dismiss every goddamn symptom as not relevant.

Have they started you straight on 150 dose? How does it feel?

[FarmerDJ in reply to NWA6]

I was started on 100mcg as my T3 and T4 dropped to zero 3 weeks after radioactive iodine treatment. 4 weeks later it was increased to 150mcg as I was still getting leg pains and feeling generally unwell. In 2 weeks I'll have a further blood test.

[FarmerDJ in reply to NWA6]

Maybe the spots and boils are due to having a compromised immune system... just a thought. I feel a bit better in myself on 150mcg levo but its early days, almost 2 weeks into the dose, so will know better as it settles. Certainly the cramps in my feet and hands have reduced.

[NWA6 in reply to FarmerDJ]

I think they arrive because of an overall sluggish system. Despite having Hashi’s for over 10yrs and being Hypo to some extent or other for that period (because I needed T3 too) I have had the most amazing immune system. It became a running joke that I never get any virus’, no colds, no V&D nothing, I’ve never even had flu ever on my entire life.

[FarmerDJ in reply to NWA6]

Wow lucky you.. I was always hyper with graves until they decided I needed RAI.. and felt like shite ever since being hypo. Happy days lol

[NWA6 in reply to FarmerDJ]

My sister was Hyper, that was interesting 😉 me on the sofa sleeping and her running around like a loon 😂

[SlowDragon Administrator in reply to FarmerDJ]

Bloods should be retested 6-8 weeks after each dose increase in Levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low B12 can cause acne

Low vitamin D sore joints/feet

Low vitamin levels are extremely common

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).

Guidelines on Levothyroxine dose is approx 1.6mcg Levothyroxine per kilo of your weight.....but some need more, some need less

Getting vitamins optimal can improve conversion of FT4 to FT3

Have you tried strictly gluten free diet?

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and reduce symptoms

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet




(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

Always get actual results and ranges on all blood tests and keep good record of what you were taking and how you felt at each test

[FarmerDJ in reply to SlowDragon]

I do my bloods fasting and takes meds after each test. As I'm from the uk, the GPs and endocrinologists keep all the test results online so I dont get a copy, they just highlight the issues to me and give me supplements where necessary.

[SlowDragon Administrator in reply to FarmerDJ]

This is UK based forum

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.

Many of us didn't make progress until we did this

Absolutely essential to see exactly what has been tested and equally important what hasn't been tested yet

Also vitamin levels need to be at optimal levels for Levothyroxine to work well

Do you need actual results and ranges

Eg B12 range is typically 180-780. GP would say B12 was fine if result was 210 or 690. Many patients on Levothyroxine need B12 over 500

Similarly vitamin D. Rarely tested. Yet is often low when hypothyroid. Vitamin D only needs treatment by GP if result is under 50nmol. (NHS use to have to treat if result was under 80nmol....but range changed to cut number they were obliged to treat)

self supplementing vitamin D recommended to keep vitamin D at least around 80nmol and around 100nmol may be better

[FarmerDJ in reply to SlowDragon]

Thankyou for this information it is most helpful. I will request copies in future so I can see for myself.

[SlowDragon Administrator in reply to FarmerDJ]

I only discovered, when I finally got access to my historic results in 2015 ...I had had severe vitamin D deficiency for years....was never even aware it had been tested .....was never told results or prescribed vitamin D.

Getting vitamin D optimal was key to my own progress...... turned out to be gluten intolerant, confirmed by endoscopy and deficient in B vitamins and magnesium...more info on my profile

Wouldn't have made any progress without this fantastic forum

[FarmerDJ in reply to SlowDragon]

It's an absolute godsend into fully understanding our conditions and shared experiences. GPs and endo's are so busy that we barely get time to talk to them before they are throwing us out the door for the next person.

[SlowDragon Administrator in reply to FarmerDJ]

Yes...always keep good record of your results and dose of Levothyroxine, plus how you feel

An excel spreadsheet showing results overtime can be instructive

Ridiculously thousands of thyroid patients are forced to get full testing privately as NHS rarely tests FT3 (even if patients are on T3!)

[SlowDragon Administrator]

Do you always take Levo on empty stomach and then nothing apart from water for at least an hour after. ?

Many take Levothyroxine early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

verywell.com/should-i-take-...

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.

[FarmerDJ]

I always take it first thing in the morning with some peppermint tea (not green tea) and leave other medications until lunchtime. I can be a bit of an evening eater so night meds would be harder to manage.

My 100mcg is Almus (Actavis)

My 50mcg is Teva (only just started these 2 weeks ago)

The spots were appearing while just on the 100mcg

[SlowDragon Administrator in reply to FarmerDJ]

Teva brand upsets thousands of people

It's a Marmite brand in that many hate it but a few (usually lactose intolerant) love it

healthunlocked.com/search/p...

If you feel Teva is upsetting you get new prescription for 50mcg asap and get "no Teva" added to all future prescriptions

Teva contains mannitol, research suggests it changes gut flora

bmj.com/content/360/bmj.k71...

Always stick to a brand that you know doesn't upset you

Personally I would only take Levothyroxine with water, not peppermint tea "just incase" it affected absorption

[FarmerDJ in reply to SlowDragon]

The bloating was occurring, although milder, when I was hyper and on carbimazole. This got worse while off all meds awaiting RAI for 5 weeks. 2 weeks after RAI I went into a zero reading of T3 and T4 and the bloating was terrible, had sight problems, tongue ulcers and couldnt walk (coordinate movement) properly so they started me on 100mcg of the Almus Brand levo. It's hard to pinpoint exactly when the spots started to occur but it was around the time I started dropping T3 and T4 I think.

[SlowDragon Administrator in reply to FarmerDJ]

Bloating is extremely common. Often strictly gluten free diet helps improve gut symptoms

See you are trying Apple cider vinegar. Literally thousands of posts on here about low stomach acid

Low B12 common issue...doesn't always show up in blood test.

Strongly recommend getting all four vitamins tested....plus TSH, FT3 and FT4 are absolutely essential

Important to do blood tests as early as possible in morning and fasting and last Levothyroxine dose 24 hours before blood test

Research shows 20% Patients with no thyroid can not regain full health on just Levothyroxine

ncbi.nlm.nih.gov/pmc/articl...

But before considering adding any T3 all four vitamins must be optimal and if gluten is a problem, strictly gluten free diet too

The only way to know if gluten is an issue for you is to try without it and see if symptoms improve

But only do one thing at a time

First step, probably to get Activis 50mcg

Then test vitamins ...if any need improving only add one supplement at a time, waiting at least ten days to assess before adding another

Email Dionne at Thyroid Uk for list of recommended thyroid specialist endocrinologists who will prescribe T3, if you need it

[FarmerDJ in reply to SlowDragon]

Thankyou for all your help, I will follow your advise.