Dry eyes

[Hillman51]

Does anyone with under active thyroid get really dry eyes... mine are so dry, when I wake up in the morning, I have to prise them open,and then they are so gritty and dry. I wear distance and reading glasses, and have my eyes checked regularly.

[SlowDragon Administrator]

Dry gritty eyes common with Hashimoto's

Hypromellose eye drops can help

No longer available on prescription as they are available OTC. Cheap on eBay - £6 for 6 bottles. (No doubt NHS use to pay about £10 per bottle)

Eyes can be swollen when hypothyroid so that eyelids don't shut properly and this can also cause dryness

[Hidden in reply to SlowDragon]

Do you happen to know if it is specifically associated with Hashis, or the hypothyroidism?

[SlowDragon Administrator in reply to Hidden]

Don't know. I have Hashimoto's. Been using eyedrops 20 years plus

My optician says eyes are swollen and lids don't close properly

Some improvements since started T3, but not cured!

[Hidden in reply to SlowDragon]

I know someone on levo with hypo (and prob Hashi, but if doc tested, he didn't tell her). I've always thought she was probably undertreated and dry eye is one of her symptoms. She's given up on drops and uses some goo thing (there's probably a better term than goo!).

[SlowDragon Administrator in reply to Hidden]

Then recommend she gets full Thyroid and vitamin testing

We see thousands of people left on entirely inadequate doses of Levothyroxine

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...

[Hidden in reply to SlowDragon]

Yes I know. I've suggested twice over the years that she might be undertreated and she didn't want to hear. Think she's on about 100mcg (though come to think of it, that was a loong time ago, so goodness knows), but has health issues that I always wonder about. Still, it's not actually my business, and as I've mentioned it twice, I don't think I can do much more.

[SlowDragon Administrator in reply to Hidden]

Yes I have similar experiences with two friends who have multiple hypothyroid symptoms. But both think GP is God and that only having testing TSH is "fine"

You can only suggest someone gets full Thyroid and vitamin testing ......Up to them to decide

Wish I hadn't had blind faith in inadequate tests for 20 years. Only made progress once came here to this forum, saw how common low vitamins and gluten intolerance were....got full private testing and finally made progress

[Hidden in reply to SlowDragon]

yes, hard to watch but ultimately I can affect me, not them, and I can make sure my kids are forewarned.

[Hidden in reply to SlowDragon]

Did you do testing for the gluten? I've discovered a lab (a good one) that will do private testing, as well as full thyroid panel (except rt3). My doc does the thyroid except antibodies and I'm not sure knowing those numbers will help me... but I'm interested in the gluten/celiac.

[Naomi8]

I have been using Lumicare individual phials at night-the drops when mild,the gel when severe.Bought in bulk from Amazon or Ebay.Even cheaper if expiry date is close.

Just added some T3 to my NDT & its cleared up.May have been due to undermedication or needing a bit more T3.Plus regular use of drops/gel with hyaulonic acid has helped.

[Hillman51 in reply to Naomi8]

Thanku, I will look for these drops, I get good days and bad days with them. Also very sensitive to light, could wear sunglasses all the time😂. I can never sit facing a window or they start to water, no matter if it’s sunny or dull. ....

[SlowDragon Administrator]

Are you still only on 25mcg Levothyroxine?

healthunlocked.com/thyroidu...

Suggest you get Full Thyroid and vitamin testing

[Hillman51 in reply to SlowDragon]

Yes I am, it’s never been raised in 2 years, even though I have blood test every 6 months, but sometimes if I feel unwell I think I need a stronger dose... have got a blood test in about a month , so we,ll see. 😊

[SlowDragon Administrator in reply to Hillman51]

Just testing TSH and FT4 is completely inadequate

All Thyroid tests should be done as early as possible in the morning and fasting and last dose of Levothyroxine 24 hours prior to blood test.

So if you normally take Levothyroxine when you wake up, delay until after blood test at 9am

Levothyroxine does not "top up" your own thyroid production.

So if (for example) your body needs equivalent of 125mcg Levothyroxine per day ......but your thyroid is beginning to fail and is only making equivalent of 100mcg ......GP tests you ....you start Levothyroxine at 25mcg ..... initially yes you end up with higher levels. Your thyroid is still making 100mcg and you "top up" with 25mcg pill

However after few weeks/months your Pituitary/thyroid notices you're taking (tiny) dose of Levothyroxine...and pituitary stops asking your thyroid to work so hard....perhaps halving thyroid output to equivalent of just 50mcg

You end up even more hypothyroid than you were to start with

Yes older patients should start on 25mcg.....but they still need to increase dose slowly over time.

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

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

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

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)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

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

[pennyannie]

Hello Hillman

Please just make sure anything you use for your eyes is preservative free.

[Hillman51 in reply to pennyannie]

O.k I will thankyou😊

[Treepie]

My eyelid stuck to my eye twice and it was painful.I get GelTears on prescription and use mainly before bed.

[Lora7again]

Yes I suffer dry eyes and I use eye gel drops

[magnoliauk]

I also have dry eye and when I need to I use Carbomer gel morning and night. My eyes are also light sensitive but I just make sure I have my sunnies with me.

[milupa]

Do you have any other symptoms that might point to Sjogren’s?

sjogrens.org/

[DIYqueen]

referencing milupa, do have dry mouth/poor saliva production and/or swollen salivary glands (behind jaw/front of ears), joint pain/stiffness, dry cough etc - can google symptoms for Sjogren's to see. It is another autoimmune condition. If you suspect it see Dr there are some blood tests that help diagnosis.

[Hillman51 in reply to DIYqueen]

I do have a dry mouth and joint pain... no swollen glands or dry cough though....

[DIYqueen]

Worth a quick chat with Dr? With autoimmune diseases, as we know, many odd symptoms can occur. I am now in habit of telling her everything even if they seem unrelated.

[Hillman51 in reply to DIYqueen]

O.k thankyou. 😊