Symptoms: shortness of breath, chest and joint pain especially lower back pain, my blood pressure has been high too for the past month so have been put on medication . Referred to cardiologist.
I am taking 125 Teva thyroxine
Blood test results:
Serum folate level: 10.0ug/L(2.7)
Serum vit B12 :692ng/L(160.0-800.0)
Serum free triodothyronine 3.7(2.5-5.7)
Serum TSH level:0.75mU/L(0.3-4.2)
Serum free T4 14.0pmol/L(9.0-23,0)
Can anyone please advise on if I am under medicated or what could be the cause of my symptoms. Thank you
Written by
cbraffe
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Yes. After thyroidectomy you need full replacement dose
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
Your results show both FT4 and FT3 are only 35% through range
Thank you so much. I am on vit D and ferritin supplements as I am low. I posted those in an earlier post. I will contact the GP tomorrow. What upsets me the most is, the doctors do not seem to look at the low levels as the cause of other symptoms. For instance rushing to put me on blood pressure meds before doing a full thyroid check and then referral to a cardiologist. I believe everything is connected to the low levels and they took the time to listen then one will not end up with a multitude of conditions
These findings show that lactose intolerance significantly increased the need for oral T4 in hypothyroid patients.
Presumably you are on a lactose free diet too?
As you have lactose intolerance you may eventually need addition of small split doses of T3
But first step us to get Levothyroxine dose increased until FT4 is in top third of range
After thyroidectomy about 20% of patients need addition of T3
There's over 102,000 members on here......precisely because current treatment guidelines are so poor
Literally thousands of patients left on wholly inadequate dose of Levothyroxine or have genetic or gastric reasons for needing addition of small dose of T3
Perhaps some of your symptoms are side effects of the meds for blood pressure? I realise you are lactose intolerant but TEVA levothyroxine gave me joint and muscle pain and beta blockers gave me lower back pain. Bisphosphonates gave me hip leg and foot pain and muscular pain so medication can come with side effects.
Personally, I don't think you need a levothyroxine dose increase. If your vitamin levels improve your thyroid hormone will function more effectively. I don't think your symptoms are caused by your dose. You are well within range and any symptoms would be very minor. My non medical opinion is that symptoms are coming from elsewhere. I would stick to your currant dose and work on vit levels. If possible avoid TEVA.
Ensure a calcium rich diet and add in magnesium and K2-MK7 if taking vit D3 supplements.
I did not. The doctor suggested a dose reduction. My throat feels as if I am chocking and most days I can not get out of bed. I am at a point where I wish I had remained hyper. I am on 2 grains of NDT. I have palpitations, loose stools, chest pain, joint pain , dry throat and cough . Fatigue . I am fed up . I am on vit D and was on Iron but the doctor suggested I stop taking it as my b12 was getting too high
Just to say glad we've now have some blood test results.
It's good in that your T3 and T4 are balanced at roughly 35% through the range, and that you are converting the T4 well.
As detailed by SlowDragon you need to increase your T4 slowly in 25 mcg increments until your T4 is up in the upper quadrant of its range at around 20.
This will also have the effect of increasing your T3 which is the active hormone your body runs on.
Once with an increase you'll need to wait 6 weeks for it have taken effect and then repeat the blood tests and see where you then, and maybe repeat the whole exercise once again, during which time I'm sure you will start to experience some relief of symptoms.
Yes, I was very breathless, and my ferritin came in at 22 - the bottom of the range was 15, but with a top of the range at 250 - not acceptable for a patient with a thyroid condition, as I read that ferritin has to be at least at 70 for thyroid hormone replacement to work.
So far so good, let's hope your doctor covers the ferritin, iron, vitamin D blood tests, and the increase in Levothyroxine.
I can't see a ferritin result only that you were prescribed 2x 210 ferrous fumarate -
Vitamin D needs to at around 100 - I think -
B12 - don't know my results are " active B12 " and the numbers look very different to this :
The thing is we need someone who knows, rather than me guessing - could you start a new post asking for vitamin and mineral help and there are people on here, who know, the answers, but they probably won't find our little conversation down here.
The Admins come in and initially answer, as best they can, what they can.
If you have the results of ferritin, folate, b12 and Vitamin D pop them in again as a separate question. You now have the answer for the Levothyroxine to be increased and just need confirmation of the vitamins and minerals. If you want, reply to SlowDragon and you'll get the answers you are looking for, if you have the results that she has asked for.
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