Trying to get for with COPD and hypothyroidism

[sobs1962]

I've read an article saying that hypothyroidism causes more exacerbations of COPD than those that are euthyroid and I have been trying to get some exercise most days but my depression and anxiety make it extremely difficult to get motivated and when I do some exercise, I feel wiped out afterwards and cannot do it two days in a row because I get really bad pain in my legs and I'm wondering if I should really push myself through the pain. I'm 100% sure that my Vitamin D levels are extremely low as the doctor took me off my Accrete d3 1.5g/400u tabs months ago. I should at the very least try and get outside in the sun when I can but again my anxiety makes this extremely difficult. I haven't had any blood done since last year and just feel like I'm actually dying. I want to feel better but can't get prescribed T3 as endo needs to do bloods and psychiatrist has no experience with liothyronine and says he will liaise with the endo and my GP. In the meantime I really do want to help myself and if anyone can suggest a supplement I can take that will boost my vitamin d and maybe boost my metabolism and any advice on taking exercise would be greatly appreciated,sorry about length of post just feel crap and my husband says some days I look grey and the dark circles under my eyes look like bruises.

[SeasideSusie Remembering]

sobs1962

if anyone can suggest a supplement I can take that will boost my vitamin d

That's not possible without knowing your Vit D level. The dose of D3 that you would take is based on your level, too little wont help raise a low level, too much can lead to toxicity. Maybe consider doing a fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Come back with the result for recommendations of the dose of D3 that you need and information about the important cofactors needed when taking D3.

I've read an article saying that hypothyroidism causes more exacerbations of COPD than those that are euthyroid

I have COPD, also Bronchiectasis, and I can't say that being hypothyroid has caused more exacerbations. What are you prescribed for your COPD? Are you having frequent exacerbations?

[greygoose]

Could be that you are under-medicated and over-exercising - which will make you more hypo.

Can you post last years labs to give us an idea, please? Tell us exactly when they were done, what you were taking at the time, and if your dose was increased after, and we'll be better placed to advise you.

Have you had vit B12, folate and ferritin tested?

[sobs1962 in reply to greygoose]

I am going to have to demand that vit D, B12, folate and ferritin get tested because my doctor doesn't connect these levels with my thyroid function and would explain why these are not tested routinely and why I have not taken any vit d for 3 months as doctor says I should be able to get enough from sun [ UK = no sun ] Moving on here are the last bloods I had done at my GP practice in February 2020:-

Serum TSH Level 0.42mu/L [0.35 - 5.50mu/L ]

Serum Free T4 Level 21pmol/L [10.00 - 20.00 pmol/L ]

Plasma Free T3 level 3.6 pmol/L [3.5 - 6.50 pmol/L ]

Serum Prolactin level 146mu/L [38 - 430.00 mu/L ]

Blood magnesium 0.66 mmol/L [0.70 - 1.00 mmol/L ]

Notes:- Free T4 and TSH levels reflect appropriate thyroxine replacement.

Blood magnesium for tel app and rpt in 3/12 with U&E, bone profile and Vit D.

Both T4 and magnesium results typed in red indicating outside normal range but throughout, says Normal- No Action.

I am trying really hard but it appears the doctors aren't listening, are brainwashed or simply just don't care.

I was on 160mg of Propranolol prolonged release but have now come off them over a 3 week period and am taking Promazine 25mg [anti psychotic] twice daily for my anxiety but expect it to take a few weeks to really take affect and will have to put with the physical symptoms until it does.

Levothyroxine - 100mcg - NorthstarX

Levothyroxine - 25mcg - Teva

previously on 150mcg reduced to 125mcg last summer and since changed practices have been on different brands of Levothyroxine, consistently on Mercury Pharma before that.

I must admit to being really worried [though keeping it to myself] about how my brain is working, when I type it's as if I'm dyslexic and when trying exercise that requires coordinating arms and legs I am really struggling and wonder if you think that I should consult my GP as it appears to be getting worse.

I've got to admit I feel like I'm on my way out and told the doctor this back in February and I wonder just how ill I need to get before anyone actually does something.

[greygoose in reply to sobs1962]

OK, I see. Your TSH and FT4 may indicate that you are taking enough levo, but the problem is, you can't convert it to T3, the active hormone. And, it's low T3 that causes symptoms. And, the brain needs an awful lot of T3! With an FT3 that low, it's not really surprising you have brain-related symptoms. Dyslexia is a hypo symptom. But, you really shouldn't be exercising with such a low FT3. Just gentle walking for the time being, or you will be making yourself worse.

Are you taking Propranolol for high blood pressure? High blood pressure - along with anxiety - are hypo symptoms. And, the Propranolol has probably been affecting your conversion. Be interesting to see if your conversion has improved on your next test now that you've come off the beta blocker.

Many, many people get along badly with Teva - although a lot of doctors/pharmacists refuse to accept that. But, it would be much better if your doctor prescribed extra Northstar so that you can cut a tablet in quarters, rather than taking two different brands. But, if you could get back on Mercury Pharma, that would be better still, if you did better on it.

Ignore magnesium results, the tests aren't reliable. You can have an over-range result but still be deficient in magnesium. Your doctor is very, very wrong about the Vit D. We have people on here who live in hot, sunny countries that are still deficient in vit D. But, doctors tend to know next to nothing about nutrients.

I am trying really hard but it appears the doctors aren't listening, are brainwashed or simply just don't care.

Probably a combination of the three. They don't have much education in thyroid, but are taught that it's no big deal, and we're all just lying, hypochondriac, attention-seeking wingers, looking for an excuse for putting on weight! And, quite frankly, it doesn't matter how ill you get if they don't know what to do to help you - and they probably don't. You need to learn about your own disease.

So, what can you do to help yourself?

* First of all, stop all that exercising. Just gentle walking or swimming until you get your FT3 higher.

* Either try and get nutrient testing from your doctors, or do a private test. Your GP won't understand the results, anyway, so the odds are you're going to have to self-treat with those. We can help you.

* You could either try and source your own T3, or wait and see if your conversion improves now that you've stopped the beta-blocker. But, you do need more T3, that is the source of your problems: low T3.

* Above all, be kind to yourself. Things will improve with more T3.

[sobs1962 in reply to greygoose]

Thanks for that, I've decided to get on to my GP on Monday and explain my current symptoms as they are very like the symptoms of pernicious anaemia,especially the palpitations and chest pain, along with lightheadedness and poor coordination and extreme clumsiness and my eyesight is deteriorating rapidly. I'm going to make them listen to me whether they like it or not.

[greygoose in reply to sobs1962]

Good for you! I hope you manage to get through to them.

[sobs1962 in reply to greygoose]

Just an update,taken to hospital last night due to high heart rate,palpitations and intermittent chest pain. They did tests but confirmed that my heart is fine. Rang the GP when eventually got back and explained that I suspect vitamin b12 deficiency and they are giving me b12 medication despite my blood levels apparently showing as fine over the last 7 years or so. They won't do blood tests due to coronavirus but the test they do is not effective at diagnosing b12 deficiency as is is total b12 blood test. The doctor says that if my symptoms improve after 2 -3 weeks it will be because I have "hidden b12 deficiency" . Apparently the chances of overdosing on b12 are slim to rare as is a water soluble vitamin and any excess is eliminated through urine. Don't know what the dosage is as can't pick I

up prescription till tomorrow. Fingers crossed the b12 will do the trick and I'll start feeling better quite quickly. Thanks for your support especially during lockdown as having lots of time on your hands and mental health problems can make you imagine things and worry more about health problems than in "normal" circumstances.

[greygoose in reply to sobs1962]

Well, that's a result, anyway. Just a pity that your health had to deteriorate to such an extent before anybody did anything about it! Hope the B12 helps.

[sobs1962 in reply to greygoose]

I feel quite optimistic but everything crossed.

[greygoose in reply to sobs1962]

Good!

[sobs1962 in reply to greygoose]

Just had phone consultation with cardiologist and he is concerned as my private blood test results show low TSH and increased T4 that I may be on too high a dose of levothyroxine and it should be reduced as this may be the reason for heart palpitations. I tried to explain that endo said may be a conversion problem but it seems doctors have very fixed views on this and I'm now worried that if my levo is reduced I will feel even worse than I do at the moment and I don't know if my GP will listen to or understand my side of things. Any advice on how to try and convince the GP that reducing levo is not the solution and waiting to see if b12 does the trick of removing palpitations.

[greygoose in reply to sobs1962]

* It's not about TSH or even FT4. You're only over-medicated if your FT3 is over-range.

* T3 is the active hormone, the one that causes symptoms if it's too high or too low.

* So, you cannot know if you need to reduce your dose without testing the FT3.

* T4 is basically a storage hormone, it doesn't do much.

* TSH does nothing at all except tell the thyroid to make more, or less, thyroid hormone.

* Palpitations can be due to under-medication. So, if your FT3 is too low, due to poor conversion, that could be causing your palpitations. But, you won't know unless the FT3 is tested.

* The heart needs plenty of T3 to function correctly. Low T3 is worse for your heart that high T4 or low TSH.

* You will not reduce your dose unless your FT3 is tested and found to be well over-range.

I don't know if that will work, but if you look like you know what you're talking about, you stand a better chance of convincing him than begging. But, to be honest, there's not much to be done about ignorant doctors because they think they know it all - after all, they've been to med school, haven't they! But, it's strange because cardiologists usually know more about thyroid than GPs and endos.

I'm not sure low B12 causes palpitations. Where did you get that idea? Low ferritin/iron might, though. But, if the heart itself is fine, then there's not need to worry about the palps. They may be unpleasant, but not dangerous. So, why should you reduce your dose? There's absolutely no clinical proof that it needs reducing, so just say that you refuse to reduce it unless they can give you a very good reason to do so.

[sobs1962 in reply to greygoose]

I've looked on a good few websites at the symptoms of pernicious anaemia and I have a lot of these symptoms, including dementia like symptoms, poor coordination,extreme clumsiness i.e dropping things, banging into things and knocking things over. I spoke to a doctor at my GP practice yesterday and told him about these symptoms and I would like to think he wouldn't suggest prescribing me b12 unless he thought it would help alleviate my symptoms and the information I've read on here says that it is essential to test for b12 levels to help with thyroid health,the doctor says my b12 levels in the past have been ok but it depends what they regard as ok as the range is apparently from 200-900. Chest pain and palpitations are listed as symptoms of pernicious anaemia too.

[greygoose in reply to sobs1962]

Oh, goodness! Don't misunderstand me. I'm not suggesting B12 isn't important! I had lots of terrible symptoms of low B12. I just didn't think that palpitations was one of them, that's all. It's more likely to be low T3 causing your palpitations.

[sobs1962 in reply to greygoose]

Hi, I was wondering what symptoms you had with your low B 12 as I'm beginning to think these palpitations may be due to withdrawal from Propranolol as only stopped taking them on Thursday last week but doesn't explain dementia like symptoms and poor coordination although these symptoms are in intermittent but the main concern is when typing keep spelling words wrong almost as if I'm dyslexic and I have always been a good speller and good at expressing myself when writing.

[greygoose in reply to sobs1962]

Dyslexia and dementia-like symptoms are symptoms of low T3. I think an awful lot of your problems can be put down to low T3. It really does need to be tested.

Symptoms of low B12? Well, the obvious neuropathy, and dizziness to start with. Then, later on, I started to lose the use of my right arm. At first, it just showed when I was driving, I couldn't steer straight, the car kept pulling to the right, where my arm was dragging the steering wheel down - although, of course, I didn't realise that at first. I thought there was something wrong with the steering, and had it checked. I was told there was nothing wrong with it, but it kept getting worse, and I didn't want to drive anymore. And, then I had trouble gripping and lifting with my right arm. But, it never occurred to me that it might be anything to do with B12.

Then, my head got wobbly. I couldn't keep it up-right. It kept flopping to one side or the other. Once again, I didn't put that down to B12, but I was worried. So, anyway, the next time I got my thyroid tested, I asked for nutrients as well. The stupid doctor would only do B12 and ferritin, giving me long-winded, unintelligible reasons why the others weren't necessary - they were only vitamins, after all! B12 came back at about 430, if I remember correctly, and stupid doctor said it was 'perfect'! I started supplementing, anyway. And, lo and behold, after a while, I was able to hold my head up straight, and the life came back into my arm. I still have the neuropathy, of course, but far, far less dizziness. Just on odd occasions.

But, given that the neuropathy began when I was 27, it's not surprising it's still there. It's irreparable, now. I remember distinctly when it began because I was heavily pregnant and kept walking into walls. I thought it was something to do with the pregnancy. Well, maybe it was, but indirectly.

But, I'm rambling again, so I'll shut up, now! lol

[Marz in reply to greygoose]

b12deficiency.info/signs-an...

Palpitations as a symptom of B12D are included in the link above. I have them when my next jab is due and sometimes afterwards ! Like wise in the early days of taking T3 through the day - palps would tell me when the next dose was due ! Confusing 😷

[greygoose in reply to Marz]

Oh, really? I didn't know that. Well, I've learnt something today. Thank you. But I still think the OP needs her FT3 testing urgently.

[Marz in reply to greygoose]

Absolutely - yes to T3 testing .. very important.

[sobs1962 in reply to Marz]

Sorry dosage is actually going to be 50 mcg.

[sobs1962 in reply to Marz]

Thanks for that but it appears I am being given 25mcg dose orally so don't know how much good that'll do if I do have B12D but confused as to whether my symptoms are due to low T3 or B12 or both.

[sobs1962 in reply to sobs1962]

Sorry the dosage is actually 50mcg.

[Marz in reply to sobs1962]

I would say both ... Once you are supplementing do remember that further B12 bloodtest results will be skewed and your GP will withdraw your B12.

Not sure 25mcg is enough to help - is it Cyanocobalamin ? There are other types if B12. Maybe better to buy from Amazon - Jarrow Methylcobalamin 5000 mcg and a good B Complex to keep all the B's in balance. Use one pot then take the smaller 1000mcg lozenge.

Greygoose is right about low Iron and Ferritin causing heart issues.

[Sheba678]

Perhaps you could try Magnesium. There are many types available on the market, not all of which are well absorbed. Magnesium can also cause loose stools. I use Magnesium Glycinate which appears to be well absorbed and does not cause me issues. It should be available at a good Health Food Store. I go to Revital.

I understand that Magnesium helps release the body's vitamin D , helps the body's conversion of T 4 to T3, and helps support healthy cortisol levels, amongst its myriad other functions. A good reference book Ive used is Recovering With T3 by Paul Robinson.

Its best taken at least 4 hours or more away from your thyroid medication and after a meal. As it has a calming, relaxing effect it may be best to take it after dinner.

If you prefer not to take it orally there are gels and magnesium creams available to apply on the skin. My experience has been that some of these might initially cause itching and irritation on the skin and this usually wears off after its been used for a while. You could speak to the sales person at the health food store to find out which product is best for you.

I hope this will be helpful and also suggest you ask your GP what their thoughts are on this supplement for you.

Wishing you good health.

[vocalEK]

I agree with sticking to gentle walking for now, but not every day. Give your body a chance to rest up between your exercise sessions.

Get that Vitamin D test as soon as possible. If your blood level comes back super low, your doctor may try to pawn off the 400 IU pills on you, and that won't do the trick. He might even be generous and offer 800 IU. Still way too low. I use this calculator grassrootshealth.net/projec...

It utilizes the ng/mL measurement, so you will probably want to use this converter to determine how that lines up with the UK system of nmol/L grassrootshealth.net/?post_...

When taking Vitamin D3, if 5,000 IU or more, it's important to also take Vitamin K2-MK7, which helps the D route calcium where it is needed -- bones and teeth -- instead of into soft tissues where calcium is problematic (kidneys, blood vessels, breasts). In addition, magnesium and zinc are additional cofactors.