This is a first! Advice needed please

[Nessynu]

Hi all. I have hashimotos. I took eltroxin ( Ireland)for over a year and it was making so irritable (I'm convinced it was the fillers) so I got my endo to give me Tirosint sol. It was great for a few weeks (no irritability) but gave me other bad symptoms such as panic attacks and fast heartbeat etc. I know now thats it's stronger than eltroxin. I was initially started on 21 drops which is the equvalant of 75 eltroxin tablet but felt over medicated. I have reduced it slowly over the past 7 weeks and am now down to 5 drops a day of Tirosint. Bloods last week (only TSH & T4 are in range. Vitamins are good except b12 a little low so I've been supplementing. I woke again this morning feeling a fast heartbeat, sweating, a bit anxious/shaky. What is going on? I don't have test results to have.

[shaws Administrator]

Having results 'in range' doesn't give enough information for members to respond.

Once we are hypothyroid, this is the method to get the best results from blood tests. TSH is highest early a.m. and drops throughout the day.

Always get the very earliest appointment (even if made weeks before) and it is fasting (you can drink water) and allow a gap of 24 hours between last dose of hormones and the test and take afterwards.

Do you have a print-out of your results - with the ranges - so that responses can be more informative.

A Full Thyroid Blood test enables members to respond more fully.TSH, T4, T3, Free T4 , Free T3 and thyroid antibodies.

Also ask for B12, Vit D, iron, ferritin and folate to be tested - deficiences also cause symptoms. B12 and Vit D are ' pro-hormones' and have essential work in our body.

[Nessynu in reply to shaws]

Thank you Shaws and Slow Dragon. Doctor only tested TSH 0.3 and T4 13.4. I don't have ranges. B12 is 503. Ferritin 12.1 Folate 6.7 I have asked for for a printout including ranges from my doctor that I will be ready on Monday. I never realised anxiety and Palos could be z sign of being under medicated. I did pose this question to my doctor and Dr Google and both said no.

[shaws Administrator in reply to Nessynu]

Doctors are apt to only look at the TSH result and adjust dose according to it alone.

They appear to be unaware of any symptoms at all.

I had severe palpitations, but I now know it was due to levothyroxine. Levo seems to be finefor millions worldwide but some of us don't improve.

[SlowDragon Administrator]

Anxiety and fast heart rate can be due to being under medicated

Please add ACTUAL results and ranges

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 as you have autoimmune thyroid disease (Hashimoto's)

please add actual vitamin results and ranges

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Nessynu in reply to SlowDragon]

Thanks Slow Dragon. I've requested a printout of my bloods with ranges and should have them in Monday. I'm strictly gluten and dairy free. On the Aip diet a while now. Fasting bloods always! I don't eat any calcium foods or supplements at all.