My Doc says that my FT4 and TSH levels are not good at all.
FT4 2pmol/l range 11 to 22
TSH 70 mu/l range 0.30 to 4.20
I have an awful lot of other results as well, including glucose and bloods.
I have felt nauseous and had diarrhea for longer than I can remember. I thought Hypothyroidism made you constipated. Does anyone have an idea what may be going on and whether other results might give me a clue?
I am on Levothyroxin 50 micrograms but the doc said this would undoubtedly go up. I've felt pretty bad for a couple of weeks, very down, tired so that I can do even less than usual and sometimes crying. Are these side effects?
Thank you for any help you can give me.
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Sarfran
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You are right - these results are dreadful. I'm not surprised you feel awful. Make sure you get your blood re-tested after 6-8 weeks on this "starter dose" on levo so you can get an increase. Also it would be worth testing your key nutrients - ferritin, folate, vit B12 and D, as your levo works best when these are optimised.
It will take a while to be optimally medicated - but at least you have now started getting treatment. Good luck x
You will feel pretty awful with these levels. I wouldn't worry about other issues until you are on at least 100 mcg levothyroxine. Hypothyroidism can affect many things. It's possible your diarrhoea is due to IBS which may improve as your hypothyroidism is treated. I'm assume your doctor is aware of this, it could have an effect on how you absorb your levothyroxine, the next blood test will show if you are absorbing it well (fT4 will rise a fair bit). Although magnesium salts are sometimes used to treat constipation I would take a little magnesium supplement (not oxide or hydroxide) because you are likely to be low in minerals due to the diarrhoea. You could try calcium magnesium citrate but taking one tablet daily instead of the recommended two.
It will take many months to recover from this although you should start to feel better within a few weeks. If your diarrhoea isn't improved in a few months I think it needs to be investigated as a separate issue.
I can't remember my thoughts at the time but it looks like I meant 'magnesium citrate'. Calcium magnesium citrate is good if there is suspicion of calcium deficiency. I think I got muddled and meant to say magnesium citrate.
The tiredness and depression are symptoms of hypothyroidism. Your body will have been struggling for a long time to cope initially by increasing cortisol production which with the introduction of levothyroxine will start to decrease. The sudden drop in corticosteroids, the bodies attempt to cope, unmasks the reality of hypothyroidism. Your gp is correct it is going to take time to recover. It takes at least 6 weeks for levels of levothyroxine to stabilise, then a repeat blood test, then a 25 mcg increase, then another 6 weeks for a repeat blood test and so on until symptoms improve or TSH is around 1. I believe it takes 6 months to a year to reach optimum levels.
Did your gp test for thyroid peroxidase antibodies? If these are positive it means that you have hashimoto’s disease, an autoimmune disease that results in destruction of your thyroid. If this is the cause it is worth researching further as many people find eliminating gluten from their diet can help.
You are in the early stages of treatment, be kind to yourself it will take some time to recover. There is a lot to learn but you don’t have to know it all at once. I wish you well on your journey to better health.
I have felt nauseous and had diarrhea for longer than I can remember. I thought Hypothyroidism made you constipated.
Constipation can be a symptom of hypothyroidism. Your nausea and diarrhoea may or may not be connected.
If your hypothyroidism is autoimmune (Hashimoto's, the most common cause of hypothyroidism and usually confirmed by raised thyroid antibodies) then this can cause gut problems so it could be associated with that.
Your results show that you are severely hypothyroid, a normal healthy person would have a TSH of no more than 2 (often around 1) and FT4 around mid-range. The aim of a treated Hypo patient on Levo, generally, is for a TSH of 1 or below with FT4 and FT3 in the upper part of the reference ranges if that is where they feel well. So you can see that you have a long way to go.
The protocol after starting Levo is to retest 6 weeks later, increase by 25mcg, then retest and increase every 6-8 weeks until your levels are where they need to be for you to feel well. It's not a quick fix, it can take months to reach your optimal dose where you feel well.
For thyroid hormone to work properly (our own and replacement hormone) we need optimal nutrient levels so you could maybe ask your GP to test:
Vit D
B12
Folate
Ferritin
and it would be beneficial to know if your hypothyroidism is due to autoimmune disease so you could also ask for thyroid antibodies to be tested - Thyroid Peroxidase (TPO) and Thyroglobulin (Tg). You may get TPO tested, the Tg antibodies may not be done at primary level.
If you have any other results you are welcome to post them, with their reference ranges, as there may be something there that we can comment on.
To simplify it for now, if you have any results for the vitamins I mentioned you could post those, and if you've had a full blood count done post any abnormal ones and MCH, MCV, MCHC, and haemoglobin (that tells us if you have anaemia). Also, if you had an iron panel done that would be useful (tells us if you have iron deficiency).
Many thanks, I'm going to ring today as I've felt dreadful the last few days and just thought I'd check whether it could be the Teva brand of Levothyroxin.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Look through all the results you have and see if you have had thyroid antibodies tested
Any vitamin tests
Also coeliac blood test
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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels, thyroid antibodies and coeliac blood test if these haven’t been done yet
IBS, gut issues are common with autoimmune thyroid disease. Many people gain weight and have constipation...but a significant minority suffer weight loss and diarrhoea.
It takes 6-8 weeks for each dose of levothyroxine to have full effect
Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).
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.
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
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
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. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
I went from being extremely constipated for years to very loose throughout the day for five years. I had a colonoscopy but no other investigations and they just gave me Immodium. I was then found to be Hypothyroid. Really should have been caught sooner but then it was discovered I had a severe Zinc deficiency. As I eat very healthily I believe this was down to the Hypothyroidism causing low stomach acid and low nutrient uptake.
Zinc deficiency causes diarrhoea. Look it up.
However a Zinc deficiency will interfere with the proper function of your Thyroid too so which comes first? I have a normal daily bowel motion now for the first time in 12 years. So it was either the Thyroid or the Zinc. Anyway I would ask for your Zinc level to be tested x
That's really helpful, thank you Michelle. I'll definitely look into that. The Doc has given me antacids which I did wonder about. I'm glad you have a settled bowel now, it's horrible having the nausea and diarrhoea. I can't wait to be sorted properly! X
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