Under active thyroid

[Harmitage]

Does anyone get breathless as if thyroxine isn’t working and hot flushes all time

[Hidden]

Hey Harmitage, yes, it can happen, these are hypo symptoms. How much do you take, how long have you been on it?

[ellj]

Yes I do even though my blood results are in range.

The hot flushes happen in an instant and can even cause me to almost faint.

The breathlessness is not nice, I often can't even get a sentence out without stopping a couple of time to get a breath.

[SlowDragon Administrator]

Common symptom if under treated on too low a dose and/or low vitamin levels, especially low iron or ferritin

When were thyroid and vitamins last tested

How much levothyroxine are you currently taking?

How long on that dose?

Do you always get same brand of levothyroxine?

[SlowDragon Administrator]

do you have any actual blood test results? if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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)

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

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

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

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.

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

[shaws Administrator]

Hi Harmitage

I note that you've been a member since 2016 but this is your first post. So welcome to our forum.

You haven't given some thyroid background history on your profile.

There are a number of symptoms we can get when hypothyroid or taking levothyroxine, which is T4 alone and it is an inactive hormone and has to convert to T3 (liothyronine).

It is T3 which is the Active thyrod hormone and it is T3 which is needed in our millions of T3 receptor cells and brain and heart contain the most. To get an idea of how you are converting T4 into T3 you need a Full Thyroid Function Test which is:-

TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. We are aiming for a TSH of 1 or under and a FT4 and FT3 towards the upper part of the ranges.

The 'frees' are rarely checked but there are private labs that do home finger pin-prick tests. If your GP wont do all of the tests but if you decide to do so, privately make sure you are well hydrated a couple of days before blood draw so that it flows easily.

The aim is a TSH of 1 or lowere but many doctors assume that 'somewhere' in the TSH range is fine but that's not correct.

We need to know the FT4 and FT3 and the fact that you're breathless would suggest to me you don't have sufficient T3. The GPs rarely test the Frees but you should enquire.

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

The aim is a TSH of 1 or lower and FT4 and FT3 towards the upper part of the ranges.

GP should also check vitamins/minerals, Vit D, Vit B12, iron, ferritin and folate. Everything needs to be optimum.

Post your results on a new question/post.

[SSE106]

Hi, Harmitage, It might be too much thyroxine you are taking, or you are sensitive to thyroxine . There are a lot people on this forum sensitive to thyroxine , Then turn to other alternative, in my case, was the consultant prescribed t3 and thyroxine, which has made me a bit better. If it is too much of thyroxine , you can test it by reducing a bit , see how that goes.

Or if it is too low, adding a bit more. It is very sad that a lot of the time we have to be our own doctor.