Flushing and low thyroid

[Sonnykate1]

Hi I wonder if there ar some insights into my awful flushes in relation to low thyroid. I take levothyroxine 125 and have no idea what my t3 or t4 is. When I was first diagnosed my gp said although my thyroid was low I had symptoms of a over active thyroid. I find the flushing is becoming debilitating now, so embarrassing in meetings etc. I am 61, otherwise healthy and well through menopause Any thoughts?

[fuchsia-pink]

Welcome to the forum.

If your GP thinks you may have an over-active thyroid, it's not clear why s/he is prescribing levo ... but either way it sounds as if you are not currently optimally medicated.

You may be best off getting private blood testing - you will see lots of posts here about this. Full testing would be TSH, free T3, free T4, thyroid antibodies and key nutrients - ferritin, folate, vit B12 and D. Post the results and the lovely people here will help you.

Good luck x

[SlowDragon Administrator]

First thing is, 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

Do you have Hashimoto’s?

Ask GP to test vitamin levels and thyroid antibodies if not been tested

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)

Is this how you do your tests?

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_...

[Sonnykate1 in reply to SlowDragon]

Thank you for this it is a very comprehensive reply. My NHS gp has just done the standard tests and in fairness did tell me the numbers but I can remember as it's a while ago. I was feeling relatively ok on the levothyroxine 100 at the start but the gp increased it after my last test results I was still low. The extreme flushing began with the increase and has been getting steadily worse. I have only been diagnosed with low thyroid as have 5 of my sisters.

[greygoose]

Everybody could be said to have symptoms of hyperthyroidism and hypothyroidism at the same time. And there's two possible reasons for this: a) a lot of symptoms can be both hypo and hyper symptoms; b) the hormone you are taking is not distributed evenly amongst all the thousands of cells that need it. Some can be getting too much, whilst others not enough - or none at all!

Or, it could just be that your doctor has no clear idea about symptoms. Not many of them do.

What are these symptoms she thinks are hyper?

[Hidden in reply to greygoose]

Thankyou GG, that is the simplest and clearest explanation I've read on why some parts of me seem hypo and others hyper. And it can change from day to day or on the same day.

By the way, (excuse the intrusion Sonnykate1 ), am I right in saying that both the brain and the heart need T3 to work properly as they can't convert it from T4 very well?

[greygoose in reply to Hidden]

I've never heard that said, no. In fact, the brain converts so well that some people insist that the brain needs T4 because only T4 can cross the blood/brain barrier. Which, of course, isn't true, either.

[Hidden in reply to greygoose]

Right, that's that hypothesis gone! Back to the drawing board

[Sonnykate1 in reply to greygoose]

The original symptoms I had, when the GP began testing me, were increased heart rate, anxiety, it like my system was speeded up as with hyperarousal. My moods were up and down and my memory was very poor. I also had aches and pains in my joints although I do have some arthritis in my knees and hands.

[greygoose in reply to Sonnykate1]

Anxiety can most definitely be a symptom of hypo/low hormone. I don't know about the increased heart rate. But, having anxiety does not mean you're hyper.

[Hidden in reply to greygoose]

I don't know what my heart rate was before being hypo but it can be rather fast. It's mostly in the mid 80s, but sometimes 70, and the other day the resting rate was around 96 for no obvious reason!

Maybe the heart is trying to make up for the lack of thyroid hormone by beating faster.

[greygoose in reply to Hidden]

Well, the way one doctor explained it to me - and you know me and my opinions about doctors, so I didn't take it too much to heart (pun intended!) - he said that low thyroid hormones over extended periods caused the arteries to harden, and therefore the heart had to beat harder and faster to force the blood round the body. What he didn't say was whether it was reversible or not, which it would have to be or taking thyroid hormone replacement wouldn't sort it out. And, I've never seen that written anywhere in research or articles about hypothyroidism. So, I really don't know.

[Hidden in reply to greygoose]

Makes a lot of sense. Like a disabled person who has to work much harder to achieve the same thing as someone fit, a hypo heart can only do its job by working twice as hard.

I just hope it IS reversible, and it won't be too late. I'm supposed to have a 48 hour heart monitor this week but have heard nothing yet. Hope the letter isn't lost in the post.

[greygoose in reply to Hidden]

I think it must be reversible, because my heart is ok now, and my blood pressure has come right down.

[SilverAvocado in reply to greygoose]

For me, being hypothyroid causes a high heartbeat. At the moment I'm adjusting my dose based almost completely on pulse, when the dose is an improvement my pulse reduces.

[SlowDragon Administrator]

Thyroid UK website just been updated today ...so some of links I gave you no longer working

thyroiduk.org/getting-a-dia...

[Alanna01]

I have developed terrible flushing (I'm dark skinned so for it to be so noticable was unusual). I went to a private Dermatologist who diagnosed rosacea but also said my thyroid was very inflamed and I was probably chronically undertreated. Therefore she would not treat it further, as the flushing would be worse the more undertreated I was and any topical applications at this point would be a waste of time and my money without also treating the underlying issue. She said come back to her when I've dealt with the thyroid.

It also affects my eyes so she did refer me to an ophthalmologist as well as an endo, which I could not afford the endo either and am putting up with looking either like I've drank too many or dog tired or chronically embarrassed.

I'd say you are more likely to be undertreated. But menopause could also be responsible as well.

[Sonnykate1 in reply to Alanna01]

I'm sorry you re experienceing this also it's horrible. Its interesting because my GP also diagnosed rosacea and gave me a topical cream which didn't make any difference to what was happening to me. I think when the covid crisis begins to recede I will go back and have a mor eindepth discussion with my GP and possibly get some tests done privately. Good luck

[Hidden]

I'm 71 and have had hot flushes for 20-30 years, long before any thyroid symptoms! But since being hypothyroid they have seemed different in some way - impossible to describe. At fist I could tell the difference between that and a normal flush, but it all seems to have run together now. Wear light clothing next to the skin (I can't stand nylon any more and haven't worn jumpers for years) and layers of easy to take off things.

The adrenal glands, together with the thyroid work together to control metabolism. It's one of the adrenal hormones that cause the "Fight or Flight" adrenalin rush. When the thyroid can't produce enough hormone the adrenals struggle too. You could compare it to a man with a bad leg trying to support one with only one leg. And the adrenal hormones are not as good as the thyroid in controlling the body's "Steady state.

With hot flushes, the sex hormones (also from the adrenals) may be affected too. So it's not surprising you get them. I'm no expert and have gained almost all my knowledge of the thyroid on here, but think maybe the adrenals are over compensating for the lack of thyroid.

But you need T3 and T4 tested as well as TSH to get any idea of what is going on. When the Thyroid UK site gets sorted there's a list of some of the many possible hypothyroid symptoms there which you could show your doctor.

[Sonnykate1]

Thank you all for your support and expertise I will keep an eye on the site and get mor tests carried out when the crisis allows.