Hi, Sorry me again. Is it normal for your throat to have a few lumps here and there. Is your thyroid supposed to feel solid or squishy? Mine feels really hard and I thought it would be squishy. Is it normal to feel like you have something stuck in your throat now and again?
Since being on 100mcg 13 weeks now, I’ve felt up and down, but I have noticed my heart rate is slightly higher. Anxiety has also been well up and down, but tonight I really have had a panic, I sometimes get weird sensations in my head as well. I’ve also had times where I’ve felt confused.
I know my TSH is below normal but T4 is mid range but maybe I need to go back down? Really feel like I have something stuck in my throat when I swallow. I do need to get my TFT’s done again as my surgery pharmacist asked me to get it checked again in 6 weeks and it’s now 7 but unfortunately the labs don’t test T3. Any suggestions would be greatly appreciated.
Also if I have hasimotos how do you know when your thyroid is working normally and when it isn’t because surely sometimes it does and sometimes it doesn’t?
TIA
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Cade83
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The lumps may be thyroid nodules, so please start supplementing with Lugol's iodine, which has been known to get rid of them. The medical profession are a bit too keen to get rid of thyroids with lumps by ablating them, creating serious problems as they are wedded to thyroxine as the only medication, which can never be the answer for people without a thyroid to supposedly convert the thyroxineT4 storage hormone into the active hormone T3 or triiodothyronine.
I recommended iodine to a patient of mine who had thyroid nodules medically diagnosed, and she still has her thyroid and was doing well the last time I saw her, before the lockdown.
Thanks to the misinterpreted results of Wolff & Chaikoff's experiment with mice and iodine back in 1948, doctors have been trained to treat iodine like poison for thyroid patients. Dr Guy Abrahams identified Wolff & Chaikoff's mistake, and it was he who trained Dr David Brownstein about the desperate need the thyroid has for iodine. He has a website power2practice.com where you can find a lot of useful information.
Either way we need to take high enough dose levothyroxine to replace thyroid output
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
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 if not been tested yet
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.
RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
I would use caution with iodine as you have Hashimotos. It can cause flareups in some hashis patients.
Forgive me as my brain is foggy atm, so I just googled the reason and I'll put it below as I can't put it into understandable sentences atm. Your gp can order a thyroid ultrasound to check the lumps out and hopefully put you at ease. I have a hard right sided lump that is a harmless nodule and a good percentage of the population have nodules and never know.
From google:
WHAT CAUSES THYROID NODULES AND HOW COMMON ARE THEY?
We do not know what causes most thyroid nodules but they are extremely common. By age 60, about one-half of all people have a thyroid nodule that can be found either through examination or with imaging. Fortunately, over 90% of such nodules are benign.
Also from Google about iodine and Hashimotos:
Iodine stimulates the activity of the thyroid peroxidase (TPO) enzyme, which triggers thyroid hormone production. This is why so many thyroid supplements contain iodine, even though the thyroid only needs enough iodine to fit on the head of a pin each day in order to perform its duties.
Iodine supplementation stimulates the production and activity of TPO. For most people with Hashimoto’s, TPO also happens to be the site of autoimmune attack, and surrounding thyroid tissue is damaged in the process. So everytime TPO production is stimulated, the immune system, which perceives TPO as a foreign invader to be eradicated, responds more aggressively and amps up the attack.
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