Hi All, I was diagnosed as having a severely under active thyroid in Nov 2018 after the birth of my little boy and been taking Thyroxine since. I have been on 100mcg since Feb. My last bloody test in August showed my levels were within the ‘normal’ range but my GP listened to my concerns (low mood, tiredness, poor concentration and fog) and agreed to put me on 125mcg to see how I got on. This was four weeks ago and I certainly feel better in the areas mentioned above.
However, I just can’t clear my throat! I continuously clear it throughout the day and it never feels like I’m able to shift it. I also had this before I started taking thyroxine in 2018 and as soon as I started treatment, it went. Does anyone else suffer with this or have any advice? It’s so frustrating and part of my job is public speaking so I’m finding it really difficult to manage!
Any held is gratefully received! Unfortunately, I don’t have a copy of my blood results but apparently everything else showed as normal too.
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ALW198
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Hi ALW198. From what you’ve written it would suggest that you are not on an optimal dose of thyroxine. Please get a copy of your previous and latest test results. You need to study them along with your symptoms so that you can find what’s ‘normal’ for you. Never take it as wrote what ‘normal’ is.
I too used to suffer with a hoarse and croaky voice, constantly clearing my throat. It is a known hypo symptom.
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
Presumably you have Hashimoto’s?
Ask GP to test vitamin levels alongside thyroid levels
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
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
Are you currently taking Teva?
Teva, Aristo and Glenmark are the only lactose free tablets
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
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
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
I’m not sure, was just told to take Vit D so I do!!
Starting to realise I definitely don’t know enough about all of this. It’s a minefield. My GP has never retested my Vit levels so I guess I’m not really being sorted, just putting plasters on things happening? Hard in these times with only getting phone call appointments too so don’t have the face to face time to really explain or ask the questions I want to.
It’s quite exhausting, certainly contemplating going privately, only in my early 30s and can’t imagine dealing with this forever.
Not near my medication right now but will check and reply later.
Thank you for all the information, as confusing as it all is, it’s really interesting.
Firstly, you should obtain your test resuls and post them on this forum for advice. I don't recommend accepting "normal" as an answer. You need to know where your results fall within the range. You might have low or below the range T4, T3 and if yout TSH is within the range they will tell you your results are normal because that's the only test they will do. They will only test TSH. My basic test is TSH, T4 and T3, as I was below the range with T3 and NHS don't usually test this. I do my own tests privatly.
Other members of this forum will give you more in depth advice on testing.
Secondly - this is my personal experience - I have the same problem and after some research I have found out it is called post nasat drip. This started with my Hashimoto's. I had been undermedicated and needed T3. It was also worse when I was on Teva brand of Levothyroxine and when I consumed dairy. 6 years ago I had a really bad sinus infections which took a year, 2 lots of antibiotics and steroid spray to clear. I now use sinus rinse whenever I feel my sinuses are getting blocked, which helps. Currently I tend to have post nasal drip in the mornings but it gets better after an hour or so. I have a good and not so good days, but it's not as bad as it used to be. I really feel for you, as I work in education and talk to children all day, speaking while constantly clearing your throat is very frustrating. However, I have a male colleague who has a habit of clearing his throat and nobody takes any notice. Some people do it when they feel nervous, so after living with this for 4 years I came to somewhat accept/learn to live with it.
You could try and find out what is your trigger. I copied this from another website, hope it helps - It can happen for a number of reasons: allergies, viral infections (including the common cold), sinus infections, irritants in the air (such as fumes or dust). Less common causes include something stuck inside the nose (common in small children), pregnancy, and certain medications. Temporary – and normal – causes of post-nasal drip includes certain weather conditions (especially cold, dry air) and spicy foods.
|| This is my personal experience, I have not seen a doctor regarding this (only when I had the sinus infection). As I had to self diagnose my Hashimoto's after GPs dismissing my symptoms and my blood test results, I rely on my own research and advice of this forum. Although now I see a private consultant regarding my Hashimoto's and source my meds from abroad. ||
So, I would start by finding out your medication is the correct dose, brand and type for you (in depth blood test resuts, monitoring your symptoms), trying to identify the trigger (sensitivities to food, environment...) and maybe trying the sinus rinse - it takes a while to get used to it, but this is generally my go to during my not so good days.
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