I am a new member of this group. I was diagnosed with hypothyroidism last year but I was suffering with most of its symptoms 4 years prior to my diagnosis. One of my symptoms was intolerant to cold that I was sleeping with electronic mattress with 5 out of 6/ and room temperature should have been above 27c and all nights i was sweating that water was running on my body. Now with medication I get this symptom ten days before my period and it is very disturbing as in the morning I feel exhausted. I heard from GP over these 5 years I am going through menopause and these are before menopause. I don't believe this that I heard from age of 34 for any problem. my first T4: 10.7 ( 9-19), TSH: 7.5 (0.2-0.4)
then after 3 moth using 50 microgram levothyroxine T4:15, TSH:5.5
Doctor increased my dose to 100 which caused anxiety T4: 17, TSH: 0.1
Then another GP reduced the dose with my symptoms. 62.5 Microgram for 4 days then 50 Microgram then T4: 16.8 TSH 6.7
Now I am on 62.5 microgram for 2 days and rest 50 microgram.
But I get that feeling freezing and cold for about 10 days.
I have no ideas which type of hypothyroidism I got and what to do or what to ask.
Please any suggestions?
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Tala76
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I have no ideas which type of hypothyroidism I got and what to do or what to ask.
my first T4: 10.7 ( 9-19), TSH: 7.5 (0.2-0.4)
Your initial results suggest Primary Hypothyroidism. Unless you have had antibodies tested you wont know whether your hypothyroidism is autoimmune, but it doesn't matter much because the treatment is the same for hypothyroidism whatever the cause - Levothyroxine. With autoimmune hypothyroidism (patients call it Hashimoto's) the immune system attacks and gradually destroys the thyroid. Whilst these attacks happen, test results and symptoms can fluctuate and dose adjustments may be necessary. To know if you have Hashi's you will need to test Thyroid Peroxidase antibodies and Thyroglobulin antibodies.
then after 3 moth using 50 microgram levothyroxine T4:15, TSH:5.5
Doctor increased my dose to 100 which caused anxiety T4: 17, TSH: 0.1
That was too big an increase. Dose changes should be in 25mcg increments and it's very likely that the big increase in dose may have caused your anxiety.
Then another GP reduced the dose with my symptoms. 62.5 Microgram for 4 days then 50 Microgram then T4: 16.8 TSH 6.7
Now I am on 62.5 microgram for 2 days and rest 50 microgram.
Why was your dose reduced from 62.5mcg on 4 days to 2 days? A TSH of 6.7 is a hypothyroid result which means that you should have an increase in your dose.
The aim of a treated Hypo patient, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.
If you add the reference ranges for your results - FT4 in particular, TSH not so necessary, then we can see where your FT4 lies within it's range. Reference ranges vary from lab to lab so it's impossible to interpret your FT4 result. With the range my lab uses, which is 7-17, you would be very close to the top of the range, but we also see 9--19,11-23, 12-22, and others, so we need the range that comes with your result.
How are you doing your test? To compare results accurately, tests need to be done under exactly the same conditions every time. Always advised here, when having thyroid tests:
* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH
* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.
* Last dose of Levo 24 hours before the test, take that day's dose after the blood draw. This is because if you take your Levo before the blood draw the test will measure the dose just taken and show a false high. If you leave longer than 24 hours the result will show a false low.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
Also, do you take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, and water only for an hour either side, as absorption will be affected. Take any other medication and supplements 2 hours away from Levo, some need 4 hours.
I really appreciate for your advice. I never knew I should not take my levo before my blood test or stop my B-complex a week prior to blood test. my Labs range is 9-19 for T4 and 0.2-0.4 for my TSH. My blood test is in the morning but I am always taking tablet as soon as I open my eyes , then go for blood test. this time I would not. Really thanks
The reason I am taking 62.5 microg is, when I take 76 microgram I feel agitated that evening and day after so I tried half 25 and it worked better.
But I will do what you said for next blood test. Not to take my tablets.
I requested those Blood test you mentioned. Thanks I really appreciate. your message and your recommendation are brilliant that I did not get from GP. xx
Ideally you want TSH to come right down - a high TSH means your thyroid is struggling - and for free T4 to get nice and high in range. You were probably slightly over-medicated on 100 mcg ever day, when you results were at their best but you felt anxious, but have come down too much. On the figures given, assuming early morning blood tests and 24 hours from previous levo, you will probably feel best on 75 mcg and possibly 100 mcg some days each week ...
But ideally you would have full blood testing done, rather than just free T4 and TSH. That means TSH, free T4 and free T3 (as a minimum) plus thyroid antibodies (if not done before) and ideally key nutrients - ferritin, folate, vit D and B12 - as your levo works best when these are good. I've had some success with my GP by saying these are the tests recommended by Thyroid UK - but you will see LOTS of tests here about private testing [there are discounts on the Thyroid UK site and one company usually has a discount on Thursdays
SeasideSusie gives great tips on how to do a home blood test if this is something you want to try.
Ask GP to test vitamin D, folate, ferritin and B12
These are frequently very low, especially if cause of your hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies
About 90% of primary hypothyroidism is autoimmune thyroid disease....so it’s likely
As others have said, the aim of levothyroxine is to increase the dose slowly upwards until TSH is under 2. Many people will have TSH well under one when adequately treated.
If been left under medicated it’s often necessary to increase the dose of levothyroxine very slowly.
Ask GP to test thyroid antibodies and all four vitamins at this 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
About 90% of primary hypothyroidism is autoimmune thyroid disease
Also request coeliac blood test
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
I have applied these, unfortunately I cannot go to do blood test weekdays and the centre does vaccination on Saturday. So I will do it as soon as I got a chance.😀
Most members do diy blood test via Medichecks, Thriva or Blue horizon
All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Remember to stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results
Only do private testing early Monday or Tuesday morning and then post back via tracked 24 hour postal service
I am taking multivitamin (wellwoman, calcium, iron as I am anemic, d, e . I take them in lunch time or afternoon that they don't affect on my thyroxine tablet.
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