Top of range bloods - but I don’t feel anything! What now? Is it Central Hypothyroidism?

[Bearo]

I’ve been titrating Levo for over a year and I’m on 100mcg. My blood results from MMH show I’ve reached the top,but there’s no prize!

TSH 0.01. (0.27-4.2)

FT4. 24.9. (12-22)

FT3. 6.5. (3.1-6.8)

They wouldn’t do vitamins this time but I’ve been supplementing since my results in October so they shouldn’t be too low.

I stopped biotin a week before and my last dose was 24 hrs before. I’m not diagnosed with Hashimoto’s and I’m not gluten free. Blood test was 8.40am.

When I started Levo Jan 2020 my TSH was 4.9 and FT4 was two points below range at 10. The blood test was just part of an annual check up now I’m over 60 and I discovered my TSH had been borderline for a year or so , so I badgered GP for another test and she gave me Levo to ‘try a little bit’. So maybe Central Thyroidism but I haven’t broached this with GP. My TSH has been low since I started Levo and FT3 & 4 have both risen with each dose increase.

I didn’t have too many symptoms when I started Levo and I feel just the same now. Two things I thought might be thyroid related - patches of exema (oops, spelling?) on my hands, and a very weepy eye are no better. My debilitating motion sickness which now comes on whenever I try to do anything is no better. I still have really cold feet in bed and wear layers in the cold months. I still lack energy and motivation. I still have back ache all the time. My brain is slow and my memory is shocking.

The only time I’ve noticed a reaction to the Levo was a surge of energy for five days when I moved from 50mcg to 75, and my poor sleep has gradually improved but I still wake in the night and find it hard to drop off again - although recently this is more down to being cat-bombed than waking for no reason .

I’ve just had a blood test with GP so they’re bound to want to lower the Levo. Do I refuse as I don’t feel over medicated or go for a small reduction?

What do I do next? Continue on Levo? Ask to be checked for Central hypothyroidism?

I’m grateful not to be as unwell as many on this forum but I feel like a fraud and very confused.

[greygoose]

Whether you have Central Hypo or not, the treatment would be the same, because hypo is hypo, whatever its cause. All that can ever be done is to replace the missing hormone.

That said, if the problem is with the pituitary, other hormones should be tested. The Pituitary doesn't just produce TSH, it produces all sorts of other hormones, too. And, if they are also low, then that could be why you're not feeling better. But, you'd have to see an endo for that. A GP would be completely out of his/her depth.

[PixieElv in reply to greygoose]

Hi GreygooseDo you know which other hormones please?

Thank you

[greygoose in reply to PixieElv]

pituitary.org.uk/informatio...

Tests for the pituitary.

[PixieElv in reply to greygoose]

Thank you

[greygoose in reply to PixieElv]

You're welcome.

[helvella Administrator Thyroid UK in reply to PixieElv]

Have a look at the rightmost part of the attached diagram. It lists the other hormones which should be tested in suspected central hypothyroidism.

[Bearo in reply to helvella]

Thank you

[PixieElv in reply to helvella]

Thank you helvella

[Bearo in reply to greygoose]

Thanks, Greygoose

[AS14]

You need all vitamins recommended here to be optimal in range as well as good levels of iron and cortisol. Thats the full iron panel that needs checking not just ferritin.

If you have high in range T3 but still feel hypothyroid having either too low cortisol or iron can cause this.

You need both to be good for T3 to work correctly in the cell.

You can find good explanations of this on both Paul Robinsons website and Stop the thyroid madness.

Stop the thyroid madness call this “ pooling” I dont believe in pooling myself and think Paul Robinsons explanation of needing cortisol and iron to make T3 more effective in the cell more accurate description.

They both mean the same thing, T3 is in the blood but not working properly inside the cell.

Im afraid I dont have any links but both very easy to find, both have their own websites, fb page and books.

These are the two most common reasons for high T3 with continuing hypothyroid symptoms.

[Bearo in reply to AS14]

Thanks for taking the time to explain that. I’ve never had a full iron panel but have had lots of low in range markers in general blood count. Haven’t checked cortisol either.The problem with my symptoms is not knowing if they are thyroid related - I don’t have the really common symptoms (apart from dry eye and weak nails).

[AS14 in reply to Bearo]

I think all you can is test the the things that have been suggested here and once you have the results post them and Im sure you’ll get the right advice. Cortisol is important but a simple vitamin deficiency can cause problems, some can make you feel awful.

Make sure to include a full iron panel.

If your gp wont test most of us do our own testing which is simple and not expensive.

Medichecks is popular and its the one use.

[Bearo in reply to AS14]

Thanks. I’ll start with GP and go from there.