Need help. Test results confusing. Bad symptoms. Hypothyroid or hyperthyroid? Complications with prednisolone use for PMR.

[pomeranion]

Endocrinologist unhelpful. Described symptoms and said contact GP for dry skin and use moisturizer. Extremely dry skin, scalp (sores) face (dry and scaly sores) severe mood swings, hunger extreme, insomnia, nightmares, blurry vision,. (cataracts). To name just a few. TSH .934 Ft4 1.75 fasting results. Levothyroxine just reduced from 88mcg. to 75mcg. Stopped taking any about a week ago. Symptoms still bad. Any help appreciated.

[PixieElv]

HelloHave you got any ranges for you blood results please? It’s difficult to tell without?

also do you know about your vitamins?

SlowDragon has got some great advice on optimal levels.

[pomeranion in reply to PixieElv]

The ranges are as follows: TSH 0.270-4.200 /FT4 0.82-1.77. As far as vitamins I'm on a multi, calcium, K2, D3, Omega 3. I do have malabsorption concerns because of my bypass surgery 40 years ago. My Endo is aware of this. Thank you for your reply.

[SlowDragon Administrator]

Levothyroxine is a replacement thyroid hormone because you are not making enough yourself

Stopping levothyroxine likely to make you extremely unwell

Looking at previous posts, are you still on steroids

Many steroids affect/reduce TSH

Essential to always test Ft4, Ft3 plus test vitamin D, folate, ferritin and B12 at least annually

Reducing dose levothyroxine inappropriately can significantly reduce vitamin levels

Always test thyroid levels as early as possible in morning and last dose levothyroxine 24 hours before test

Please add most recent results and ranges (figures in brackets after each result)

Just testing TSH and Ft4 is completely inadequate

What vitamin supplements are you currently taking

When were vitamin levels last tested

[pomeranion in reply to SlowDragon]

So many questions. I wish my Endocrinologist was that thorough. I know all of my health problems are connected to my autoimmune system. Yes, I'm still on the steroids because ofmy PMR and RA. I have been reducing gradually. The Dr. finally thought they were addressing this by reducing the Levo. dosage 3 times from 112mcg. to 75mcg. I am still experiencing severe symptoms. That is why I have stopped taking the Levo. What kind of symptoms would I be experiencing without any Levo? I have all the severe symptoms of hyperthyroidism. I failed to mention I have had gastric bypass surgery about 40 years ago so the malabsorption problem would possibly complicate things. I'm just so frustrated with the Dr. not taking my complaints seriously. That is why I find this forum so valuable. I've learned so much about PMR and RA also. Why don't they test for more than TSH and Ft4? I've seen 2 Endo Drs. and both wanted me to stay on 75mcg. even after my complaints. What more can I do? Test results 11-9-21 TSH 0.468 FT4 1.76 /Standards TSH (0.270-4.200),

FT4 (0.82-1.77). Last tested 1-26-22 TSH 0.933 FT4 1.74. Not tested since discontinuing Levo on 2-4-22. What do you think?

[SlowDragon Administrator in reply to pomeranion]

Suggest you get vitamin D, folate, ferritin and B12 levels tested ASAP

What vitamin supplements are you currently taking

Was thyroid test done early morning and last dose levothyroxine 24 hours before test

TSH completely unreliable as on steroids

No Ft3 or vitamin results

Stopping levothyroxine is at best unwise ….suggest you reduce dose slightly rather than stop

[pomeranion in reply to SlowDragon]

Thank you for the quick reply. I take a multivitamin, calcium, K2, D3 and Omega 3 fish oil. I just messaged my Endo. about my concerns about not testing T3. I have had gastric bypass surgery about 40 years ago. This might contribute to malabsorption.That is why I am on prednisolone because the pill didn't help with PMR pain. The last tests were done in the early afternoon while I fasted and didn't take Levo for over 24 hours. I will ask that more tests be done. I previously took Armour before I started seeing the current Endo and he switched me to Levo. Said he doesn't prescribe Armour. I know the steroids are affecting my symptoms and fluctuating Levo dosages. I am at my whits end.

[SlowDragon Administrator in reply to pomeranion]

Suspect you have low vitamin levels/low Ft3

You need to test all four vitamins and TSH, Ft4 and Ft3

Last dose levothyroxine 24 hours before test

Test EARLY Morning before 9am ideally

[pomeranion in reply to SlowDragon]

Sounds like a plan. Thank you.

[radd]

pomeranion,

Sorry to hear you are feeling soo unwell but why have you stopped taking your Levothyroxine?

[pomeranion in reply to radd]

I just can't stand the hyperthyroid symptoms

I am still experiencing. Thank you for your sympathy. I wish my Drs. were that concerned.

[radd in reply to pomeranion]

pomeranion,

Gosh , this is complicated.

Prednisolone can raise androgens & looking at your past posts you advise of hair thinning which is also a hypo symptom (T3 deficiency) and a more likely cause, unless you have a sensitivity to the DHT (testosterone metabolite that may induce balding) .

TSH .934. (0.270-4.200)

FT4 1.75 (0.82-1.77 )

Except thyroid hormones look good on the surface but it’s hard to tell without FT3 what is actually going on, and now you have stopped medicating thyroid hormone replacements?!

Hypo and hyper symptoms are very easy to mix up and Levo can work against us when we have iron deficiencies (which can also be a cause of hair loss) and/or cortisol issues. Stopping your meds will be making things worse long term and especially if you have cortisol issues which is likely with your other conditions.

Why are docs reducing thyroid meds? Have you had previous elevated thyroid hormone levels and if so has Hashimotos been considered? Your medicating steroids for PMR and RA risk skewing thyroid antibody tests but it would be prudent to assume Hashimotos if you are low on thyroid hormones.

Going back to basics and considering your gastric bypass, have you had iron tested? Also VitB12, folate and Vit D?

[Kauaii]

If you stop taking the medication completely, you'll feel really bad. Hopefully you just meant you've reduced the amount you take, but it still takes weeks before your body readjusts and starts feeling better. Hang in there!