Thyroid T4 concerns

[Bamagirl1961]

I have been extremely concerned about my thyroid. I have gone to my doctor but he doesn’t seem concerned. My T4 is high and he said that he will monitor it. What does that mean? My weight is skyrocketing and I am keeping my calories under1500 a day. My energy level is zero. My skin is extremely dry, my hair is falling out, I have sleepless nights, I am constantly cold, and I have restless legs at night. I know this isn’t normal. I am on 112 mcg of synthroid. Any ideas? I am tired of begging my doctor to help me.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis) usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

Recommended on here that all thyroid blood tests early morning, ideally before 9am last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Just testing TSH and Ft4 is completely inadequate

Come back with new post once you get results

[DippyDame]

As SlowDragon has advised you need a full thyroid test...the results will reveal any problems!

Your symptoms suggest hypothyroidism/ undermedication

But first you need to optimise the vital nutrients as advised.

You say your T4 is high, unfortunately this only part of the story!

T4 is the storage hormone, most of it is converted to T3, the active thyroid hormone. This happens in various tissues in the body eg the liver.

T3 then has to reach the nuclei of the cells before it becomes active

T3 is essential to every cell in the body and for good health must be available in an adequate and constant supply

Low FT3 = impaired health with signs and symptoms of hypothyroidism

We don't know your FT3 so we cannot tell how much active hormone is available.

If your FT3 is low, along with your known high FT4, then you may have a T4 to T3 conversion problem and would benefit from the addition of a little T3

Right now, without full results we cannot be sure.

However I'm not a medic and not qualified to diagnose,

Meantime, this may be helpful

thyroiduk.org/if-you-are-hy...

Feel free to come back and ask any questions you might have and with any results you have.

Just my thoughts based on my personal experience and reading

[radd]

Bamagirl1961,

Welcome to our forum,

Levothyroxine often works well for so long but if there are deficiencies in the required cofactors, then it can eventually fail. Optimal iron levels are essential, also Vit B12, folate and Vit D.

Others have given advice re thyroid hormone testing. Do you have Hashi? How long have you been medicating?

[Bamagirl1961]

My T3 is 0.874 and my T4 is 1.26. I take 112 mcg of Levothyroxine. I am exhausted and my weight keeps going up even though I am on a 1500 calorie diet. I have told my doctor about my symptoms but he says he will monitor it. I am going to go to an endocrinologist next week.

[SlowDragon Administrator in reply to Bamagirl1961]

Please add ranges on Ft4 and Ft3

Request/insist Dr test folate, ferritin, vitamin D and B12

Have you had thyroid antibodies tested to see if your hypothyroidism is autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune

Assuming it is autoimmune, you need coeliac blood test done BEFORE considering trial on strictly gluten free diet

Calorie controlled diets can reduce conversion of Ft4 (levothyroxine) to Ft3 (active hormone)