Feeling like something us stuck in my throat - Hashis/subclinical hypothyroidism

[Nat2021]

Hi

I was diagnosed with Hashis 3 months ago - i am trying to conceive and blood tests flagged subclinical hypothyroidism TSH was 5.5 and elevated antibodies. I was given 50mg of Levo which i took for 6 weeks then had another blood test and it my TSH was 3.3 - my levo was upped to 75mg which i started last week.

For the last 2/3 weeks i have noticed a funny sensation/feeling like something is stuck my throat. - i cant see any goitre or lumps externally - i have never really had any major symptoms other than struggling to get pregnant which is why i had blood tests initially

I have read it could be due to iodine deficiency? I don't think i have had this checked - any ideas what it might be? .

[SlowDragon Administrator]

This feeling should reduce as dose levothyroxine is increased slowly upwards

Likely to need further increase in levothyroxine after next test

75mcg is only one step up from starter dose

Always test thyroid levels early morning, ideally before

9am and last dose levothyroxine 24 hours before test

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Many people find different brands are not interchangeable

Essential to also test vitamin D, folate, ferritin and B12

Have you had these tested

What vitamin supplements are you currently taking

Levothyroxine contains all the iodine you need

Never take any extra iodine unless tested and found to be deficient and under care of an iodine specialist

Too much iodine can cause hypothyroidism

[greygoose]

Your thyroid is probably a little swollen, it doesn't always show on the outside. It can be swollen on the other side, pressing against your oesophagus. I had that feeling long before I was diagnosed, and thought it was a problem with my throat. I went to see an ENT specialist. The silly man looked down my throat and told me there was nothing wrong with me! Never occurred to him that it might be my thyroid.

Your thyroid would become swollen if you were iodine deficient, yes. The thyroid enlarges its surface area in order to absorb more iodine. But, you have Hashimoto's Thyroiditis - Thyroiditis means 'swollen thyroid'. And Hashi's is not caused by low iodine. So, whatever you do, don't supplement iodine in any way, because that can make Hashi's a whole lot worse.

[Nat2021 in reply to greygoose]

Thank you - is there anything i can do to help this? I had no problems/symptoms other than struggling to conceive and thats why i started levo.

Do i need to be concerned? If something is not right i would rather get it investigated if its going to delay my chances of falling pregnant

[greygoose in reply to Nat2021]

The only thing you can do for Hashi's is take thyroid hormone replacement - levo, usually. And, keep increasing the dose until your levels are optimal - i.e. symptoms gone. You probably do have symptoms that you haven't associated with thyroid - after all, there are over 300 of them. But, even if you don't, the swollen gland and inability to conceive are symptoms. When you're on the right dose, the swelling should go down. And, you should conceive. But you need to make sure that they are giving you full thyroid testing: TSH, FT4 and FT3. Just testing TSH - which they usually do - is useless. It's not even a thyroid hormone.

One other thing it's essential to do is get the basic nutrients tested: vit D, vit B12, folate and ferritin. They all need to be optimal for your body to be able to use thyroid hormone correctly. And, yours could very well be low, as you're hypo.

[Nat2021 in reply to greygoose]

Hey! I was just a lite confused as i didnt have this symptom before starting levo - only afterwards? I have only just had my levo upped to 75 as was on 50 and it had come down from 5.5 to 3.3 and i need it under 2.

My vit d was 41nmol in january i have been following a protocol for almost 3 months and getting it checked again soon.

B12 was around 390 so been taking bl12 (the mythl one) and b complex

Folate and ferritin were fine

[greygoose in reply to Nat2021]

Well, what often happens is this: say your thyroid was putting out 100 mcg thyroid hormone - T4 and T3 combined (that's just an example, I can't remember the exact numbers). And you start taking 50 mcg T4. Your TSH drops, so less stimulus to the thyroid, so it's like having a reduction in your total amount of thyroid hormone. So, more symptoms appear.

Or, another scenario: your thyroid was making x amount of T4 and y amount of T3. You start taking T4, but your body is not very good at converting exogenous T4 to T3, so you become more hypo, and develop new symptoms. It's really not unusual to develop new symptoms when you start levo, or have the old ones get worse. But that does not mean that it's the levo causing it. It's the change in levels and ratios that causes it.

I have only just had my levo upped to 75 as was on 50 and it had come down from 5.5 to 3.3 and i need it under 2.

You're more likely to need it under 1. When they say that you need a TSH of below 2 to conceive, they are not recommending a TSH of 2, but that's the maximum it should be. Because the higher the TSH, the lower the thyroid hormones - I'm afraid I don't know how much you know about all this, so forgive me if I'm telling you something you already know.

But, it's not the TSH that has a direct effect on conception and pregnancy. TSH doesn't affect anything much. It's a chemical messenger from the pituitary to the thyroid to tell it to make more hormone. As thyroid hormone levels increase, the TSH drops.

What is important in pregnancy is the T4, because it's mainly T4 that crosses the blood placenta barrier and keeps your baby alive and healthy until it develops its own thyroid.

So, just testing TSH is absolutely not enough. It's not that reliable a guide to thyroid status. You need at least your FT4 tested. But, also your FT3, because that's what's going to keep you healthy during the rigors of pregnancy. It's damned hard work! And, you need all the strength and energy you can get.