hi there , hoping someone can help me…

[Void1234]

i have a long standing goiter and hashimotos that hasnt gave me too much bother to date. I am on 75mcgs of thyroxine and its generally been ok. However , after going through a stressful event this jan this year it started to cause a few problems, i started to feel dizzy, couldnt handle stress well , adrenaline surges and my goiter was swollen much more than usual and i put this down to stress. I also developed a panic disorder. The GP done my TSH, in feb it was 1.8 then June it was 2.39 , the goiter was getting uncomfortable when i was lying down etc due to swelling and last night i headed to A&E to get checked out as was worried … they advised me the TSH was 3.65 and free thyroxine 19.6 - but within normal range. They referred me to surgeon for removal and more scans , but im really not sure if im Hypo or Hyper now and the next steps as very worried. I know im on the limits of normal but wanting some advice if anyones found themselves in similar position? Or questions i need to ask. Ive asked for ultrasound etc from hospital.

thanks

[greygoose]

With a TSH of over 3, you are very far from 'normal', even though that is in the so-called 'normal' range. You are still hypo. 19.6 could be good for FT4, although you haven't given the range so we don't really know (please, always give ranges with results) but that doesn't mean that your FT3 is also good. It could be low, and it's low T3 that causes symptoms.

So, you really need to get that FT3 tested. If your doctors won't/can't do it, would you be able to get a private test? Details of private tests here:

thyroiduk.org/help-and-supp...

How about nutrients - vit D, vit B12, folate, ferritin - have they been tested? They're probably low causing problems, too.

[Void1234 in reply to greygoose]

Hi , the range they tested the FT4 was 12-22 pmol, Tsh was 0.27-4.2mlU/L, folate , ferritin all ok. Ive actually sent away for private tests so hopefully get them soon.

[greygoose in reply to Void1234]

OK, your FT4 is quite high, but so is the TSH. So, it's possible that the FT3 is low, that you're a poor converter. And that could be due to low nutrient levels. But Hashi's people are often poor converters.

What do you mean by 'ok'? It's not OK we want, it's optimal. Do you have the actual numbers: results and ranges?

[SlowDragon Administrator]

ALWAYS test thyroid levels early morning, before 9am and last dose levothyroxine 24 hours before test

Is this how you did your test?

If doing private testing test early Monday or Tuesday morning

What vitamin supplements are you currently taking

ESSENTIAL to test vitamin D, folate, ferritin and B12 at least once a year

Which brand of levothyroxine are you currently taking

Teva is currently only brand making 75mcg tablets

Teva brand upsets many many people

Approx how much do you weigh

75mcg is only one step up from starter, unless extremely petite, likely under medicated

[Void1234]

Thanks for the advice Slow Dragon, so GP called and said my FT4 looks on the hyper side and TSH Hypo , im really not sure what that means, but as Grey Goose said im going to get the private tests and investigate further. My goiter has got quite large and swollen and its uncomfortable sleeping. I understand them wanting to take it out , but id like to understand the medications i might need. Vitamin side i take ViT D , Berocca , selenium , garlic. I take also a cerazette pill. Im 12 stone weight active, but lots of life stressors, Ive a good diet lots of salads, some fish, limited gluten, take lacto free as cant take dairy. Teva 75mgs

[SlowDragon Administrator in reply to Void1234]

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

You need vitamin levels tested …privately if GP won’t

Dizzy …low B12 often the cause

Panic attacks suggest you are under medicated on inadequate dose levothyroxine

12 stone = 76 kilo

Guidelines on dose levothyroxine by weight is 1.6mcg levothyroxine per kilo of your weight per day

76 x 1.6mcg = 121mcg levothyroxine per day

You might need a bit more….or a bit less

But very unlikely 75mcg dose is high enough

[greygoose]

No way is your FT4 on 'the hyper-side'. lol It would be a hell of a lot higher - well over range - if you were hyper.

Berocca is a waste of time and money - like all multis:

* It contains the wrong type of B12 for good absorption - cyanocobalamin, rather than methylcobalamin

* it contains the wrong type of folate - folic acid rather than methylfolate

* it contains vit C, which would block the action of B12 in the body, anyway

* it contains zinc and mangesium which should never be taken together because they block each other! And it doesn't say what type of magnesium, either, but I would guess the cheapest and least absorbable.

So, you won't get much out of it. Far better to take your supplements individually, and correctly spaced.

Are you taking all these supplements well away from your thyroid hormone - four hours for vit D and magnesium.

Little point in eating 'limited' gluten. You have to be 100% gluten-free to get any benefit from it.

[Void1234 in reply to greygoose]

Hi , just an update , i done my private bloods and here are the results TSH 1.21 mu/L, normal range 0.27-4.2mu/L , T4 18.9 normal range 12-22 PmoI/L, FT3 4.9 PmoI/L normal range 3.1- 6.8 PmoI/L I am really not sure how ive jumped from the higher to lower TSH so quickly but im meeting ENT next week and really not sure how they will view this? Im still in normal range , from these but i honestly feel rotten. Any steer appreciated, im at menopause age and am think is this swinging my levels about?

[greygoose in reply to Void1234]

You feel rotten because you're a poor converter and your FT3 is too low. The results may all be in-range, but I'm afraid that doesn't mean much. It's where the results fall within that range that counts.

I don't think menopause swings results around, no. And, there's no accounting for the TSH. It does what it wants. But, were both tests done at the same time of day?

[Void1234 in reply to greygoose]

Hi Yes both morning periods. Is there any questions i should ask the endo ? Or next steps thanks for your response

[greygoose in reply to Void1234]

Morning periods, ok, but that's not saying much. What time? Because the exact time is very important where TSH is concerned.

Have you had your nutrients tested: vit D, vit B12, folate, ferritin? Sometimes poor conversion is caused by nutritional deficiencies.

Do you have Hashi's?

[Void1234 in reply to greygoose]

Hi yes have Hashi’s, 9am tests done no food taken. I got by Iron levels, Folate, all checked inJuly and all ok and that is why GP referred me on to Endo - Vit D i take 3000 IU daily.

[greygoose in reply to Void1234]

Well, with Hashi's, levels are bound to jump around a bit because of the nature of the disease. And, Hashi's people are very often poor converters, and there's nothing they can do about it except take T3.

[Void1234 in reply to greygoose]

Thanks for advice , Grey Goose ive had alot of stress recently and that hasn't helped matters. Having a goiter I just notice alot more swelling , which is just worrying me abit.

[greygoose in reply to Void1234]

I doubt it's anything to worry about. With Hashi's, swelling comes and goes.

[Void1234]

Hi yes, vit d is evening with my selenium.

[SlowDragon Administrator in reply to Void1234]

You need to click reply otherwise other poster isn’t alerted

Suggest you ditch the Berroca

Stop any supplements that contain biotin a week before all blood tests

Get tested

Assuming folate or B12 are low …..getting a good quality vitamin B complex

Eg Thorne Basic B

[Void1234]

Hi all, just to provide another update on my thyroid , i met with Endo and all bloods they said where perfectly in range and my symptoms were not thyroid related. They said to take out thyroid as was giving problems with swelling. I am abit concerned if they take it out , the battle then to get my levels right. If they will not listen at this stage.