Hypothyroid or long covid?: Hi, I’d appreciate... - Thyroid UK

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Hypothyroid or long covid?

Dandelade profile image
27 Replies

Hi,

I’d appreciate some opinions. Endocrinologist says not typical hypothyroid symptoms and referred me to a long covid clinic.

Symptoms are fatigue, then brain fog, then dizzy, then speech problems (slowed speech, stutter, problems finding words). If I rest then the stage doesn’t develop, but I’d have to not work for that to happen. Worse in late afternoon early evening but sometimes wake up bad and get worse.

Up to date tests:

TSH 0.53 (0.27-4.2)

Free t4 18 (12-22)

Free t3 4.1 (3.1-6.8)

B12 79 (37.5-188)

Vit D 80 (50-250)

Folate came back with error. Have been supplementing methyl folate and vitD for months.

Tests taken 24th from levo no food or drink, 7:30am.

According to endo optimal and no t3 trial.

Anyone else similar symptoms? What would you do next?

Thank you in advance for your support.

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Dandelade
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27 Replies
SlowDragon profile image
SlowDragonAdministrator

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

FT4: 18 pmol/l (Range 12 - 22)

Ft4 only 60.00% through range. Room for dose increase

FT3: 4.1 pmol/l (Range 3.1 - 6.8)

Ft3 only 27.03% through range

So currently under medicated and poor conversion

Most people when adequately treated will have Ft3 at least 50-60% through range minimum

EXACTLY What vitamin supplements are you currently taking

Dandelade profile image
Dandelade in reply toSlowDragon

I’ll have to wait till I get home and look at the bottle beyond methyl folate and vit d! I researched before I bought them but brain fog can’t remember details now…

Dandelade profile image
Dandelade in reply toSlowDragon

I’ll try the suggested b complex thanks slow dragon. Here’s a pic of what I’m taking currently…

SlowDragon profile image
SlowDragonAdministrator in reply toDandelade

in week before blood test when you need to stop vitamin B complex….instead just take the Methyl folate you have there (that’s the one I use week before blood test )

How much vitamin D are you currently taking ?

Probably need higher dose in winter than summer

Do you also supplement magnesium

Dandelade profile image
Dandelade in reply toSlowDragon

3 sprays a day, so 225 micrograms/ 9000UI of D3 and K2 each.

Don’t do magnesium supplement. I got confused with some people saying you needed to know if it was magnesium or zinc that you were deficient in and don’t do the wrong one without testing but then couldn’t see where to get tested?

SlowDragon profile image
SlowDragonAdministrator in reply toDandelade

no point testing magnesium

If your taking vitamin D and on gluten free diet (which is low in magnesium) you’ll likely benefit from addition of magnesium supplement

Best taken afternoon or evening …..at least four hours away from levothyroxine

Zinc ….you could test

Personally I just take zinc once a week

SlowDragon profile image
SlowDragonAdministrator in reply toDandelade

Better You vitamin D spray with k2- The red bottle

One spray = 1000iu

Read the small print on back of the bottle ……Catches many people out

So 3 sprays per day is 3000iu per day

Dandelade profile image
Dandelade in reply toSlowDragon

Gah! The cheeky swines. Thank you, will look for mg and zinc…

SlowDragon profile image
SlowDragonAdministrator in reply toDandelade

The green bottle - one spray = 3000iu

But doesn’t have K2 in it

SlowDragon profile image
SlowDragonAdministrator

Looking at previous posts

Still on 125mcg levothyroxine

Which brand

You have Hashimoto’s

Have you had coeliac blood test done via GP before trialing gluten free diet

Are you now on absolutely strictly gluten free diet and/or dairy free diet

SlowDragon profile image
SlowDragonAdministrator

Also….rather than just taking folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement

SlowDragon profile image
SlowDragonAdministrator

Push for next dose increase in levothyroxine …..perhaps an increase of 12.5mcg daily

Work on improving low vitamin levels and if not already gluten free or dairy free it’s always worth trying these

Then get full thyroid and vitamin retested in 2-3 months

If Ft4 is at top of range, but Ft3 remains low ….look at getting T3 prescribed alongside levothyroxine

vast majority of endocrinologists are diabetes specialists

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3 if necessary

tukadmin@thyroiduk.org

Dandelade profile image
Dandelade

Thank you for the comprehensive response Slow Dragon, appreciated and some things to try.

Yes on 125micrograms of levo, not tested for coeliac but don’t eat gluten.

I’m not going insane though and those can be hypothyroid symptoms?!

SlowDragon profile image
SlowDragonAdministrator in reply toDandelade

Yes …absolutely

Most people when adequately treated will have Ft3 at least over 5.5 (if not higher) before feel well

tattybogle profile image
tattybogle

Hi Dandelade .... i've experienced what you describe ever since i've been on levo (2003) if i push myself too far .... including the speech issues .... so , if it's long covid , i'm ahead of my time.

Doctors /Endo's seem to be rather 'hard of hearing' on the subject of what constitutes a 'typical thyroid symptom' ..

1990 ...... recently 'treated' thyroid patient describes to Doctor how their muscle power , then brain , then speech, keep 'crashing' ~ as though the cells have suddenly run out of juice .... The doctor remembers being taught that thyroid hormones are long lasting ,and most of his thyroid patients don't complain of this , so the fluctuating symptoms described by this patient can't be thyroid ..... "those aren't typical thyroid symptoms ... i'll refer them to the Psychology Dept."

Repeat with another patient every 6 months until ....

2005..... recently 'treated' thyroid patient tells the (Same) doctor how their muscles, then brain , then speech, keep 'crashing' ~ as though the cells have suddenly run out of juice .... The doctor remembers that thyroid hormones are long lasting, so the fluctuating symptoms described by this patient can't be thyroid ...... "those aren't typical thyroid symptoms ... i'll refer them to CFS/ME dept."

Repeat with another patient every 6 months until ......

2022 ..... recently 'treated' thyroid patient tells the (Same !) doctor how their muscles, then brain , then speech, keep 'crashing' ~ as though the cells have suddenly run out of juice .... The doctor knows that thyroid hormones are long lasting, so the fluctuating symptoms described by this patient can't be thyroid ..... "those aren't typical thyroid symptoms ... i'll refer them to the Long Covid dept. ...... odd how many Thyroid patients get 'Something Else' just when i've made their thyroid condition better ~ then they come down here saying they are improved , but aren't quite right ,and saying they can't lead the physical life they used to before their thyroid problem ..... hey-ho , it must be 'Something Else' because my text book said it can't be thyroid " ..

" next patient please" ...

",....no, i don't think they are thyroid symptoms if they can come and go like that , (i've been treating thyroid patients for 30 yrs you know , and i know what i'm doing).... .... are you perhaps feeling depressed ?"

Dandelade profile image
Dandelade in reply totattybogle

I’m sorry you’ve gone through it too tattybogle, but also thank god. I’m so thankful to feel a little less alone here. It’s not in my head and it’s exactly like you say. I just run out of juice. If it was something else why would I be perfectly fine then not. And why would I be improved, then go back to not right, after every dose increase. Deaf ears. And if one more person dares to even hint I might be depressed it’ll be hard to not give them a mouthful!

Lotika profile image
Lotika

I only get the dizziness if I am taking too much T4, but in my case, yes to brain fog, fatigue, problems finding words and forgetting what I am talking about in the middle of the sentence, let alone problems finding words - that too. So, it's similar for me.

I recently tried the Igennus dissolvable vitamin b tablets and whilst they are not cheap, they seem much more effective than any other multi-B I have tried in the past. I seem to absorb them better, I think.

Dandelade profile image
Dandelade in reply toLotika

Thank you Lotika, I’ll look up the b supplement options and keep it in mind.

pennyannie profile image
pennyannie

Hello Dandelade :

Just for reference the accepted conversion ratio when on T4 monotherapy is said to be :-

1 / 3.50 - 4.50 T3/T4 with most people feeling at their best when they come is this range at 4 or under.

So if I divide your T3 into your T4 I'm getting your conversion ratio at around 4.40 so slightly wide of the middle ground.

We generally feel at our best when our T4 is up in the top quadrant of its range as this should in theory convert to a good T3 reading running at a slightly lower % through the range to the T4.

I read that ferritin needs to be at least over 70 for any thyroid hormone replacement to work well - do you have a current reading.

I'm sorry your doctor is suggesting this is long covid -

I think you are under medicated and hope once your core strength vitamins and minerals are optimal you will be better placed to discuss a dose increase with maybe a different doctor.

Dandelade profile image
Dandelade in reply topennyannie

Thanks pennyannie, always good to hear people saying the same thing. Last ferritin I have was 67.8 (13-150) from feb. The recent one has an error reading. I think ferritin might be ok? I have black pudding every other week, hopefully it’s helping something!

pennyannie profile image
pennyannie in reply toDandelade

I know I feel better with a ferritin at around 100 - so maybe try the Black pudding weekly !!

Dandelade profile image
Dandelade in reply topennyannie

Worth a try! Black pudding for breakfast every day next week 🤣

pennyannie profile image
pennyannie in reply toDandelade

If you fancy a change I'm on the Asda chicken livers -

1 little tub weekly, defrosted and flash fried down in a little olive oil - then whizzed into a pate with a little mayo if too dry and stored in the fridge in an old jam jar.

A spoonful a day helps this medicine go down - especially with a dollop of Hellmans !

Dandelade profile image
Dandelade in reply topennyannie

I’m sure it’s nicer than it sounds! I do like a good pate 😋

Zazbag profile image
Zazbag

It's insufficient T3, not "long covid".

Thalia56 profile image
Thalia56

if those are your only symptoms (only meaning restricted to, not in any way to minimise them), I suspect it’s more likely to be related to your low T3 than to be long Covid, even though symptoms fit both. But please be very careful about resting and pacing in the meantime, just in case it’s Covid-related; many people with long Covid have tried to push through and got much worse as a result. Do hope you feel better soon.

Dandelade profile image
Dandelade in reply toThalia56

Thank you Thalia56. At least if it is t3 there’s a hope for an improvement. I am pacing as much as I can, feeling sorry for myself today though and resting where I can!

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