Hi everyone. I hope everyone had a wonderful Thanksgiving. I'm so thankful for all those that took time to help me in the past and can hopefully help me now.
I was started back on levothyroxine on November 18, 2022. Initially 25 mcg. Have since saw a doctor that increased it 50mcg. But I'm still having a symptom called orthostatic hypotension. It's killing me and the doctor doesn't have much of anything to help other than agree my free T4 is really low by last lab done. She doesn't know why my blood pressure keeps dropping like this. If I stay laying down I'm okay. But this morning while I was using the restroom I passed out and hurt myself I think I was more embarrassed than hurt. I read it could be my levels are just so low but having this happen is extremely scary. One minute I'm okay and the next I'm out. This puts me completely out of the land of the living. Nobody can function like this. I've also been told to increase my salt. So if anyone can advise me on this or has suggestions please let me know. I haven't had a full thyroid panels done yet I only have TSH and Free T4. I'll post them. If this is bc of low levels how long is this going to last?? I'm terrified after passing out this morning. And I'm also having low blood sugar as well. I'm not a diabetic been okay my entire life and none of this has ever been a problem until my thyroid started having problems.
Thank you again for taking time to help me. -Lisa xoxo
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I started having pain around my back in the area of my kidneys right before this started. labs aren't showing any infection. So now I'm dealing with both pain and low blood pressure (passing out) Thank you so much.
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Wow okay thanks for all the info. I just wonder how long until I can increase. She was like just take your meds and see you if anything changes. Obviously she has no idea about this thyroid thing. And this gp is my only choice for who knows how long. I guess I'm stuck on 50 mcg. Oh I pray this gets better. I can't drive or work I can't function like this. Omgoodness!! I weigh 150 pounds. No other labs she said she'd retest in 2 months. I'm so upset😥 I can't go 2 months.
Thank you for everything. I appreciate it. -Lisa xoxo
It is possible it is something else that is also being affected by your thyroid. I started passing out long before my thyroid numbers were off, and it was iron! I was low in iron. Demand a full blood work and if necessary, go to an emergency department or see another doctor. Passing out is serious and your doctor should take it as such.
Could you 'persuade' your dr to do TSH, FT4 and FT3? The FT3 is important as the 'active' hormone, and I suspect yours is probably low, whereas it needs to be in top half of range for patients to feel well. There is also a condition known as Low T3 syndrome (non- thyroidal illness) and there is info about this on-line.Sadly doctors and endos will normally only use TSH tocdiagnose thyroid issues in UK and abroad which is dundamentally wrong. TSH (Thyroid Stimulating hormone) is a pituitary hormone and only shows how much thyroid is in the blood at the time of the test. What they should be checking are the actual thyroid hormones FT4 and FT3.. FT4 needs to be in top half third of range, or just over for some patients) and TSH needs to be 1 or below for most to feel well, but we are all different and what suits one doesnt necessarily suit another.
Tests needed are TSH, FT4, FT3, TPO, tgab and Trab (the last one for Graves/hyper), Ferritin (iron), full iron panel, Vitamin B12, folate, magnesium, potassium, zinc, copper (the last 3 drs rarely check or Vitamin D due to cost).
If dr refuses these you could do a home finger prick test to include TSH, FT4 and FT3 for £29. This is a fully accredited NHS Lab based at the Royal Devon & Exeter Hospital, so doc should take note of these. There is also Medichecks who do vitains and minerals also and I think they have an offer on at present for 25% off, otherwise they have offers on Thursdays. If you join Thyroid UK they have a list of recognised companies incuding these and you can get discount. If you supplement with B12 you would need to stop that several months before the test, and if you supplement with biotin you need to stop that about a week before.
Also do you have your blood test early in the morning before food, just drinking water? Plus take the levo after the test, leaving a 24 hr gap between your last dose and the test. The reason for this is that TSH alters during the day and if you have it after say lunch sub-clinical hypothyroidism can be missed.
A xortisol test would also be a good idea as yours could well be low, so worth discussing with your doctor to rule out Addison's.
Hopefully you have access to your on line records, if not just ask for a form to sign to get log in details. Otherwise you can ask for free printouts so you can keep an eye on your results and what was tested!
Deep breathing and listening to calming music can also help. If you are not happy with your doctor's response you can always ask for a second opinion from another at your surgery.
According to Earl Mindell's The Vitamin Bible low blood pressure, which can cause passing out, may be helped by a vitamin/mineral and low b/p is taken seriously in some countries. I think it's chromium but you'd need to check.
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