Under active Thyroid with symptoms!

[Chelly04]

I have a long history of thyroid problems, diagnosed in 1986 with Graves Disease, had a Thyroidectomy in 1988, have been taking thyroxine since late 1988. In the past 15 years I have been suffering with dry eyes, dry mouth, dry ears, dry nose, and dry oesophagus. I have been tested for Sjogrens but everything has come back negative. Now they are suggesting it could be the Graves Disease causing these symptoms.

I have found a lot of information on Graves’ disease with overactive thyroid but nothing for Graves Disease with under active thyroid! Does anyone have any information on this?

[Lalatoot]

Chelly welcome. Those symptoms could be caused by being on too low a dose of levothyroxine and being hypo.The symptoms of hyper and hypo are not clearcut like the lists you read on the internet. In reality you can suffer the same symptoms hypo and hyper.

I have been hyper and am now hypo so can say from experience that the only way I can tell is by thyroid blood results.

For example I lose weight when I am undermedicated hypo but the lists would give this as a hyper or overmedicated symptom. I have had palpitations hyper and hypo

Have you got any blood results you can share?

[PurpleNails Administrator]

Welcome to forum.

Symptoms can be very varied & individual, what is seen as Graves like symptoms could be inadequate thyroid replacement.

How much replacement do you take?   Do you always have same brand?

Did you previously take antithyroid medication? Was any other treatment given such as radioactive iodine as well as thyroidectomy.  

When you have a blood test to test thyroid function is it in morning,  fasting overnight, delaying dose until after draw?   

Do you take any supplements? Supplements containing biotin need to be avoided before blood draw as can interfere with test & skew results.

What has been tested & what are result?.  You are entitled to you results obtain online access or printed copies with ranges.  

For full thyroid function you need

TSH

FT4

FT3

TPO & TG antibodies.  TSI & TRab - these may not have been tested recently, but should have when diagnosed.  

Also important to test Folate, ferritin, B12 & Vitamin D.

Gluten often issue with thyroid autoimmune.  Any gut issues? 

The surgery removes possibility of thyroid overproducing & being hyper but doesn’t remove the autoimmune aspect - you do still have Graves - it’s just the victim (the thyroid) has been taken out of the equation.  

With dry eyes, are eyes gritty? Swollen? Any Redness? Any Eye bulging or puffiness.  Thyroid eye disease closely associated with TRab & Graves & can occur at any time, a specialist needs to diagnose & manage & is often poor recognised.

Once you have results we can advise better.

[SlowDragon Administrator]

Welcome to the forum

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

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

Please add most recent thyroid results and ranges if you have them

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

On levothyroxine we need OPTIMAL vitamin levels for levothyroxine (Ft4) to work well to give good active hormone (Ft3)

Also many Graves’ disease patients (like Hashimoto’s patients) find strictly gluten free diet might reduce symptoms

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

EXTREMELY common after Thyroidectomy to have low Ft3 relative to Ft3 on just levothyroxine

Many people need addition of small doses of T3 prescribed alongside levothyroxine

First step is to get FULL thyroid and vitamin testing done

Come back with new post once you get results