Hi all, I'm hoping someone can help me with this. Since being diagnosed with Hashimoto's around 2 years ago, I've continuously increased my levothyroxine dose, and have seen little improvement in symptoms and lab results. My TSH has consistently been in the 4.5-20 range and my Free T4 has consistently been in the middle to top of the range. As far as symptoms go, I'm fatigued, constipated, depressed, but also regularly have problems with restless legs, excessive sweating, and occasionally hot flashes (the sweating and hot flashes seem to be a blood sugar and/or hormonal problem), and I thought I had become pretty good at recognizing when I feel hypothyroid and when I need to increase my dose.
But my most recent test results are very confusing.
TSH: 0.109 (range: 0.45-4.5)
Free T4: 1.80 (range: 0.82-1.77)
My TSH has dropped dramatically and my T4 is just above the reference range, which is the complete opposite of what it usually is. Yet, I still feel hypothyroid. The fatigue continues to slowly get worse and worse, just as it always has. I still occasionally struggle with lack of motivation and depression. I'm still always constipated. But my labs somehow show the opposite of what I'm feeling.
The only thing I've changed is my diet, and even that I've only slightly changed. I've been trying to eat small but more frequent meals (and I haven't been very good at that because I sometimes have to work 8 hour shifts without any break for food), and I've been eating more fruits and a few more vegetables (I've not been very good about that either)
I've done this because I've found that keeping my blood sugar at a more consistent level has dramatically helped with the sweating and hot flashes. If I start feeling one coming on, I just eat a small meal and it goes away. I don't see how this could cause me to stop needing to increase my levothyroxine dose
So the only thing I could think of was that maybe my body is having trouble converting T4 to T3? My endocrinologist doesn't ever have me test T3 as he thinks it's unnecessary and I doubt he would see any reason to test certain vitamin levels such as B12 and ferratin. Personally, I don't even see the point in seeing and endocrinologist as all he does is order tests every few months and adjust my dose of levo accordingly, and I can do that on my own. I've asked him repeatedly if there is anything else I can do to have better thyroid health and he says my only 2 options are to keep increasing my levothyroxine dose until my body has destroyed as much of my thyroid as its going to, or get surgery to remove my thyroid so I don't have to continuously increase my levo dose.
So I guess I'm asking, does anyone think I'm on the right track as far as my body not being able to convert t4 to t3 very well? And how do I find an endocrinologist who actually has solutions?
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CraftyGamer19
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I did just realize that I've had my ferritin and B12 tested in the past for other reasons but they were both considered normal.B12: 419 pg/mL (range: 232-1235)
Ferritin: 41 ng/mL (range: 15-77)
These were both tested about a year and a half ago and about 6 months after I started treating hypothyroidism
I've also had problems in the past with what I think are heart palpitations (it feels like my heart skips a beat), and it seems to have gotten worse lately. I think that can be a symptom of B12 deficiency, but it can also be a symptom of hyperthyroidism.
They can also be a symptom of anaemia and your ferritin was terrible. Less than 30 is considered ferritin deficiency and you were barely above that 18 months ago.
I am currently taking 75mcg levothryroxine on alternating days with 100mcg. It is not always the same brand as I get whatever generic bran my pharmacy carries. But i do always take it exactly as instructed - on an empty stomach, first thing in the morning, and not eating for an hour.I do not currently take any vitamin supplements because they are usually expensive and I find it difficult to remember to take them since I can't take many of them in the morning with my levothyroxine.
Are you saying that when I test my TSH and T4 that I should do it on the morning before I take my levothyroxine dose? The most recent test was done at around 3pm, whereas I normally test sometime in late morning. Could that be why my tests were weird?
Unfortunately, I live in the US and I do not think there is any way for me to order a test to do at home. I would have to convince either my GP or my endocrinologist to run a more extensive thyroid panel and vitamin levels. But I will try and find some good supplements and see if I feel better with those.
I am currently not on a vegetarian or vegan diet and I never have been. I have already been tested for coeliac disease, which came back negative, but I did try a gluten free diet after that test regardless and I don't believe I noticed any difference, except that I had frequent heart burn.
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