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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