Thyroid medication requirements : Do you need... - Thyroid UK

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Thyroid medication requirements

Sailing14 profile image
6 Replies

Do you need less thyroxine medication if you are a lot less active than before and under stress? If so, should you try to exercise to avoid fluctuations?

TSH falling since last March due to above.

T3 and T4 normal throughout plus vitamins.

Also, does the thyroid gland still produce some hormone? Previous RA patient since 2004.

Thank you

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Sailing14 profile image
Sailing14
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tattybogle profile image
tattybogle

purely from my own anecdotal experience ..'possibly' yes. i do think perhaps i need 'a bit less' when i am doing 'a lot less' physical activity.

However it's also a bit of a "chicken and egg" question for me .... when a dose decrease was made based only on 'out of range results' when i was actually feeling ok, it has resulted in me becoming much less active .

last summer i very slightly increase my dose .. and also at the same time made a conscious effort to do more regular physical work. I got better and better over the summer and more and more able to work consistently without crashing ... but then it stopped feeling so good by the end of october ( i probably over did it with the work , i usually do) , and i have since put the dose back to where it was since i tend to hibernate and be a lazy sod until the end february anyway. I may well try putting it back up a smidge in spring and see if the same thing happens again.

As for "does the thyroid still produce some hormone ?" .. that depends on

a) how knackered it is.

b) how low the TSH is.

if it is not completely atrophied due to autoimmune damage , then it is still technically capable of producing 'however much T4 and T3 it is able to', depending on how damaged it is ... but while the TSH is kept low (due to taking additional thyroid hormone) , the amount actually produced will probably only be a very negligible little trickle,

But if for example thyroid hormone was stopped /very severely reduced and then the TSH went considerably higher, then it will be 'asked' to make 'more' T4 / T3 again and also the ratio of T3 : T4 will be increased . Whether it will able to produce ENOUGH when it is asked , is the real question though . If it is too damaged the TSH can 'ask' all it likes , but the thyroid still wont be able to make enough.

PurpleNails profile image
PurpleNailsAdministrator

It’s possible activity / stress levels are affecting thyroid.   Activity depletes thyroid hormones so reducing normal activity may mean you end up having higher levels, but varying activity levels from day to day is how many people live their lives.  & when illness & stress is involved imposing a exact exercise regiment to ensure thyroid levels stay right is impractical & may not resolve issues.  

Activity is not the only reason TSH reduces & TSH is not reliable to make conclusions about activity affecting thyroid levels.  it’s FT4 & FT3 you need to monitor - are they increasing?  “Normal” means in range but what’s normal for you.

Is RA radioactive ablation?   Radioactive iodine (RAI) - .The eventual outcome of treatment is different for each person, most are left with very little if any function, but once it’s at an insufficient level, replacement is used & what function remains is not investigated by doctors as not relevant to treatment.  

tattybogle profile image
tattybogle in reply to PurpleNails

i assumed RA rheumatoid arthritis... will have to re-write my rely if it is actually RAI :)

Sailing14 profile image
Sailing14 in reply to tattybogle

Sorry. I had RAI treatment in 2004.

tattybogle profile image
tattybogle in reply to Sailing14

ok ,, so ignore the "autoimmune damage" bit in my earlier reply and replace it with 'RAI damage' ..but this many yrs after RAI, i would think it is unlikely that your thyroid can now produce much anyway. depends on how 'effective' the RAI was. which is not something i know much about , so i'll shut up :)

McPammy profile image
McPammy

I take T3 and T4 combined medications. On starting T3 I noticed I had a lot more energy than I’d had in years. Obviously extremely grateful after being in a situation where I could barely walk due to being very under medicated for years. I’m a poor converter of T4 to T3 and have had a positive DIO2 gene test diagnosis. I find that I need to exercise to keep my levels in a good place. My TSH is always just about in range. My exercise consists of just walking briskly. I generally do this twice a day. Or go for one long walk during better seasons. I joined a gym in Dec 22 to use their treadmill so I can keep my brisk walking up. I don’t want to run in case I cause any joint damage etc as I’m 64 and want to keep being able to walk each day. I’ve noticed though that if for some reason I cannot keep to my regimen for longer than a week. Like this past week as I’ve got influenza, that by about day 5/6 I start to feel over medicated. I get dizzy, wake too early and my legs can go from feeling a bit too light to extremely heavy. So what I do when these weeks occur is slightly reduce my dose or even miss a dose. Next thing I know is I’m absolutely fine again. I believe it’s all about balancing your energy output along side what dose of T3 you are ingesting. Tricky at times but mainly ok as long as you can be consistent in your input and output of energy. T3 is an energy boosting drug but going over medicated can have the opposite effect. I’m a creature of habit so 90% of the time I feel absolutely fantastic. Full of energy. Good mood. And positive thoughts. I eat as healthy as I can too these days. It’s all about balance of T3 doses versus energy expenditure.

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