Elderly mum put on lots of weight and is exhausted

[Pinkpetite]

HelloMy mum has been on thyroxine for 40years. All the females in the family on her side are on thyroxine. Her dose used to be 125mcg or 150mcg I can't quite remember. Over the years they've reduced her dose as of course they've only been doing limited blood tests. She is now on 75mcg/100mcg alternate days but takes 100mcg daily as she feels so exhausted. She has put on about 3 stone in weight over very recent years and cannot walk far at all now as it's too much for her. I've arranged for a blood test measuring the T3 as well as T4 the usual TSH ferritin FBC and vit D. I feel she probably needs an increase in dose but she already takes 100mcg daily unbeknownst to them. How do we navigate this? Would it be a good idea for her to take just the 75mcg daily before her blood test in 10 days time? Or stick to 100mcg and just tell them? I'm also wanting her to see a private endocrinologist in the Dorset area. Can anyone private message me if they've found a good one? Many thanks 😊

[Lalatoot]

Pink, She needs to stay on the dose she is on. Any change of dose takes 6 - 8 weeks to change things so changing now would invalidate the blood tests. At the moment you don't need to tell them anything.

If your mum takes her levo once a day, leave 24 hours between her last dose of levo and her blood test. To do this you might need to alter the time of her levo dose the previous day. She should not take her levo on the day until after the test. This way you are measuring her ft4 at its lowest.

Once you have the results is the time to start the discussion about the dose she is on and any changes to that dose. Post the results on here and we will help.

[pennyannie]

Hello Pinkpetite :

It sounds as though your Mum's thyroid medication has been reduced too far and her metabolism slowed too much and now at too low a level to allow her any QOL.

Generally in primary care doctors seem to only be able to run a TSH function test and sometime a Free T4 reading on which to dose adjust medication which is inconclusive.

We need to also see a Free T3 reading to know how well the T4 is converting to T3 which is the active hormone that runs the body and It is too low a level of Free T3 that causes all the symptoms of hypothyroidism.

So to help you better the minimum we do need to see is a TSH, Free T3 and Free T4 blood test reading and range drawn from the same blood sample.

No thyroid hormone replacement works well until core strength vitamins and minerals are up and maintained at optimal levels and if ferritin, folate, B12 and vitamin D are low these will compound your mother's health and well being further.

When metabolism runs too fast, or too slow, the body has trouble extracting key nutrients through food, no matter how well and clean one may eat, so to be thorough having results for ferritin, folate, B12 and vitamin D as well as inflammation and antibodies would give us the most thorough of blood test results to help and advise on.

If you go into Thyroid UK - the charity who support this forum - thyroiduk.org there is page of private companies who offer a range of blood tests and can run a full thyroid profile ( around 10 blood analysis ) from one venous blood draw.

I think, between them, Blue Horizon and Medichecks cover the country offering a nurse home visit to draw the blood which I find the least stressful option to action for myself, once a year.

If Mum is taking any supplements these need to be left off for around the week before the blood draw so we see exactly what her body is holding onto and she needs an early morning appointment and must refrain from taking her daily dose of T4 until after the blood draw so leaving around a 24 hour window from her last dose of T4 - Levothyroxine to blood test.

Once with the results start a new post with all the readings and ranges and you will be talked through the next best steps back to better health for your Mum.

[Pinkpetite in reply to pennyannie]

Thank you. Her Gp is doing the T3 ferritin vit D too so I will see what the results are like. Should she stay on the 100mcg dose and just tell them?

[pennyannie in reply to Pinkpetite]

Ideally, your Mum needs to be on the same dose of T4 for around 6-8 weeks before the results of that dose can be assessed well from a blood test result and she needs a TSH, Free T3 and Free T4 taken from the same blood draw.

Arrange a morning appointment for the blood draw by around 9.00am and make sure there is around a 24 hour gap from her last dose of T4 so we see what she is ' holding ' and that she takes her daily dose after the blood draw.

Just reassure her that Levothyroxine is a storage hormone - it does not matter that she waits to take her daily T4 until after the blood draw.

[Pinkpetite in reply to pennyannie]

Thank you will do.

[humanbean]

This may be of interest and relevance :

healthunlocked.com/thyroidu...

And this might be helpful - no guarantees though - it depends on how your mother eats now :

knowablemagazine.org/articl...

[Pinkpetite in reply to humanbean]

Thank you I will take a look.