I was diagnosed in December 2019 with an overactive thyroid (hyperthyroidism) with a T4 reading of 99, with palpitations and heat intolerance amongst my symptoms After tablet medication including the radioactive pill, which actually triggered thyrtoxicosis; I was formally diagnosed as having Graves’ disease as my eyes were bulging and the skin on my legs was thickening.
In May this year I had thyroidectomy and given thyroxine: all was well until the heat intolerance started again mid June and this week my face is breaking out in small blisters.
Is this connected to thyroxine dosage / brand ?
Also I thought T3 etc were range readings but some people refer to them as an actual medication, can you kindly explain this in detail please. Thank you
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Graves is an auto immune disease for which there is no cure as the cause is within as something has happened to trigger your immune system to turn and attack your body rather than defend,
Graves tends to get diagnosed when one's immune system starts to attack either the thyroid or the eyes as the symptoms can be very distressing - and with the thyroid being a major gland - Graves is considered life threatening - if not medicated.
By removing the target of the immune system attack, the thyroid - the seriousness of Graves is then downgraded and then with the thyroid removed the patient is referred back to their doctor where it is believed primary hypothyroidism is best treated,
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg :
Some people can get by on T4 only medication - Levothyroxine.
Some people find they need to also need to add back in a little dose of T3 - likely to replace that little bit lost when they lost their thyroid - making a T3 / T4 combo :
Some people can't tolerate T4 and need to take T3 only medication - Liothyronine.
Whilst others find their health restored better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human thyroid gland and derived from pig thyroid, dried and ground down into tablets, referred to as grains.
For all things Graves Disease and AI - www,elaine-moore.com
Thank you for your swift and full reply. Slkng with greygoose’s info , I am better informed and as I have a blood test with my endocrine nurse kn 11 Aug I will be asking more questions about T3/T4 medications.
In my teoky to gregoose I refer to my history of taking levothyroxine with no reactions and I maybe clutching at straws to think my facial rash could be a brand issue but I don’t want to rule it out just yet as the brand I started on Monday is new to me (Accord)
Fortunately I have a face to face GP nurse on Friday about the skin on my legs- she will therefore see my facial rash.
Meanwhile I am using Sudacrem as a base for my makeup 🤭
Yes, it may well be a process of elimination regarding the blisters.
It could also be linked to Graves Dermopathy - please dip into Elaine Moore :
How are your eyes - are you still being monitored by a Graves Ophthalmologist and Endocrinologist ?
T3 is the active hormone which the body runs on - T4 is basically a storage hormone that your body needs to be able to convert to T3 within the body.
Optimal conversion of T4 requires optimal levels of ferritin, folate, B12 and vitamin D so as well as getting your TSH, Free T3 and Free T4 blood analysis also ask if these core strength vitamin and minerals can be run and we can advise from the results and ranges what this all means.
It is recommended to have an early as possible morning blood test appointment.
We suggest you take your daily T4 medication after the blood draw - so the measure is of what your body is holding onto - rather than what you have just ingested.
We also suggest you stop taking any supplements that are being tested for around a week before the blood test, for the same reason and also any supplements containing biotin should also be stopped for around a week prior to the blood test as this substance can interfere with some Laboratory assay measuring systems.
T3 is a thyroid hormone. Also called Triiodothyronine when it is natural and made by your thyroid. And Liothyronine when it is synthetic made in a laboratory. They are both called T3 for short. The blood test is either Free T3 (FT3) or Total T3 (TT3 or T3). It is the active thyroid hormone.
T4 is the thyroid storage hormone, which doesn't do much until it is converted into T3. Also called Thyroxine when it comes from your thyroid. And Levothyroxine when it comes from a laboratory. The test is either Free T4 (FT4) or Total T4 (TT4 or T4).
The tests we always need to go for are FT4 and FT3 because they are the form of the hormones that are readily available for use by your blood. The Total T4 and Total T3 measure the the total amount of hormone in the blood, both the Free and readily available hormone, and the hormone that is bound to proteins for transport, and doesn't distinguish between the two.
Your outbreak of blisters is more likely to be due to the heat than the levo pill. If it were due to the levo pill, it would have started as soon as you started the levo. But, there is always the the possibility that you are allergic to one of the fillers/excipients in the pill. But highly unlikely it is due to the active ingredient, the T4 hormone.
thank you greygoose for your speedy and full reply. I understand the medication much better now. I was actually taking a vlmbi of carbimazole to reduce my thyroxine levels together with levothyroxine before the thyroidectomy and hoped the heat intolerance would “go” after the op. Which it did fir a few weeks. My face is full blown itvhy and blotchy today and I am contacting my pharmacy for details of the brands I was prescribed pre op as I thought it could be a brand issue.
Well, it could be. Different people react differently to different brands. That is something that most doctors - and pharmacists - have difficulty understanding because, as they say, the active ingredient is the same in all of them. I think they're being deliberately obtuse - especially the pharmacists, because they of all people should know about fillers/excipients and how they vary. But, if it only happens in the heat - is it hot where you are today? I'm cold! lol If it only happens in the heat, it seems to me more likely to be heat intolerence caused by the hypo itself.
Hi greygoose. It is definitely not the heat - as oddly I am quite balanced heat wise this week and even in the heatwave weather here and on holiday in Greece I have not had a facial rash.
Find out which brand of levothyroxine you were taking previously
You need to get vitamin D, folate, ferritin and B12 levels tested
Request these at next blood test
Are you currently taking any vitamin supplements it yes….what exactly
Always test thyroid levels early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
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