I found what I believe to be an informative and interesting article for people who suffer with Hypothyroidism and all it’s complications.
Doctor's like to dismiss us when we complain of unusual pains this article proves what we already know that “we are not crazy”.
Hello Batty1I have read the article, but there is no mention of T3, or the need for optimal levels of vitamins and minerals, or non-conversion, or possible dietary adjustments. It is quite a basic read of hypothyroidism. There are lots of better articles, although plenty of worse ones too, out there.
Where it says that when TSH and T4 levels are within normal limits with levothyroxine treatment, that any remaining symptoms are not related to the hypothyroidism, this is absolute rubbish.
I am speaking from my own experience.
Thankyou for posting this, it may be useful to someone. Any information can be useful to some people. Sorry that I 'm not that person.
Life would be soon much easier.
👍
I liked it for its reference to hypothyroidism and pain … not for T3 talk.
Sorry if I seemed dismissive, or upset you.I just get frustrated when most published articles are very narrow-minded in their opinions. They always say the same...
Research shows or suggests that there is no evidence etc etc..
The reason is probably because they haven't researched the right people, who, in turn, would prove to them that their research is flawed.
It is the state of society today, that if you challenge a narrative, or try to provide a different point of view you are not even considered, but blacklisted, having first been debased.
They could try using members on this forum who have lived experiences, many of whom could give the relevant evidence that is absent in his research.
I wasn’t upset with your opinion of the article and I 💯 agree but I was just pointing out I picked the article for referencing pain with hypothyroidism… which I suffer with tremendously and get dismissed by doctors.
Since being diagnosed 3 years ago, whilst I am lucky not to have developed any joint or muscular pain, I have noticed a stiffening of the joints, widespread weakness and loss of strength. The stiffening has gone since I stopped levothyroxine and started liothyronine. Apart from the vast amount of symptoms, I have developed high blood pressure for the first time in my life, having always been low. I have developed hyperglycaemia, arthritis in my finger joints bilaterally, and dupuytrens contracture bilaterally. I have also developed high cholesterol and non-fatty liver disease.
I have wondered if everything is related.
A few sources have said yes, it could be, but most medics say no, of course not.
Seems a bit coincidental to me.
Unfortunately for me I can never stop T4 but I do take a combo of T4/T3 my pains rage on but Im also someone who developed PSA shortly after In lost my thyroid.
DandyButch If you are interested in a really clear and understandable review of clinical data evaluating T4 mono vs T4/T3 combo AND T3 mono - see the study I linked here:
healthunlocked.com/thyroidu...
Question 14 reviews T3 mono.
It only covers trial data through 2014, but it’s a completely objective presentation of what the trial studies returned.
I also had low blood pressure until after a year or so on Levo when it suddenly leapt to borderline high. Also prediabetic hbA1c results (but I’m 70 now and it does increase with age). And aching finger joints.
Cholesterol, however, went down when optimally dosed.
Bearo DandyButch
Dandy- the high cholesterol caught my eye too as something that ISNT related, as in my experience and in reading other forum member guidance/experience, cholesterol always goes down after Free Ts optimize.
So maybe that is actually caused by something else for you?
Hi. That is the problem. I am not optimal yet. Far from it. So the fight goes on....
Ah, I see. I thought you were saying your cholesterol shot up after starting Levo/improving Ts.
But yes, my cholesterol crept up while I was undiagnosed, but once on Levo, cholesterol creeped down!
I loved the part in the article that suggests ruling out hypo before/as part of initial treatment decisions for joint pain.
Imagine if other disciplines could do the same - like, patient presenting as depressed… check thyroid function first! Patient is fatigued … check thyroid function first! Imagine that!
The article said this:
Screening for Hypothyroidism and Joint Pain: The American Thyroid Association recommends that screening for hypothyroidism begin at age 35 and continue every five years.
Well THAT sounds like a great idea! My symptoms started at 43. Would’ve saved me tons of mystery to have thyroid tested at 35, and at 40, etc instead of waiting 8 years of growing and diversifying symptoms!
But then I was curious… “American Thyroid Association “… guidelines, standards… I’ve never seen any American standards. So I clicked to their website and read their standards and…
TERRIFYING!!!
Levo only, recommends against Lio combo, and beauties like this: “FREE T3: Measurement of free T3 is possible, but is often not reliable and therefore not typically helpful.”
It’s a wonder anyone is treated with any effect at all with all the things I read in their guidelines.
I think the only saving grace here in the US is doctors have way more discretion and leeway to do what they want, and as I e said, as long as you have some kind of health insurance, then the costs for the patient aren’t totally prohibitive. Which we can debate all day long, but generally.
Either way - love the article. horrified at the ATA guidelines . Makes me question everything on this board if not for the fact that this board makes logical sense and is actually making me feel better. Yikes.
Hello FallingInReverse,
I agree, earlier testing would be much better.
However, it fails to address the fact that many, many people with hypothyroidism in the UK, under our NHS, are not optimally tested, let alone optimally treated.
They are more concerned about cost and box ticking than about patient health. Here, in my experience, it is not considered or treated as a serious health condition, and medics seldom consider symptoms when prescribing. Computer says no.
Many on this forum recommend lower TSH and higher % through range for T4 and T3 to give optimal health than the NHS who base their dosing on just TSH within range, which is quite broad. So, if you fall in the top end of range, regardless of symptoms, you will be told it's normal, therefore no treatment.
If your treatment is sub-optimal, with hypo symptoms, but within NHS ranges and considered by NHS as normal, the researcher states that the pain symptoms are not hypothyroid related, and must be treated as a separate condition. This is absurd, in my opinion.
I obviously don't live in the USA, but wonder if you experience similar ' within range' variations, when testing. Also here in UK, NHS only test TSH, and only base treatment on this result. Do they only test TSH in USA?
When I look back to my 2018 blood work from an annual diagnostic physical (comprehensive health screening, not with my regular doctor), it has TSH (which was 2.9 0.4-4.0), FT4, FT4 index, and Total T4. Unfortunately I didn’t get another physical until 2022, at which point my TSH was 85. So that was a no-brainer. At that point I have notes I jotted down that they re-tested to include TSH, FT4 and FT3, but I was never able to track down whether they did or not.
I then went to my regular doctor, and he did a follow up, I can’t remember exactly but basically a “thyroid panel” which included:
TSH, Total T4 and adding one type of Thyroid Antibodies, PLUS Total T3 and T3-Uptake.
When I see a post here with T3 Uptake tested, I can guess they are in the US.
At that point I found this board, and I started asking my doctor specifically for what I need. I email them with the exact list of blood tests, I ask them for exactly what refill I want. And - since I figure they know I’m making sense - I get what I ask for. Not sure how “out there” I’d have to be before they pushed back, but so far no push back.
So in general, in the US, I think it’s OUTDATED, but once you as a patient know what you need, the doctor has complete discretion to do what they see as necessary.
They might not know on their own about “in range” vs “optimal” - but if told, there are no restrictions like the NHS lays down.
I love my doctor as a person, and for lots of other health issues, and he is extremely well intentioned.
For example, when the 50 mcgs Levo wasn’t working, he took the weekend, did some research, and came back with something “experimental “ to try, which ended up being T3/Lio.
He dropped by 50 to 25 and added 10 Lio/day. So he really really meant well, but just didn’t know better.
I can’t make any generalizations as I am only one story. And I found this forum, so I stopped needing a doctor to diagnose/treat me and figure things out, and really only need a partner with the ability to write prescriptions. Which he does.
Did you continue or stop the T3 /Lio.?
I am still on it, while I’ve taken a series of 6-8 week periods to get my Levo back up from that dreadful 25 mcgs towards a target replacement dose (by weight I’m titrating towards as much as 100, currently at 75.)
My plan has always been to try to stop the Lio, as I was never given a chance to see if I would be fine on the right dose of Levo only.
Right now I’m closer to optimally medicated than Ive ever been - having been so undermedicated for so long.
In the next 2-6 months I’m pretty sure I’ll be trying to reduce the Lio and concurrently increase the Levo. Doing the math on precisely how to do that will be my next challenge!
Not as easy as it sounds. Do you know if you are a good converter?
No idea, by the time I found this forum and knew anything, I was already on combo.
Never had FT3 tested before I started Lio.
I have no reason to believe I’m not though…! I dream of a day I can take one simple Levo pill in the morning : )
I can’t stand ATA and in the US depending on your doctor depends on what they test … labs don’t interfere with doctors orders … but doctors here pretty much test just TSH and FT4 unless your like me (thyroid-less)
Batty1 hello fellow American!
DandyButch
Good point, as I forgot to mention, blood test labs and pharmacists here would never do something different than a doctor asked.
That’s definitely another big difference between the Uk and US.
This is a problem here.... I only found out today following a telephone appointment with my endocrinologist (four months after last one)I was told it didn't matter whether I had the blood tests, requested by the endocrinologist, done at the hospital or GP surgery. So, as the GP is more convenient, I, naturally, chose the GP.
It transpires that regardless of the request made by the endocrinologist, the GP will only test TSH.
So, the T3 tests she requested have not been done!!!! So, the endocrinologist is prescribing based on TSH and weight only.
She is going to request more blood tests. She is writing to the GP. However, this time, if the GP won't do them all, I will have to have them done at the hospital.
Also, based on my TSH results she cannot prescribe more T3.
She has recommended a referral to a psychiatrist. Apparently they are allowed to prescribe loading doses of T3 to treat depression, which I have. So another long wait.....
I have another appointment with the Endocrinologist in about 6 weeks after the blood tests. But the only thyroid tests will be TSH and T3.
The fight goes on, and on, and on.
I found it useful. It rounded out some things we certainly experience and know about. This ‘official’ source is important. It’s just a pity no medics seem to pay any attention to any ‘official’ sources other than those aimed at cutting costs. They are pathetic, looking for a pat for ‘saving’ pennies.
I got OA even though have good T3 levels. I agree though if ever I had seemingly random aches and pains without cause in the past it was because my thyroid was not right. HRT has been the OA answer as I have not had any flares since starting it and can run again injury free.
Thank you so much for this article Batty1. I have very poor finger joints (and others) that I assumed was osteoarthritic degeneration but having read the article it looks as if there's hope of reversal of the degeneration. I have an endo appointment on Thursday, if he's approachable I will see about increasing my meds, so thanks to you for lifting my spirits and perhaps even healing my joints!
back again - people saying I have thyroid issues - I don’t know what to do?
don’t know what’s happening 
Dealing with dismissive doctors...advice?
Low blood sugar issues with hypothyroidism? 
why don’t people get on with TEVA? 
