Probably for about 6 months now I have noticed I don’t have defined collarbones anymore and there seems to be a build up of fat instead. I’ve attached a photo of my left side as this side is much more prominent than the right. I notice it when I do my make up as I stretch my neck forward and that’s when it seems to be most noticeable.
It doesn’t feel like a lump, it’s soft and squishy. I had a thyroid scan recently and they didn’t notice it, generally the scan was fine but showed hashimotos thyroiditis. I do have difficulty swallowing sometimes too.
Anyone have a clue what this might be or is it just from weight gain? I gained about 3 stone in 3 months when all my issues started in 2017 and haven’t been able to shift it - despite now eating 10x better and exercising regularly.
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katyy94x
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Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
TSH should be under 2 as an absolute maximum when on levothyroxine
I have this too, asked GP, asked Ear Nose and Throat at hospital…. They don’t really know, suggesting it might be lymph or fatty tissue. It didn’t show up as anything sinister on ultrasound or MRI
I think now I’m close to optimally replaced (a moving target) it’s going down a bit. Definitely still there though.
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
As you have Hashimoto’s you should be tested for coeliac
Has this been done
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten.
Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too.
Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Thanks so much for all your help. Waiting for GP to respond to my request for an endocrinology referral, full iron panel test, coeliac test and some other outstanding bits.
Was more the lump/fat I'm baffled by. Be interesting to see if it goes down once everything else is sorted. I will ask the GP about it when i see him.
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Lump front of neck
Thyroid scan
Hashi's pain in the neck
