Need to know please

[Tife]

Hi Everyone! I've been diagnosed of hyperthyroidism and doctor prescribed me propranolol 40mg and levothyroxine 50mg to use together once daily. I hope it's safe to use

[PurpleNails Administrator]

Welcome to forum

Was is hypERthyroid or hypOthyroidism?

What were your blood test results?

Add them with lab ranges. TSH, FT4 & FT3.

Have any thyroid antibodies been tested & or any nutrient which need to be optimal for thyroid health. Eg folate, ferritin, B12 & vitamin D.

propranolol is often prescribed with an anti thyroid for over active thyroid. It has an anti thyroid element & lowers uptake of Levo & reduces FT4 : ft3 conversion.

No other medicine, food, supplements, drinks except water should be taken with Levo. You need to leave a gap if you take other medication.

[pennyannie]

Hello Tife and welcome to the forum :

The Propranalol is a beta blocker which should ease any heart palpitations being experienced and it will also slightly down regulate your ability to convert T4 into T3 as it is generally too high a T3 for you - that causes symptoms of hyperthyroidism.

However I have never heard of T4 - Levothyroxine being prescribed at this juncture - were you already hypothyroid and already prescribed T4 and this a lower dose perhaps ?

What symptoms are you dealing with and can you share with forum members the blood test results that were run for these prescriptions to have been given to you :

Ideally these look like a TSH + Free T3 + Free T4 readings and ranges + possibly an antibody reading look like = TPO -TgAB - TRab - Tsi _ or a TSH thyroid Receptor and number ?

[Tife]

I'm grateful for the reply. Here is my TFT

Color

[PurpleNails Administrator in reply to Tife]

Is your thyroid issue a new diagnosis? & based on above results the doctor has given you Levo & propranolol, or did you have an existing condition?

Your results aren’t usual because you often see low TSH with high FT4 & FT3 (hyper) & when TSH is high it is due the FT4 & FT3 being very low.

You might see such results if you had been hypothyroid & then added a replacement in the days / week before retesting.

Your FT4 is high & FT3 over range. I’d expect you to have hyper symptoms with these levels.

[pennyannie]

I'm a little confused as to why your doctor has prescribed the T4 -

your T4 result is already in range at around 60% and increasing the T4 will likely also increase your T3 which is currently over range and likely what is causing your symptoms -

As already detailed the Propranolol will likely cause some down regulation of T4 into T3 and that is what is required -

I think adding in a prescription for T4 simply makes matters worse at this point in time :

Do you have any readings for the antibodies so we can try and understand why this may have happened ?

However if your doctor is just understanding the TSH reading - this is in fact over the range and signalling that your thyroid is struggling to function and that you are heading towards becoming hypothyroid and will then be in need of T4 thyroid hormone replacement medication.

Are you being referred to an endocrinologist - are you suffering with any other health issues, and where are you - as there is nothing on your Profile page ?

If you wish to reply to anyone in particular you need to make sure you reply in their reply box and their name comes up as you start replying.

We can all read what you are writing as it is your post so there is no need to keep repeating yourself.

[Tife in reply to pennyannie]

Thank you so much for this. Please what do think I should do? I'm confused!

And also, the conclusion of the result that I sent is what?......hyper or hypo?

[pennyannie in reply to Tife]

What diagnosis has already been made ?

If thyroid antibodies haven't been run - this is a next step along with a referral to an endocrinologist as your results are not as one would expect to see if the thyroid were functioning properly.

A normal thyroid function test would have a TSH down at around 1.20 - a T4 at around 50% through its range with a T3 in percentage terms tracking slightly behind the T4 :

[Tife in reply to pennyannie]

I have these symptoms: coarse voice and neck nodule

Symptom

[pennyannie in reply to Tife]

Ok - so you have a nodule causing this over range T3 reading - so likely causing these symptoms - have you seen an endocrinologist or waiting for an appointment ?

[Tife in reply to pennyannie]

I have seen an endocrinologist and he assessed it then prescribed levothyroxine and propranolol

[PurpleNails Administrator]

We need to see your blood test results when you were diagnosed.

If you have hyperthyroidism the thyroid or a thyroid nodule is over producing. You blood test results would show over range FT4 & FT3 and low TSH.

Nodules can be cold non functioning or hot (toxic) hyper function. They can also occur without autoimmune or with. So testing antibodies important.

Was this ultra sound scan report? Ultra sounds don’t conclusive reveal function, has to be assessed with blood test results.

A nuclear scan is only was to show visual picture of funtion.

If hyperthyroid you would need to be prescribed an anti thyroid eg carbimazole or PTU. Not more hormone. Levo will make hyperthyroidism worse.

Who prescribed the replacement? Have they explained your results to you?

[Tife in reply to PurpleNails]

Hmmm....they did not explain my results to me in details, He only told me it's hyperthyroidism What test am I running next please?

[PurpleNails Administrator in reply to Tife]

If dr has diagnosed hyper, why increase levels further. They have given the wrong treatment.

Do you have hyper symptoms?

You need thyroid antibodies tested.

TPO, TG, TRab & TSI.

Have you only has the 1 thyroid tests? Any repeat or follow up.

Go back to your doctor & ask why Levo was prescribed.

[Tife in reply to PurpleNails]

Thank you so much....I will feed you back as soon as the test is been done

[Tife in reply to PurpleNails]

For the symptoms : slightly swollen neck and coarse voice

[Tife in reply to PurpleNails]

Good day Admin, Thanks for helping so far. I have been to some laboratories around me, it's just so unfortunate they are not running the test you requested of me to do which is Thyroid antibodies

[PurpleNails Administrator in reply to Tife]

Are you still on 50mg levo, or has this changed?

Have you had recent FT4 & FT3 blood test?

Do lab offer any of these these?

TRab (TSH receptor antibodies) - measures stimulating neural & blocking antibodies)

TSI (Thyroid-Stimulating Immunoglobulin)

TPOab (Thyroid Peroxidase antibodies)

TGab (Thyroglobulin antibodies)

[Tife in reply to PurpleNails]

Haven't started the levo since you said it's a wrong treatment for the condition. And for the antibodies test, I'm yet to see lab running those here

[PurpleNails Administrator in reply to Tife]

I never said not to treat, I said - Go back to your doctor & ask why Levo was prescribed…..

Members here are patients & you must always consult your doctor.

If your doctor diagnosed hyperthyroid (too much thyroid hormone) adding more replacement would worsen it, wouldn’t it?

Your results show quite a high TSH, when hyper this is often low or shown as 0.01. But because the TSH is high dr has given hypothyroid treatment. But your FT4 is high & FT3 over range.

I also don’t know if these results are from pre diagnosis or after any treatment.

Have your symptoms changed? Did you start the propranolol?

I think you need to re-test TSH, FT4 & FT3 again. Use a different lab, there a chance something interfered with test. Sometimes supplements can do this for example Biotin. Or antibodies can affect results.

[Tife in reply to PurpleNails]

Alright. As for the symptoms, no more coarse voiceand nodule remain its size.

The results are pre diagnosis

I'll try and re- do the test whenever I have the means...it's quite expensive

[PurpleNails Administrator in reply to Tife]

It must be difficult if you must pay for it. This forum and most members are in UK.

If your voice is better it may mean levels has changed, so is important to retest when you can.

[Tife in reply to PurpleNails]

Alright. Thank you so much, I'm grateful.