I was starting to feel a little better, then........

[man1412]

Following the advice given in reply to my first email 3 months ago and using all the knowledge I have learnt from the questions and answers in the blog, I spoke to my GP and she agreed that I should increase my Levo from 75mcg to 100mcg. She also suggested that I should try Magnesium in the evening to try to improve my sleep quality and quantity.

I am now taking 100mcg (increasing in two steps 12.5 mcg at a time) and up to a couple of weeks ago I was feeling much better, although still tired, cold and unable to lose weight despite trying to! I was sleeping longer, and my night cramps had disappeared. My heart felt less “wobbly”, and I was less conscious of it.

In preparation for my Medichecks blood test, three weeks ago I stopped taking B12, and then about 7 days before the test, I stopped magnesium and glucosamine as I didn’t know if these affected the blood results.

A week ago I started with very bad headaches and nausea, both during the night and the day. I can’t sleep at all, resorting to a sleeping table to get off to sleep as I am very tired and exhausted. My body aches and my PMR has flared up.

I took my test on Monday, following all the rules. Fasting test at 9.30 am, 26 hours after my last 100mcg Levothyroxine.

The results were:

CRP HS 1.640 mg/L ( Range <3)

Ferritin 57.50 ug/L (Range 30 – 332)

Folate Serum 31.7 nmol/L (Range >7)

Vitamin B12 – Active >150 pmol/L (Range 37.5 – 188)

Vitamin D 93.5 nmol/L (Range 50 – 250)

TSH 0.085 mlU/L (Range 0.27 – 4.2)

Free T3 4.4 pmol/L (Range 3.1 – 6.8)

Free thyroxine 22.3 pmol/L (Range 12 – 22)

Thyroglobulin Antibodies 24.50 (Range 0 – 115)

Thyroid Peroxidase Antibodies 262.0 (Range 0 – 34)

I was really surprised at the results and would appreciate your advice and guidance before I contact my GP. Is the excess of T4 causing my symptoms and suppressing my TSH? I think my conversion rate to T3 is just over 35% - is this low?

I am extremely worried that the excess of T4 could result in a return to Atrial Fibrillation. I am not sure what to do about taking my thyroxine at the moment, and I haven’t taken today’s dose. Is this a correct step? Should I leave it off or reduce my dose? Hopefully my GP will organise blood tests to monitor my levels.

Sorry for the length of the post. Your help and expertise will be much appreciated.

[AKatieD]

TSH is not important when being treated and does not cause problems. Afib is linked to hyperthyroidism not hypo and overtreated hypo is not the same as hyper.

The important ones are the T4 and T3. The T4 being slightly over the range and T3 being low suggests you don't convert T4 to T3 (this is the process for making the active hormone) well which is important and is likely to be causing your tired/ cold/ unable to lose weight symptoms.

You need T3 to be added to your treatment and then you will be able to reduce the T4 you take a tad as to feel well you proobably need them in the top quartile of their ranges.

Your peroxidase antibodies show you have the autoimmune form of hypothyroidism called Hashimotos.

Your B12 looks ok as over range b12 does not cause any problems. Ferritin and D3 a little low.

[man1412 in reply to AKatieD]

Thanks for your reply AKatieD. Do you think that my headache is caused by excess T4, and should I reduce my T4 by 12.5mcg for a while, even before I hopefully can get T3? Endocrinologists have told me that my PAF was caused by too much thyroxine. Thanks for your comments on my Ferritin level - I am trying to increase my red meat and liver etc.

[AKatieD in reply to man1412]

Sorry dont know about your headache, it is possible but I have had slightly high T4 and not had a headache. Maybe others can advise?

Seems like you increased T4 3 months ago so if it was going to cause the headache would have happened before the last week. Maybe stopping supplements before the test caused it but if so presumably you are back on them now and so the problems should be resolving soon.

Endocrinologists will say too much hormone will cause AFib but then they also look at TSH for treating thyroid and we know that is rubbish, so would not be confident in that opinion.

I have occasional AFib too but take T3 only, so been looking at this for a few years. I did find a recent study that confirms the link with hyper not hypo so will try to find and post it

[man1412]

Thank you. You could be right about stopping supplements, as the headache is improving now. It could be down to lack of sleep now! If you do find the article about AF and hyper/hypo, I am very interested to read it.