Seeking reassurance: I’m really struggling and... - Thyroid UK

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Seeking reassurance

WestElf profile image
14 Replies

I’m really struggling and hoping for some reassurance from anyone (my background and test results are in my Bio and first post). I’ve been on increased dose of 75mcg levothyroxine for two weeks. Symptoms improved the first two days but since then I’ve been feeling awful. In addition to my usual symptoms I also feel anxious and hopeless.

At my appointment with my thyroid specialist two weeks ago the doctor said that they want to get my thyroid levels fully optimised first and then start to improve sex hormones. Supposedly HRT does not work effectively if thyroid is not optimised.

I’m clinging on to this plan but now I’m doubting that I’m on the right track with thyroid and worried that this latest experiment is not going to help. I’d be grateful for any positive reassurance please.

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WestElf
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Regenallotment profile image
RegenallotmentAmbassador

What a journey, and so familiar, I’ve been round the same block with HRT prescribed too early in my 40s making me quite unwell with lasting symptoms (fibroids and destroyed digestion) and therapy for mental health clinical anxiety and depression before getting a hypothyroidism diagnosis, isn’t it frustrating. I’m happy for you that the private specialist finally helped you!

Week 2 to 4 is always awful for me with an increase. 5-7 is gradual return to ‘less shit’ this continues as you climb up the doses but does settle. My private specialist at Roseway says to keep on for 12 weeks before taking a view (unless you are working up doses or have awful symptoms obvs).

But…. Burping… for me that’s a lactose/dairy reaction and many many Levo products have lactose so have a think about ingredients in the different Levo products you are prescribed. E.g. for me Accord was so awful, gurgly, burpy, loose and frequent bowel movements so stopped after 48 hours, Teva better but made me itchy.

Your results in bio show B12 in range but that was when you were taking the multivitamin with B12 before you started Levo. I wonder if that has dropped? Some of your symptoms could also be B12 deficiency, mine appears low in range but I’ve discovered injecting and the Pernicious Anaemia forum here in Health Unlocked which has been very helpful. Apparently you can have B12 circulating but not getting used. Mine seems to be used up by stress/exercise and is work in progress. Drops like a stone if I don’t keep up with supplements r injections. Worth looking at maybe? Get tested first… I missed the boat and treated first and can’t go back 🌱

WestElf profile image
WestElf in reply toRegenallotment

Thank you so much! So reassuring to hear about the time taken to feel less awful after dose increases. As my bloods have never been out of range and I am feeling no better since starting Levo I am just worried that there is nothing at all wrong with my thyroid and I’m barking up the wrong tree.

I will look into the B12 suggestion.

Interesting re dairy… I’ve had the burping symptom for years and have tried lots of things… for me it seems unrelated to food but more to do with stress and movement… but I am happy to hear suggestions.

Thank you again!

Jaydee1507 profile image
Jaydee1507Administrator

Blood results from BEFORE I started levothyroxine - March 2024 (taken at 8am fasting with no biotin) :

TSH 2.00 (range 0.27-4.20mlU/L)

Free T4 14.2 (range 12.0-22.0 pmol/L)

Free T3 4.3 (range 3.1-6.8 pmol/L)

Anti-Thyroglobulin Abs 13 (range <115 IU/mL)

Anti-Thyroidperoxidase abs <9.0 (range <34IU/mL)

Vitamin D 83 (range 50-200nmol/L)

Ferritin 55.60 (range 13-150 ug/L)

Serum Folate 23.10 (range 8.83 - 60.8 nmol/L)

Active B12 83 (range 37.5 - 150pmol/L)

If you've stopped taking the multivit then I'd recommend a B complex to keep all your B vits in balance.

B complex suggestions: Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

helvella.blogspot.com/p/hel...

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc

Link with ideas for dietary iron:

dailyiron.net/

Do you have the blood results from when you're now on 50mcgs Levo before GP increased your dose?

Vit D is good.

WestElf profile image
WestElf in reply toJaydee1507

Thank you so much for those suggestions - I’ll look more carefully at the detail you’ve provided tomorrow. Just wanted to respond and say yes, my most recent results are in this post:

healthunlocked.com/thyroidu...

Sorry I can’t type them out just now as on phone only but I will be able to tomorrow.

Jaydee1507 profile image
Jaydee1507Administrator in reply toWestElf

TSH 0.33 (range 0.27-4.20mlU/L)

Free T4 16.8 (range 12.0-22.0pmol/L)

Free T3 4.5 (range 3.1-6.8pmol/L)

Anti-Thyroglobulin Abs 14 (range <115IU/mL)

Anti-Thyroidperoxidase abs <9.0 (range <34IU/mL)

Vitamin D 111 (range 50-200nmol/L)

Ferritin 61.50 (range 13-150 ug/L)

Serum Folate 16.90 (range 8.83-60.8nmol/L)

Active B12 79 (range 37.5-150pmol/L)

Free T4 (fT4) 16.8 pmol/L (12 - 22) 48.0%

Free T3 (fT3) 4.5 pmol/L (3.1 - 6.8) 37.8%

Your conversion rate is pretty good but you need to raise your FT4 more to get your FT3 up too.

FT4 aiming for probably over 70% of range.

A lowish FT3 will be causing you symptoms.

B12 is only just at a good level. What are you taking for that?

Folate needs to be raised further to over 50% of range. What are you taking to raise folate?

You absolutely need the increased dose and its quite normal to feel a little better before slipping back with symptoms. Things will even out and improve over time.

WestElf profile image
WestElf in reply toJaydee1507

Thank you so much for the advice and reassurance - I really appreciate it.

I’m not taking anything for B12 and folate at the moment. Issues around swallowing is a big symptom for me, so naturally I avoid swallowing pills. I’m wondering if the Better You B Complete spray would be a good option as it contains folic acid and B12. However it also contains pyridoxine which I see from the link you shared above might be problematic. I always get so frustrated when trying to buy vitamins because finding the supplements I want usually means taking something else that I don’t want - argh!

Anyway, are you recommending that I find a way to take both B12 and folic acid/B9? I will certainly do that.

Jaydee1507 profile image
Jaydee1507Administrator in reply toWestElf

The Better You B complex spray contains a low dose of folic acid which isnt as good as methylfolate. I wouldnt recommend that one.

This one from Metabolics has the correct active ingredients and the safer form of B6 P 5 P metabolics.com/online-shop/...

Alternatively, a number of people have swallowing issues and you can tip the powder from Thorne Basic B out and take it like that without the capsule.

WestElf profile image
WestElf in reply toJaydee1507

Oh that’s so helpful. Thank you. I’ll get that one.

WestElf profile image
WestElf in reply toJaydee1507

Hi again Jaydee1507, I was just looking again at all the information you provided me… you said to increase ferritin and I have actually been trying to do that (lots of issues around eating so it’s difficult but I’m doing my best)… I’m wondering if I should supplement? Or get a full iron panel blood test done? I’ve seen that recommended on here…

I remember supplementing iron when I was pregnant and I felt amazing on it! I don’t think my ferritin is low enough to supplement though? What do you think?

Jaydee1507 profile image
Jaydee1507Administrator in reply toWestElf

Many women often do feel amazing whilst pregnant. All to do with the hormones and extra blood circulating.

Ferritin 61.50 (range 13-150 ug/L)

Although this result isnt optimal its a way off deficient. Ferritin should be around 90 - 100 for best use of thyroid hormone.

To now if you have room for a supplement you should get an iron panel run. Having too much iron can make you unwell and getting an iron panel run you will then know if you have room to supplement.

Chicken liver pate a few times a week with vit C (orange juice works) can really boost your level for ferritin.

WestElf profile image
WestElf in reply toJaydee1507

Thank you. I love liver pâté so will do that with the orange juice and focus on the other dietary tips you linked me to. I’ll hold off on the iron panel test and supplements for now and see if the dietary stuff can boost levels.

Thank you again for your time and thoughtful advice.

BonnieG123 profile image
BonnieG123

I remember when (40 years ago) a general practitioner had me on different doses several times a week. He drove me away as I couldn’t remember which dose to take and I found a good endocrinologist who got me on the right dose. Your two days good reminded me of this. Is your doctor an endocrinologist?

WestElf profile image
WestElf in reply toBonnieG123

Oh that must have been confusing for you! I am in the UK and my doctor is a private general practitioner specialising in thyroid, not an endocrinologist. I trust them and they have said that this is going to be a slow process. I know that I just need to be patient but it is very difficult when I feel awful and my mind starts doubting everything. It is nice to hear reassurance on here.

BonnieG123 profile image
BonnieG123

👍🏻Good when you can trust your doctor. Best always!

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