Prior to March I was fit and healthy. Developed slightly numb toes on long haul flight. 2 weeks later had serious riding accident so didn’t see dr about toes for another 3 months. After blood test diagnosed with hypothyroidism. Started on 75mcg Levothyroxine but took 50mcg as leaflet said should not start above this if over 55 ( I’m 71). After 2 months second test TSH fine so kept on 50mcg. Questions are;
1. Are toes likely to be anything to do with Hypothyroidism?
2. Could accident have triggered Hypothyroidism ( my mother developed this at similar age)
3 I think Hypothyroidism only recently started- if so could it be getting progressively worse? So should I ask for more frequent tests. Should I ask for T4 to be included.
Fell ok now but legs a bit weak and achy but may be due to less activity after accident.
Test results 9 July 2 Sept
TSH 17.6 nr 0.38-5.33 2.1
T4 5.7 nr 7.9-14.4
Written by
VeraSimkiss
To view profiles and participate in discussions please or .
I think that you have a typo or two in the test results. Rather than us guessing what they should be, can you edit (or reply) to correct them?
helvella - Editing HealthUnlocked Posts/Replies
Having read a post or reply you have made, I wonder if you realise that you can edit (or delete) any posts or responses you have made here. That means the title, the text or images.
This is not to say you have done anything wrong. This is meant to help you by pointing out this option, and help to do so, not to criticise.
There is no need to reply to this! If it was helpful, ticking the "Like" button lets me know.
1. Your toe problem could very well be a symptom of your hypothyroidism, yes. Sounds like the beginning of a neuropathy, which can be caused by being hypo, or by having low B12 - which can also be caused by being hypo. You really need to get your nutrients tested: vit D, vit B12, folate and ferritin. Being hypo causes low stomach acid which makes it difficult to absorb nutrients, but you need optimal nutrients for your body to be able to absorb the hormone you're giving it.
2. No, the accident won't have triggered it. To have a TSH of over 17 you would have had to have been hypo for quite some time. It comes on slowly. But you don't notice it for quite a while because the adrenals take up the slack.
3. It has got progressively worse, yes. And will probably continue to do so. Depends on the cause of your hypo. Have you had antibodies tested: TPOab and TgAB? If not, ask for them to be done.
No point in testing sooner than 6 weeks after starting levo or changing dose. It takes that long for the body to adapt and the dose to settle. FT4 should always be included - and FT3 if possible - but doctors usually only test for TSH these days. But if you wish, you can always get private testing done, which will give you all the necessary tests. Details of private testing here:
Very doubtful that numb toes would be the only symptom. You probably have others that you don't associate with your thyroid. There are many, many symptoms and they can occur anywhere in the body and brain.
There is only one treatment for hypo and that is thyroid hormone replacement (levo, etc.), replacing the hormones your body can no-longer make enough of. But you asked if it was going to continue getting worse, and that depends on the cause. If it is auto-immune then is will continue to get worse as your immune system continues to destroy your thyroid. But you won't feel that because of your increasing dose of levo;
Just being 'in-range' is not the same as optimal. I would suggest you post your results on here and let us have a look, just in case.
However you are now likely ready to increase up to 75mcg
Sept TSH - 2.1
This is probably too high
Was test done early morning, ideally before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Essential to test vitamin D, folate, ferritin and B12
Lower vitamin levels more common as we get older
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
What vitamin supplements are you taking
Also VERY important to test TSH, Ft4 and Ft3 together
What is reason for your hypothyroidism
Autoimmune?
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
TSH would have been higher if tested between 8-9am
And had Ft4 been tested it would have been false high result taking Levo before test
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 somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
I had numb toes before my diagnosis and an arm that ‘fell asleep’ in bed even if it was ‘on top’. As GG and SD say, common to have B12 deficiency with hypothyroidism and I too have both it seems (test results suggest plenty of B12 circulating but classic symptoms so likely it’s not getting where it needs to be). Any digestive complaints? Linked to autoimmune, the antibody testing mentioned by the others would show that up. 🌱
If you get b12 tested don't accept GP saying it's normal. It should be well over 350 ng l without supplementation. See PA forum on HU if you're concerned and need advice re b12.
Do you gave symptoms of b12 deficiency- see B12d.org?
Levothyroxine will most likely not help your b12 levels. Unless you are vegetarian or vegan it is unlikely that a change in diet will significantly improve your b12 levels.
Some medicines can reduce b12 absorption- these include PPIs such as omeprazole and the drug metformin.
If you were developing b12 deficiency then getting a diagnosis with your GP would be helpful. This can be made much more difficult by taking b12 or multi B supplements before any diagnosis.
The PA site on HU is a very good source of information as is the PA society.
The above are suggestions for your consideration and research: I am not medically qualified.
I was just reading a paper last night about how hypothyroidism is linked to poor collagen production/ maintenance , so tendons….it commented that little research has ever been done on this, but to me it might account for lots of problems that might also be attributable to b12/ vit D. I have a fibromyalgia diagnosis and wonder if I am particularly effected ( at pregnancy I had to wear a special corset to support my hips as hormones ‘ softened joints’). I got/ get pain and stiffness in particularly in hands/ fingers, hips, back of neck/ shoulders and notably sides of knees before diagnosis over two decades ago, and currently ( as GP decided to reduce levothyroxine dose). I swim 50 mins 5x a week to get gentle, supported, exercise…I am very impressed you have still been riding, but why do you think your accident could be thyroid related?
I had riding accident 2 weeks after start of numb toes and as far as I was concerned other than numb toes I was fit and healthy. Because of this I wondered if accident had triggered the hypothyroidism ( I had broken collar bone and 10 broken ribs so fairly traumatic). It just seemed odd that first sign of hypo started on long haul flight.
You do see that some people appear to get thyroid problems from trauma to neck eg car accidents with seat belts effectively across the thyroid in neck. I suppose with numb toes you might have been holding your foot at the wrong angle in stirrups, or just got distracted by them, but don’t think ‘sudden hypothyroidism’ could have caused your accident. I got all my hormones going off kilter in a very short time so blood tests/ symptoms showed hypothyroid, diabetic and menopausal effectively all together but in my early 40s! The energy needed to actually mend your body ( even if a youthful 71) might have put a strain on the system, and it then became obvious that your thyroid was no longer up to it; again change of air pressure can play havoc…I notice it even on the ground with changing weather and can going long distance air flights ( complicated by jet lag) with my fibromyalgia pains…never attributed it to interference with thyroid hormone production or conversion but perhaps it is as it’s like a mild form of what I was talking about above when T4 dose lessened. I find it takes some time to tie how you feel, and specific symptoms, plus treatment ( drugs, supplements,even diet etc) to external events( including doing or not doing things eg gardening) so have kept a daily health diary for the last 8 years…shows me patterns and proofs, even if drs.still don’t believe you…might be worth doing that as you now tackle improving your thyroid health…
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Fluctuating TSH levels - can anyone advise please?
Help understanding ranges and T3
New member
Results advice please.
Advice please 
