I see that slowed Achilles reflex is a symptom of HT (thyroiduk.org/signs-and-sym... and have experienced several Achilles "niggles" over the past 3 years whilst training for middle distance running events (20 mile XC). Does anyone have any experience with improved Achilles function/less injuries when their thyroid situation is managed?
Thank you.
Have you ever looked into plantar fasciitis? It is a common problem in hypothyroid sufferers and has been mentioned fairly often on the forum.
en.wikipedia.org/wiki/Plant...
Hypothyroidism gets a mention on the wikipedia page above.
When I had it it presented in the most common way - my ankles wouldn't bend when I first woke up in the morning after a night's sleep, and the soles of my feet would be extremely painful. But once I walked around for a bit both my ankles and the soles of my feet would loosen up and become much more normal - until the next morning when the problems would repeat.
I always had to walk downstairs extremely carefully when I first got up.
I no longer have plantar fasciitis. I found that it disappeared when I started taking sufficient thyroid hormones. For some sufferers this might include requiring T3.
Most doctors, naturally, blame the plantar fasciitis on being overweight or lack of exercise. But neither losing weight or exercising more makes any difference to the people I've read about with the problem.
Are you still only on 50mcg levothyroxine
Symptoms should slowly disappear once on higher dose
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
8.1.24 - Private blood test (Thriva) results TPOA 240 klU/L (0-34)TgAB 92.6 kU/L (0-115)
Meds history this far: 2 months on Almus 50mcg (box states Almus, blister pack states Accord - I assume they're one and the same?) - felt awful in every respect for 2.5 weeks, then good, until 2 weeks on Teva 50mcg with negative reaction, ie anxiety and heart palpitations. Next 2 weeks on Teva 25mcg (halved the dose for relief from palpitations but then slumped back into tiredness/low mood), then back on Almus/Accord 50mcg, felt awful again for 11 days, but have now felt good for last week.
Having shown my doc the private bloods showing Hashi antibodies he then said whoops should've tested for those, sorry, so had another blood test yesterday for that purpose. Whilst with the nurse I asked that the blood also be tested for TSH, FT4, T3, ferritin, folate, Vit D and B12 but I'm not holding my breath! Once I've been back on my current meds for 6 weeks I'll get a private test done for everything the docs have missed out. It's all so expensive though isn't it!
So definitely Hashimoto’s
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.
Very likely low vitamin levels
Especially as been far too long on only 50mcg Levo
felt awful in every respect for 2.5 weeks, then good, until 2 weeks on Teva 50mcg with negative reaction, ie anxiety and heart palpitations. Next 2 weeks on Teva 25mcg (halved the dose for relief from palpitations but then slumped back into tiredness/low mood), then back on Almus/Accord 50mcg, felt awful again for 11 days, but have now felt good for last week.
Don’t be surprised if symptoms start returning at 6-8 weeks this simply means that you are ready for next increase in dose Levo
Test thyroid levels yourself privately approx 6-8 weeks after each dose increase in Levo …….
Test vitamin D twice year
Test folate, ferritin and B12 at least annually
approx how much do you weigh in kilo
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)
cks.nice.org.uk/topics/hypo...
bnf.nice.org.uk/drugs/levot...
nhs.uk/medicines/levothyrox...
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 always be below 2 on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
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).
sciencedirect.com/science/a...
The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.
Once I've been back on my current meds for 6 weeks I'll get a private test done for everything the docs have missed out. It's all so expensive though isn't it!
Testing options and includes money off codes for private testing
Just TSH, Ft4 and Ft3 test - £32
monitormyhealth.org.uk/thyr...
10% off code here
thyroiduk.org/testing/priva...
if need vitamin levels too
Monitor My Health (NHS private test service) offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65
(Doesn’t include thyroid antibodies)
monitormyhealth.org.uk/full...
personally I include testing antibodies once a year as it’s been interesting to see TPO reduce on gluten free and dairy free diet
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
And if you suspect adrenal issues use Blue Horizon as includes cortisol
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
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)
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Only do private testing early Monday or Tuesday morning.
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70:
Interesting graph showing TSH in non HT people; my TSH was 3.98 in 2011 (aged 42 - I have no recollection of why those bloods were taken) and 3.65 in 2014, which I think was when I had a scan of my neck/throat because it was a long standing joke in my family that I only took tiny swigs of water even though it appeared I was downing the lot, and I would quite often get food stuck in my throat, despite chewing to a pulp. No abnormalities were noted and no further action required. Although now in light of my November 2025 Hashi diagnosis I do wonder .....
Thank you again SlowDragon.
At my diagnosis appointment my endocrinologist performed the ankle reflex test along with looking for other physical signs.They were shocked how slow they were compared to what my blood results said. This basically confirmed my diagnosis
I hadn't had any issues with my feet or aware my reflexes were slow. I doubt many specialist or gp's perform this test or even know that it's a sign of low thyroid issues.
That's interesting, thanks. Did the reflex improve when meds were optimised?
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