confused bit scared

[Bluesadawg]

Hello again, my symptoms are very confusing, can anyone make any suggestions please?

I’ve got hashimotos (2 & 1/2 years) & on 100mcg levo (vencamil). Like probably most people with hashi’s things go up & down but my response is usually within a range typical of hypo- fatigue, fuzzy head, temp intollerance, stiff joints, slow speech etc.

recurring low iron levels..

Due to fatigue my dr put me on hrt (i’m 48), evero sequi patches. I used them for one box, felt a bit worse thyroid-wise so stopped. Going back she has persuaded me to try again for 3 months until it settles.

The perimenopause symptoms seem to have eased, though due to ongoing really stressful life events atm (& maybe a single perimenopause symptom) causing & lack of sleep lately I’m experiencing constant anxiety symptoms, more like hyperthyroidism & a weird palputation ystdy which felt a bit over the norm. Still unpleasant. The usual ongoing fatigue has almost totally gone. But this is weird, infamiliar & I don’t like it. I know people with hypo can get symptoms of hyper occaisionally as more tissue is destroyed, but this is ongoing for over a week now. What could be going on? Thankyou

[Buddy195 Administrator]

Anxiety is the worst thyroid symptom for me and always flares if my thyroid medication and/ or key thyroid vitamins are not optimal. I have similar hyper-like symptoms (high anxiety, palpitations, tremor etc) when both under and over treated for hypothyroidism. Can you share recent blood test results?

[Bluesadawg in reply to Buddy195]

Thanks for sharing. I can’t find the drs ones just at the mo, but not sure if they were accurate anyway as I thought it was just an iron test so it was at the wrong time of day (4pm) & I was taking biotin still. But I have got this from Jan ‘25:

TSH 0.53 (0.27-4.20)

Free T4 17.9 (12.0-22.0)

Free T3 4.5 (3.1-6.8)

Cortisol 340.0 73.8-507.0)

The dr thinks I have chronic anxiety from years before my hash’s diagnosis, I think she’s right also.

Thankyou

[Bluesadawg in reply to Bluesadawg]

My vitamins are currently

ferrous fumerate 210mg from drs

L-methylfolate & B12

Vitamin D3 (1250mcg) & K2 drops (200 mcg)

Currently also on zopiclone 3.75 mg this week as the anx is interferring with my sleep

[Buddy195 Administrator in reply to Bluesadawg]

Do share the GP test also when you locate it. Also, ferritin, folate, B12 and vit D- which support thyroid health.

[Tina_Maria in reply to Bluesadawg]

Your blood test from January suggests that you could benefit from an increase in your medication.

T4 - 17.9 59% through the range

T3 - 4.5 37% through the range.

I suspect that especially your low T3 is giving you the symptoms. Most people seem to feel better when both their T4 and T3 are between 70 - 80% through the range.

You could ask your GP to perhaps increase your dose. A general replacement dose is 1.6mcg levothyroxine per kg of weight, so if you weigh 63kg, you may need 100mcg - but this is just a rough guide as we are all individuals; some people need more, some are okay with less

cks.nice.org.uk/topics/hypo...

Anxiety is linked to low thyroid hormones, as the low hormones are impairing the production of important neurotransmitters, such as serotonin and noradrenaline. But once your thyroid levels are optimised, this should resolve itself.

And if you are on HRT, oestrogen can indirectly lower your thyroid hormones, as it can interfere with thyroid hormone binding, so you may need to adjust your dose upwards to compensate.

[Bluesadawg in reply to Tina_Maria]

Thankyou so much. I’ve suspected for a while that my T3 is inadequate, but keep getting told its fine. We tried raising my levo slightly a while back but it made me hyper & even halving the dose I was given, so it seems optimal for me atm.

Thats really interesting about anxiety being thyroid related too. If you don’t mind I’d like to pront your reply & take it to my dr? I’ll keep it anonymous & just mention it was in an informed forum :-).

Thanks again, that all does make sense. Hooray!! 😀

[Tina_Maria in reply to Bluesadawg]

I can tag a recent post with a publication that shows that low thyroid hormones are linked to anxiety and depression

healthunlocked.com/thyroidu...

If I was you, I would not mentioned that you have received this information from this forum, as some GPs are very dismissive of that. But you can certainly cite the scientific publication from the post I have linked, which will have a lot more power, as he cannot argue against a peer-reviewed publication! 😉

[Bluesadawg in reply to Tina_Maria]

Thankyou, yes i’ll do that 👍

[Tina_Maria in reply to Bluesadawg]

Just to check with you, when you said that if you increased your dose, you became hyper?

Some GPs claim that you are hyper when your TSH goes near the bottom or below the reference range. This is however not correct, especially when your T4 and T3 are still fairly low in range. When you are on levothyroxine treatment, your TSH should not be a guide for treatment adjustments, as the TSH response in some thyroid patients is not like it would be in a person with a healthy thyroid. So your TSH could go low (indicating high T4 and T3 levels), even if your T4 and T3 are still low (as it is in your case), not like it is the case for a normal responding thyroid. Hence, once you are on medication, you should really be guided by the free T4 and T3 and not the TSH. Sadly, many GPs do not understand this.

Also, hyper and hypo symptoms can be very similar, if you have low thyroid hormones, this can give palpitations and can make you feel strange - and as your T3 especially is still low, I suspect that was the reason for your symptoms.

[Bluesadawg in reply to Tina_Maria]

That also makes sense. I hadn’t realized low hormone levels can cause hyper symptoms too. I hadn’t gone by the blood results in that instance, just how I was feeling. Palputations & feeling strange. I assumed it was hyper because of the former, but as you’ve added the feeling stange bit yes, it probably was hypo too. Thankyou so much

[Tina_Maria in reply to Bluesadawg]

When you increase your dose, some people may experience strange symptoms, as your body gets more thyroid hormones and it can be a bit of a shock at first, but after a couple of weeks or so, you should start getting used to it. You could also do a slow increase (e.g., 25 mcg every other day at first or 12.5mcg each day) until you are getting used to the higher dose. And when your levels slowly rise, you should gradually start feeling better; it is a slow process but as they say - every little helps! 😉

[Bluesadawg]

Unfortunately I think that might not be until next week when I can get to the surgery. Can we still return to the conversation then? Thankyou

[AKatieD]

If you started HRT you may need to adjust your thyroid doseage as they affect each other.

[Bluesadawg]

Thankyou