Question about Levothyroxine

[ruby]

Hi all:

I've been on levo since the spring when my doc diagnosed me with hashimoto's due to my blood test numbers and the ct scan results and how i was feeling. we started low, i felt a bit better for a while and then started feeling lousy again. so we tested my blood, the numbers hadn't really changed, so we upped the levo to 100mcg. started to feel better fairly quickly but then starting getting cold again and fatigued and constipated, so the doc put the levo up to 125mcg. i'm getting blood work once this snow stops (seems like it never will!). i've been at 125 for about a month and feeling better except for the cold--i'm freezing all the time and am putting the heat up to 72. in the past i'm very comfortable at 67.

what i'm wondering is this--is this kind of pattern common with hashimotos--the feeling better on the new dose and then sliding backwards and needing more meds, then sliding back and having another increase.

Any thoughts would be helpful. Thanks in advance.
Ruby

[Andros]

Hi all:

I've been on levo since the spring when my doc diagnosed me with hashimoto's due to my blood test numbers and the ct scan results and how i was feeling. we started low, i felt a bit better for a while and then started feeling lousy again. so we tested my blood, the numbers hadn't really changed, so we upped the levo to 100mcg. started to feel better fairly quickly but then starting getting cold again and fatigued and constipated, so the doc put the levo up to 125mcg. i'm getting blood work once this snow stops (seems like it never will!). i've been at 125 for about a month and feeling better except for the cold--i'm freezing all the time and am putting the heat up to 72. in the past i'm very comfortable at 67.

what i'm wondering is this--is this kind of pattern common with hashimotos--the feeling better on the new dose and then sliding backwards and needing more meds, then sliding back and having another increase.

Any thoughts would be helpful. Thanks in advance.
Ruby

Hi Ruby and welcome. There are 2 things that come to mind. One, you may not be converting T4 to T3. A Free T3 test would settle that issue. It must be FREE T3 not T3. Free is unbound hormone available for cellular uptake.

Then, I am thinking low ferritin which would cause the symptoms you describe. CBC can come back just fine but if you have low ferritin, you are anemic. Ferritin is the protein that stores your iron for cellular uptake.

So, I suggest those 2 lab tests. It actually could be both things.

If you would like to share your current labs and ranges, we all would like that. Having a look see helps. We do need the ranges as different labs use different ranges.

If you have either of the above or both, raising the levothyroxine is not going to help.

I will say though that sometimes it does take a year or more of slow titration to reach euthyroid state. But I do think those tests are very very important at this point.

Are you knee-deep in snow??? Aaaaaaaaaaaaaaaargh. I don't miss it. Although our wind chill in Atlanta was 8 this morning.

[ruby]

Hi Andros:

I was just looking at some of my past posts which were in August and you were quite helpful to me then. I ended up in the hospital for a month for severe depression. They took me off the cytomel while I was in as they were trying to "streamline" my meds. Just after I got out of the hospital, my mom died very unexpectedly in mid-October. Since then I've been feeling better re: the depression and some energy is coming back and folks say that I'm looking better. So I am improving, but I'm still concerned about the thyroid, especially since it seems that as soon as the synthroid kicks in, my body also kicks in and I end up needing more synthroid.

I don't have my lab results close by and they are old. The scrip I have now is calling for testing TSH, free T3 and free T4, along with a bunch of other things: DHEA-sulfate, vitamin D 1-25OH (D1, D2, D3 total), homocysteine methylmalonic acid, HGB A C3, and a complete metabolic panel. My psychiatrist is the one handling the thyroid at this point. i guess i'll wait and see what these tests reveal and then see if i need to see my GP or go to an endocrinologist. I do have nodules and haven't had them aspirated yet...I've just been through a ton of stuff including losing a kidney in August.

Anyway, sorry for the long post. I've been putting off dealing with the thyroid since I was posting in August; there's just been too much going on in my life but now that things are starting to get better....i guess i've got the itch to get ALL the way better and not just "sorta better."

Rebeca

[Andros]

Hi Andros:

I was just looking at some of my past posts which were in August and you were quite helpful to me then. I ended up in the hospital for a month for severe depression. They took me off the cytomel while I was in as they were trying to "streamline" my meds. Just after I got out of the hospital, my mom died very unexpectedly in mid-October. Since then I've been feeling better re: the depression and some energy is coming back and folks say that I'm looking better. So I am improving, but I'm still concerned about the thyroid, especially since it seems that as soon as the synthroid kicks in, my body also kicks in and I end up needing more synthroid.

I don't have my lab results close by and they are old. The scrip I have now is calling for testing TSH, free T3 and free T4, along with a bunch of other things: DHEA-sulfate, vitamin D 1-25OH (D1, D2, D3 total), homocysteine methylmalonic acid, HGB A C3, and a complete metabolic panel. My psychiatrist is the one handling the thyroid at this point. i guess i'll wait and see what these tests reveal and then see if i need to see my GP or go to an endocrinologist. I do have nodules and haven't had them aspirated yet...I've just been through a ton of stuff including losing a kidney in August.

Anyway, sorry for the long post. I've been putting off dealing with the thyroid since I was posting in August; there's just been too much going on in my life but now that things are starting to get better....i guess i've got the itch to get ALL the way better and not just "sorta better."

Rebeca

I am so so sorry for your loss! Truly! And a kidney too? Lord; you have been through it.

Ruby; you are in the best of hands. No one could possibly understand the thyroid better than a psychiatrist! I kid you not! This is totally awesome and for that, I am happy!

When on the come back trail; take one baby step at a time. Slow but sure. You "are" going to make it; yes you are.

Good to see you again!

[ruby]

I'm glad to hear that I'm in good hands having a psychiatrist handling my thyroid; she is a very good doctor whom I've had for almost 10 years now so she really knows me. Thanks for that bit of info! And yes, we are very much knee deep and more in snow--14 or 15 inches yesterday! Today is the day to dig out.

Thanks again, Andros, for your help.

[Andros]

I'm glad to hear that I'm in good hands having a psychiatrist handling my thyroid; she is a very good doctor whom I've had for almost 10 years now so she really knows me. Thanks for that bit of info! And yes, we are very much knee deep and more in snow--14 or 15 inches yesterday! Today is the day to dig out.

Thanks again, Andros, for your help.

I am here for you, Ruby and so are the other posters. "This is the healing place!" Hah!! I should copyright that! Yes?

{{{{Ruby}}}}