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Can Levothyroxine INCREASE fatigue?
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Can Levothyroxine INCREASE fatigue?

Hi - I've had symptoms of hypothyroidism for a few years now, but bloodwork remains just within normal limits. Since we've tried everything else, my doctor grudgingly agreed to try Levothyroxine in case it was indeed, hypothyroidism. He started me very low, and gradually increased the dose to .100MCG 2x per day.

...but I have NO improvement other than I'm sleeping somewhat better at night. Beyond that, if it's doing anything at all, it's making me MORE TIRED during the day.

I am SO desperate and confused; if my thyroid was normal, shouldn't this dose make me hypERthyroid? Shouldn't I feel SOMETHING? In all honesty, I could be taking tic-tacs for any difference in how I feel, and I don't know if I should continue this medication or not.

I've been through so many medications, anti-depressants, tests, tests and more tests - I am completely desperate and honestly begging for advice or suggestions of any kind; I'm so tired I can't function. Whatever this is, it's destroying my life.

I truly believed when I started thyroid hormone, I'd either feel better or get sick, either way it would've been an answer and we could move on to something else - never once did I think it would do nothing; I've been straining every day to detect a change, any change, bad or good - ugh.  

I cannot stand this. It is beyond me that I can feel so awful and have NO abnormal tests other than low b-12 and marginally normal thyroid function.

ANY help or advice on this would be ENOURMOUSLY APPRECIATED
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Avatar_m_tn
Just because your thyroid tests fall within the so-called "normal" limits does not mean those levels are adequate for YOU.  The reference range limits are far too broad.  If you will please post your thyroid test results and their reference ranges shown on the lab report, members will be glad to assess the adequacy of your testing and treatment.
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1150172_tn?1302136101
Thank you so much for the reply, I'll get them and post everything :) though my faith in numbers has plummeted -

Wouldn't taking thyroid hormone if you were NOT low by necessity cause hypERthyroidism?
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649848_tn?1357751184
Please post your B12 level and reference range, along with your thyroid levels and reference ranges, and indicate whether or not you are being treated for your low B12 level. Vitamin B12 deficiency can cause debilitating exhaustion.

Too much thyroid medication would most likely make you hyper; however, we'd need to see your labs in order to help determine if you are, in fact, over medicated.
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Avatar_m_tn
You NEED to get the FREE T4 and FREE T3 tests.  If you have only TSH there is almost a 0 percent chance that you would ever be medicated or treated properly to feel well!

Without the Free T3 and Free T4 tests we could only speculate what may be the problem.

many people need to have their FREE T4 in the MIDDLE of the range AND, that means in addition to, they  need their FREE T3 in the UPPER 1/3 of the range.  If you are at the low end of the range there is little hope that you will feel good.  Some people do, but many people need to be well into the middle or upper range.

Simply being "within range" means ABSOLUTELY NOTHING!
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1756321_tn?1377771734
Symptoms of vitamin B12 deficiency are numerous but includes depression and fatigue. Test your vitamin D levels too. Depression and fatigue are well known symptoms of this deficiency state.
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1150172_tn?1302136101
Thank you ALL - WOW - you guys are AMAZING to take your time like this - I have some tests here in my lap, but I don't have ANYTHING like what you're talking about!

The only test with TSH I have right now is from a 12 mo old test, but it hasn't changed from last test 3mo ago - I can't find my *%# folder with all my recent miscellaneous med junk :( posting most relevant numbers while i look to see if I have anything more - I have no "free T3 T4" tests because I asked for that, and was told it wasn't necessary as my levels are normal -

Here is my TSH: 3.2 mIU/L (normal = .5 - 4.0), so I'm well below hypo level.
Here is my ONLY abnormal result, which I've been told by family, infectious disease, rheumatologist, endocrinologist doctors is 'nothing to worry about' (after they ask if I am or was an alcoholic - i don't drink at all)
B-12: 179 pg/ml (normal = 200 - 900 pg/ml)

I'd like to give you background in case anything rings familiar to someone - first, i've always been oddly tired. I'd take a nap after school, go to sleep early, and still be dead tired in the am. Also since childhood, when I'm under stress, sleep is first thing to go. Weight was always normal.

Always had mood swings related to pms. Always had abnormal anxiety that was NOT situational.

These new, FAR worse symptoms started with a high fever, flu-like symptoms, swollen glands, and an large hot red lump (told lump itself was deep, ultrasound revealed nothing) in my breast which went away with antibiotics - but the illness never did, and I'm going on three years.

Symptoms include periodic fevers, severe fatigue, periods of extreme insomnia, periods of hypersomnia (after long periods of insomnia, i "crash"), intermittent hot swollen (infected looking) areas similar to 'lump' in breast in random places (middle of back, neck, ankle, top of foot, painful glands in neck, weight gain, hair loss, dry itchy skin, loss of my outer eyebrows, (?), extreme bruising (not anemic), foggy thinking, short term memory issues, depression, daily headaches, occasional migraines, periods of uncontrollable crying, aching muscles especially in morning, extreme morning stiffness (walk sort of like a duck until it wears away, going 'Oo, Oo, Oo!' with every step like I'm 80)

Whew, think that's it. Also want to mention that I've been taking SUBLINGUAL B-12 since fatigue started, meaning tests were low despite it. I think it's the key; drs totally disregard it. Also, I was a jogger prior to this - jogged @ 20 miles a week - it was the only thing that's ever helped my life long fatigue, anxiety/depression - now, walking to the mailbox seems extreme and has me soaked in sweat.  

Unfortunately, the initial illness came after several back-to-back extremely difficult events, so family dr being aware wrote everything off as depression far longer than he maybe should have.

Tested and treated for: mono, lymes, assorted infectious diseases, depression. Told that basic bloodwork (haven't had majority of tests you guys are asking for!) ruled out lupus, hashimoto's, thyroid disorder - only receiving levothyroxomine by annoying my rheumatologist, the only doc willing to work with me. my current diagnoses is fatigue nos, CF, or FMS depending on which dr you ask.

Two more things that bother me: EVERY dr I've seen tells me lab-work shows I HAD recent infection, but it's gone - well, if every lab over 3 yrs shows RECENT infection, doesn't THAT point to something? (Ans., no according to all)

Second, dentists ask me if I have lupus all the time. I say no & ask why, to get foot-in-mouth BS, no straight answer. Googled & googled, don't know what about my mouth would cause such a strange remark.

I have good ins., BCBS and don't need referrals, I will get tests you are suggesting from my rheumatologist.

I am so sorry this is so long, I feel bad writing all this when you've given me all this info to request already, just putting it out there in case one of you've had something similar.  

Thank you so very much for taking the time to help a stranger. Some days, I just want to give up.

My sincerest thank you & my best hopes that your own situations are resolved
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1756321_tn?1377771734
B12 serum at 179pg/mL is seriously deficient and may be causing permanent damage - in particular nerve damage as B12 is essential to maintain the myelin shealth which protects the nerves.  "In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss."  Optimal B12 serum is over 800pg/mL.

Causes of B12 deficiency:

Decreased stomach acid
Atrophic gastritis
Autoimmune pernicious anaemia
Helicobacter pylori
Gastrectomy, intestinal resection
Gastric bypass surgery
Malabsorption syndromes
Crohn’s disease
Celiac disease (gluten enteropathy)
Chronic pancreatitis
Bacterial overgrowth (small bowel)
Fish tapeworm
Alcoholism
Malnutrition - eating disorders
Vegetarianism
Advanced liver disease
Transcobalamin II deficiency
Inborn errors of B12 metabolism
Certain drugs
Nitrous oxide

A thinning or loss of the outer eyebrows is a sign of hypothyroidism. This is called the Queen Anne Sign or Sign of Hertoghe.  There is an ongoing disagreement in the medical world on the TSH reference range.  The American National Academy of Clinical Biochemistry changed the TSH reference range to 0.2 - 2.5mU/L. The American Association of Clinical Endocrinologists changed the range to 0.3mU/L to 3.0mU/L.

From stop the thyroid madness:

"Did you know that there were decades of successful treatment for hypothyroid that involved nothing more than dosing you by symptoms?  The TSH lab didn’t even come into existence until the mid-1970′s.

Today, the tables have completely turned. We now live in a lab-obsessed society, where most doctors completely ignore your thyroid symptoms and make your man-made lab results with the dubious ranges the holy grail of diagnosis. And diagnosis and treatment based solely on falling in a so-called “normal range” is a consistent failure, leaving millions of patient either undiagnosed, or undertreated.

Even worse, when labs are used, the majority of doctors are only doing the TSH (thyroid stimulating hormone) and total T4 to diagnose or treat you, neither which give an accurate clue to your hypothyroid condition. Additionally, ranges are made as if from God Almighty. They are not.

So…when you visit your doctor, symptoms should be the conductor of the orchestra. Then use the right labwork, and knowledge of where results should fall, for more knowledge. Below are those patients recommend you insist to your doctor that you want, or take with you when you visit your doc.

TSH But this lab is only for diagnosis of hypopituitary, NOT to diagnose or dose your hypo by.

Free T4 and Free T3 (note the word “free”–important since it measures what is unbound and available.)

Reverse T3–to be done at the same time you do the Free T3. Then calculate your ratio with the results and measurements.

Thyroid Antibodies (anti-TPO and TgAb. YOU NEED BOTH.)

Four iron labs, which include Ferritin, % Saturation, TIBC and serum iron
Adrenal Cortisol levels (but we strongly recommend saliva tests, not the one time blood test your doctor will do. One result does not tell the whole story. See below, because you don’t need a prescription)

B-12 and Folate

RBC Magnesium and Potassium (rather than serum), plus Calcium, Sodium, Glucose (all the latter are part of the Comprehensive Metabolic Profile (CMP blood test) which you can ask for, but the CMP will only test your serum levels of Magnesium, Potassium, so you’d have to do the RBC separately)

Vitamin D (25-hydroxyvitamin D lab test…

…plus others your doctor may recommend."
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649848_tn?1357751184
I agree with Red Star that a vitamin B12 level of 179 is seriously deficient.  I was diagnosed with pernicious anemia when my levels were slightly over 200 (range 200-1100) and I do have some permanent nerve damage in my feet/legs due to lack of treatment for many years.  I was also accused of being an alcoholic because my red blood cells are larger than normal (one sign of B12 deficiency).  I take weekly injections and must keep my levels in the 800-900 range to feel well.  I think I'm safe in saying that the B12 issue is a major one for you.

That said, you really need to have the other thyroid tests done.  TSH is a pituitary hormone and is not indicative a thyroid problem, because it varies widely for many reasons.  

You need to have the other thyroid tests as suggested above.  Those would be Free T3, Free T4, TSH, thyroid antibodies.
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Avatar_m_tn
Many people need their TSH BELOW 1 if not near zero to feel well.  TSH is virtually completely useless.

Redstar, where did you get that letter from?  Was if from a Dr?  If so I'd love a copy of it so my wife & I can take it to our Dr in hopes of actually getting some treatment.  Heck we can't ever get our current Dr's to test for Free T3 let alone actually adjust dosage for my wife or even consider medication for me.
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Avatar_f_tn
Omg...I feel the same way. Are you cut from the same cloth as me? lol....What is going on, I am at the end of my rope too, and my husband keeps telling me to leave my quack doctor and find someone to help me, but I already have done stuff with her but maybe I do need 3-4 opinions...
I feel for you and everyone else on this thing who is searching for answers. Why can't we get a straight answer? My friend suggested going Holistic, only because they practice what they preach and are not afraid too...My doctor doesn't know half the stuff I read about it. It may be more money but they are one on one with you and they won't give up. I think we all should switch.
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649848_tn?1357751184
This is a very old thread and Ginger has not participated in the forum for since this was posted, so it's unlikely she will respond.

As far as doctors go, there are some very good ones out there and not just the holistic ones.  Some people have to change doctors several times, before they find one who will test/treat them adequately.  

I see you're Canadian.  We've had some members who have had trouble getting testing/treatment because of guidelines of your health care system. Is that a problem for you?
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6540474_tn?1382247833
i have been on it since i was pregnant i had my son and i cant loose weight for crap im walkin 8 miles aday and gaining weight they say im in normal range its killin me i cant even get out of  bed im so depressed on  it and they say its my fault im not loosing weight and i am mean on it i want to get off it i was loosing weight off it and gaining it back off it but now that im on it i cant loose weight at all
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649848_tn?1357751184
If you're having that much trouble, your levels are, most likely now high enough for you, even if they are in the "normal" range.

If you have a copy of your lab report, please post your levels, with reference ranges, so we can better assess your situation.
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Avatar_f_tn
I have a question if anyone still checks this. I have seen over five different Dr's over the span of 9 years for thyroid. The first Dr. was trying to help me with my daily headaches, did a blood test and called with the results saying that everything was normal other than my thyroid was a little low but nothing they were worried about. About a year later I see another Dr. with symptoms thinking I'm pregnant, only to find out that I had an underactive thyroid. He then tells me that the headaches I have been having were caused by the thyroid. Go ahead and I see another Dr. who wants to help me lose some weight by increasing my medication a bit. Seemed okay got pregnant which threw everything out of wack. Had the baby and they kept me on the increased dose because they said it worked with my levels, trying to figure out why I wasn't feeling good still. Dr. sent me to a specialist a year later to have them tell me I was on the wrong dose for over a year and because of the increased dose it was causing me to gain weight. Now my new Dr. just did a test and said my TSH was .59 I think and I was wondering if increasing my dosage would help with my fatigue and the fact that I still can't lose any weight and they tell me that it will just make me more tired!! I asked about the T3 and T4 when they did the last test and they told me that they don't need to do them because they all tell you the same thing. I'm just trying to figure out how some many Dr's can all tell me something different. What do I need done so I can feel normal and not continue to gain weight all the time. I'm even on the prescription diet pill to help with the weight loss but it isn't working as well this time like it did before. Please help if you can and if you know any sources to print off information to take to the Dr. to get some strait answers. Thank you.
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Avatar_f_tn
Your doctor is dead wrong...once on thyroid meds, it's absolutely essential to have FREE T3 and FREE T4 tested every time blood is drawn.  TSH is totally inadequate to be used alone to manage meds.  TSH is a pituitary hormone.  As such, it is subject to many influences other than thyroid hormone levels.  It's an indirect measure of thyroid status, not nearly as useful as the direct measures of the actual thyroid hormones, FT3 and FT4.

How much levo do you take?    
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