Hypothyroidism and oral problems

[morchelle]

I had my near total thyroidectomy 3 months ago, I started  on 50 mcg levothyroxine  a month after surgery. On the 2nd month, i started getting mouth sores, other mouth discomforts and some glands inflammation. I started feeling paranoid and stressed along with all the other signs, fatigue, brain fog, etc. I wonder if these oral manifestations are really part of hypothyroidism.

I had my TSH and FT4 tested. TSH was so off at 47.2  and FT4 was low at 0.481.  FT3 was low too 0.942.   Endo increased my Levothyroxine dosage from 50 to 150 mcg. (100 in the morning and 50 before dinner). I hope increase in dosage is not drastic. I am on my fist week of new dose.  I hope all these discomforts go away SOON.

I would appreciate any advice/feedback. Thank you.  

[morchelle]

@Red_Star,
I have piecrust tongue and teethmarks on my inner cheeks too. In one article I've read some may even have salivary glands inflammation. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169868/.  It's just hard to deal with these symptoms considering all the other psychological imbalances we have. We just have to be aware of all these so we can do all the precautions and take care of ourselves.

Thanks for the input. These are really helpful. Good luck to us.

[morchelle]

the test results were last friday, this is the first bloodtest after thyroidectomy.
i had normal results before surgery. By the way, had follicular adenoma (benign).

next bloodtest will be in a month. Yes I am aware that levothyroxine dosage correction would be like a trial and error thing until we get the right dose.

thanks so much for you input.

[goolarra]

Those labs were before the increase?  

As you can see, FT4 is below range, and few of us feel well even low in the range.  The guideline for FT4 is 50% of range (1.52 on your range).  So, what looks initially a "little" low is actually much sores than it appears.

FT3 is also low.  The guideline here is upper half of range (2.80+ on your range).

So, it's not surprising you are not feeling at all well.  It takes much more than three days to feel an increase.  It's 4-6 weeks before the increase reaches its full potential in your blood.  In the meantime, it's building, so you will probably feel better as you go along.  However, be aware that it often takes several dose changes before we get it "right".  It's a process and takes some patience.  

When are you scheduled for a retest?

[Red_Star]

My mouth issues with hypothyroidism include enlarged tongue with scalloping, teeth cracking off at the gum line, rapid decay.  2 years of thyroxine and my tongue is still enlarged although it has improved to some degree. I have mucin build up from head to toe and it is very stubborn to get rid of!

[morchelle]

Thanks for your reply. Blood tests done last week. I am on my 3rd day with the increased dose. I just feel more worried and depressed, fatigue lessened a bit, but my mouth issues (dry mouth, swollen tongue, mouth sores) worsened I think. I guess it's too early to tell.
TSH 47.2 uIU/ml. (0.40-5.50 normal)
FT4 0.481 ng/do ( 0.80-2.24 normal)
FT3 0.942 pg/ml (1.40-4.20 normal)

My endocrinologist prescribed the med.
thanks again.

[goolarra]

That is a pretty drastic increase.  Typically, increases are made in increments of 25 mcg max.  You didn't provide your lab's reference ranges, but FT3, FT4 and TSH look hugely off.  

There's no reason to split your levo dose.  Levo is dosed once a day.  What kind of a doctor is prescribing these meds?  

Increasing too fast can give you hyper-like symptoms.  Have you noticed any of those?