Can Levothyroxine INCREASE fatigue?

[Ginger7]

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

[Red_Star]

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."

[Barb135]

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.

[flyingfool]

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.

[Puresoul34]

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.

[Navybird]

GET AN EXPERIENCED ENDOCRINOLOGIST

[Barb135]

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?

[brittbratt101]

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