Hello. I am a 46-year-old male, and I have autoimmune hypothyroidism. This post is a bit long. So, please bear with me.
In late June 2019, I started taking Synthroid 137 (2 times per week) and Synthroid 125 (5 times per week).
In mid-August 2019, I had some blood tests, and the results were as follows:
FT4 = 1.59 (normal range = 0.82 - 1.77)
FT3 = 3.3 (normal range = 2.0 - 4.4)
TSH = 0.064 (normal range = 0.450 - 4.500)
Vitamin D, 25-Hydroxy = 21.0 (normal range = 30.0 - 100.0)
Vitamin B12 = 867 (normal range = 232 - 1245)
My endo was concerned about the low Vitamin D level. So, she ordered a bone-density scan. The scan showed osteopenia in 2 places (lumbar spine and left femoral neck).
The endo strongly suggested that I take Vitamin D supplements. I started taking Jarrow Formulas Vitamin D3 (In Extra Virgin Olive Oil) 1000 IU softgels. I took one per day, every day.
Shortly after I started taking Vitamin D, I started feeling pain on the right side of my neck (including the right side of my thyroid). Also, I started having trouble swallowing food (especially macaroni).
In mid-November 2019, I took another round of blood tests, and the results were as follows:
FT4 = 1.46 (normal range = 0.82 - 1.77)
FT3 = 3.2 (normal range = 2.0 - 4.4)
TSH = 0.084 (normal range = 0.450 - 4.500)
Vitamin D, 25-Hydroxy = 31.6 (normal range = 30.0 - 100.0)
Vitamin B12 = 655 (normal range = 232 - 1245)
The Vitamin B12 and the FT4 decreased significantly. The FT3 decreased slightly. And the Vitamin D was now normal.
In mid-December 2019, I had had enough of the neck pain and the trouble swallowing food, and I stopped taking Vitamin D. Shortly after I stopped taking Vitamin D, I started feeling somewhat better with respect to the neck pain and the trouble swallowing food.
Unfortunately, the neck pain and the trouble swallowing food did not go away entirely. Also, I developed acid reflux and a cough. My PCP suggested that I take Omeprazole or Pepcid. But those medications posed a risk of kidney failure. So, I took 10-mg Famotidine tablets (1 per day, for 3 days). On each day, the tablet suppressed the acid reflux. However, on one day, after I took the tablet, I temporarily had more trouble swallowing food than usual. On a different day, I experienced chest pains after taking the tablet.
My PCP ordered a barium x-ray of the esophagus. The x-ray showed that there was an esophageal web. This explained the trouble swallowing food. Sometimes, an esophageal web is caused by iron deficiency. However, my iron level was normal, as the following blood test showed:
Ferritin = 265 (normal range = 24 - 336)
In mid-February 2020, my endo ordered more thyroid tests, and the results were as follows:
FT4 = 1.55 (normal range = 0.82 - 1.77)
FT3 = 3.0 (normal range = 2.0 - 4.4)
TSH = 0.075 (normal range = 0.450 - 4.500)
Vitamin D, 25-Hydroxy = 22.0 (normal range = 30.0 - 100.0)
Vitamin B12 = 862 (normal range = 232 - 1245)
Calcium = 8.9 (normal range = 8.7 - 10.2)
The FT4, Vitamin B12, and Vitamin D levels came back to what they had been before I had taken Vitamin D supplements. However, the FT3 continued going down (from 3.2 to 3.0).
Also, the endo pronounced my Calcium level as normal. However, over the last 10 years, my Calcium level has decreased significantly. Here are my Calcium results over the last 10 years:
(when I was first diagnosed
with autoimmune hypothyroidism): Calcium = 9.6 (normal range = 8.5 - 10.3)
December 2013: Calcium = 9.3 (normal range = 8.5 - 10.3)
July 2018: Calcium = 9.0 (normal range = 8.5 - 10.3)
February 2020: Calcium = 8.9 (normal range = 8.7 - 10.2)
Furthermore, about a day ago, I visited my endo, and my vital signs were taken. My pulse rate was about 50 beats per minute. My usual pulse rate is in the 60s or 70s. My pulse rate 3 weeks ago (when I met with my PCP) was 68.
The endo ordered an EKG (electrocradiogram). The EKG report stated "sinus bradycardia", "minimal voltage criteria for LVH, may be normal variant", and "borderline EKG". One possible cause of bradycardia (lower-than normal pulse rate) is hypothyroidism. Also, I have been feeling somewhat lethargic and lightheaded.
So, with my FT3 continuing to go down, with my Calcium levels significantly decreasing during the past 10 years, and with bradycardia developing, what is my endo doing? She is DECREASING my Synthroid dosage because she is concerned that the low TSH (0.075) means that my bones are in danger. She could make the bradycardia worse.
The endo wanted to decrease my dosage to Synthroid 125 (7 times per week). However, I talked her into a smaller decrease (Synthroid 125, 6 times per week), (Synthroid 137, 1 time per week).
By the way, the endo said that she believes that the FT3 value is unreliable.
So, what's going on here? Why is my FT3 decreasing? Why is my Calcium decreasing? Why do I have bradycardia (lower-than-normal pulse rate)?
Is my endo correct to decrease my dosage? Or should I find a new endo?
Thank you for any information.