Me too. I can just be standing, doing nothing and start sweating. Moreover, though Im Hypo, I have an intolorance to heat not cold. I love the cold bc I DONT SWEAT. It is so emparassing. (pls excuse the spelling...)
P.S. I don't think that its the synthroid bc I had this prob b4 the meds.
Yes, I have been experiencing this very embarrassing problem since I had my thyroid
removed. In fact, I'm sitting here next the the open door, typing. Must be quite a
workout because I am sweating right now. In the clinic department where I work,
it seems l am hearing people complain all day about how cold it is. Well, they
don't have to work in that department, so I keep it as cold as the a/c will allow.
Sometimes I want to jump into the deep freezer just to cool off. My only coworker
wears long sleeves and a long sleeve lab coat to keep warm. But, there I am
self-conscious, sure I am not the lovely fresh flower I want to be. I am currently
hypo, meds are messed up again, but the cold air is a welcome treat.
So, yes, I am somewhat relieved to know there are people who share my pain.
But, when I'm cold...it has to be really cold out...I'm freezing! There doesn't seem
to be a happy medium in there for me at all :(
Thanks for getting back to me. Well I am glad that I am not alone.
Hmm. If you are saying it is not the actual medication, then what do you attribute it to?
TSH levels not right?
Thanks for getting back to me.
Sounds like your TSH level is not right either. Could this be the problem? Have you been tested for anything else to rule other reasons out?
I am currently a second year medical student and was recently diagnosed with Hoshimoto's thyroiditis (the most common form of primary hypothyroidism) and my hyperhidrosis is what caused me to seek clinical attention -It's embarrassing to do a physical exam on someone and start sweating all over them. The TSH test is the most sensitive test for hypothyroidism and is the best indicator for positive clinical outcome Why this test works is because TSH is secreted under negative feedback via free T3 (which is converted from T4 in the brain) therefore, High TSH means that there is either a pituitary tumor (Very Very RARE and tend to be familial) or primary hypothyroidism (>99%). This can be differentiated by a laboratory measurement of high free T4 (=TUMOR) or Low free T4 (=Primary thyroid dysfunction). To answer your question, the primary hypothyroidisms are clinically diagnosed with a TSH over 10 and low free T4, so your TSH being below 10 seems makes me believe that you are in a euthyroid state on your current replacement therapy. Levothyroxine (Synthroid) is literally a T4 replacement that is made by recombinant bacteria; therefore, since this is analogous to natural T4 it isn't likely to be the problem. However, I feel your pain 100% because my hyperhidrosis is currently the bane of my existence. Theoretically, after prolonged treatment there should be a down regulation of the sweat glands after a prolonged state of euthyroidism however, I am not so lucky as to have experienced this yet! The problem stems from the fact that there is a high stress level on the body which causes excess DHEA-S to be secreted from the adrenal glands (primarily due to an attempt to replace gonadal hormones like testosterone from the low Luteinizing hormone via High TSH) this causes maturation and overstimulation of the sweat glands and other things like male-pattern baldness, enlarging prostate, and thick facial hair (Hirsutism). This process is accelerated if you are overweight and/or a smoker. Hope this answers your question fully and I wish you the best..
am taking the time to write all this because there are a couple of things that you should be aware of, that you won't hear about during your medical training. I say this because you made several statements that obviously you have already been taught, that upon close examination just don't hold water.
First is the belief that "TSH is the most sensitive test for hypothyroidism". Yes, that is what is taught by most medical schools, but the reality is that TSH is affected by so many variables that it is totally inadequate as the sole diagnostic for thyroid. TSH even has a circadian rhythm that peaks at around 9 p.m. and is lowest around 9 a.m.. Studies have shown as much as a 72 % difference from high to low, so the time of day when blood is drawn is important. I have unsuccessfully searched and searched for supporting data that TSH correlates even adequately with the most important thyroid test, which is free T3. I say this because FT3 largely regulates metabolism and many other body functions. Scientific studies have also shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not correlate. Here is a link to that study.
The degree of correlation of FT3 to symptoms is amazing when considering that the symptom score was a total of 8 main hypo symptom ratings that were individually rated subjectively by the patients. If you want to be dismayed further, take a look at the variability inherent in a large group of patients that were screened for thyroid problems and then tested for TSH. The results are shown in fig. 2 on page 5 of this link.
As far as TSH correlating with T3, that is not supported by this study.
I ran across this link some time ago. If you look at Fig. 6-7 you will see that for a given individual, TSH correlated very well with FT4. In fact for each of the three individuals with test data that are plotted, the FT4 accounts for above 85% of the variation in TSH. This is very good correlation, and leaves little room for any FT3 effect on TSH.
If you look further at the three curved lines, representing three sets of data, you will see that each one is different. There is great variation from one line to another. For example if you plotted a horizontal line at about .8 TSH, the corresponding FT4 among the three would vary from about 6, up to about 14. This huge amount of variation in just three sets of patient data shows conclusively that TSH and FT4 do not correlate well at all for the general population of patients. The data show that you could establish a very good correlation of TSH to FT4 for a given patient, by running a series of tests and doing statistical analysis of the results. But the result of that would not justify the bother and the cost.
Trying to use TSH as a diagnostic is bad enough. It is even worse when trying to dose a patient by only trying to get the TSH result to fall within the range after medication. This quote is from the following link to the British Medical Journal, Sept. 1986. http://sz0102.ev.mail.comcast.net/service/home/~/FraserNoTesting.pdf?auth=co&loc=en_US&id=135360&part=3&disp=a
"We consider that biochemical tests of thyroid function are of
little, if any, value clinically in patients receiving thyroxine
replacement. Most patients are rendered euthyroid by a daily dose
of 100 or 150 mcg of thyroxine. Further adjustments to the dose
should be made according to the patient's clinical response."
So from what I have learned from patients on the Forum and what research I have done, TSH is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, free T3 and free T4. Symptom relief should be all important, not test results.
Your eyes might be further opened if you will read through this link.
Another thing you should be aware of is that, contrary to what you might hear at school, FT3 and FT4 results that fall just within the low limit of the reference range are frequently consistent with having hypo symptoms. This is easily explainable by the fact that the reference ranges have never been corrected like was done for TSH over 8 years ago. At that time the AACE came to the conclusion that there were far more hypo patients than the 2 1/2% predicted by their old reference range. When they went back and purged the data base for suspect hypo patients, and recalculated the limits, the range went from .5 - 5.0 down to .3 - 3.0. That was a drastic change. Unfortunately most labs and doctors still cling to the old range, and many hypo patients suffer from it.
Also unfortunately the data bases for FT3 and FT4 have never been similarly purged of suspect hypo patient data. With much experience with statistical analysis, I would roughly estimate that if the data bases were purged like done for TSH, that the new ranges would look more like the upper half of the current ranges. Clearly to me, that is why we hear from so many members with FT3 and FT4 in the lower part of the ranges, yet they still suffer with hypo symptoms. Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.
I hope that this small sampling of the type of info that is available will make you stop and ask questions before you become yet another doctor that does not listen to symptoms, and diagnoses by only TSH, or if FT3 and FT4 are tested and results fall within the very low area of the ranges, then conclude firmly that "everything is normal" and nothing further is needed, "Your symptoms must be due to something else."
I would have no problem with the current ranges if they were used as guidelines within which to adjust FT3 and fT4 as necessary to relieve symptoms. Instead the ranges are used as pass/fail. Where is the logic to that when the ranges are so broad? How can a test result at the very low limit possibly be equally as good for the patient as one toward the high limit of the range?
But I should warn you that bringing up these questions will not make you popular with your professors. It might even adversely affect your grades. Only in a few medical schools that we have learned about are they teaching that TSH is old hat and that FT3 and FT4 are the most important tests. Even in those schools I am not sure that they are yet teaching that the clinical approach is the best.
I know you don't have a lot of spare time, but I suggest that you spend a few minutes occasionally on the Forum. You'll find out a lot about reality in the world of hypothyroidism, as opposed to the theories you are being taught. I hope that you will pop in once in a while and let us know how these thoughts were received in school. LOL
First off I would like to say I am a student doctor; I don’t claim to be a licensed physician. Also, gimel I commend you for doing ample research on the topic and you seem quite knowledgeable about the topic. However, for this patient I stated that serum FT4 would indicate the actual manner of their thyroid dysfunction and is always an indicated test for hypothyroidism. Furthermore, I have multiple problems with your argument and have stated them below.
First off, in addressing the paper you cited regarding the FT3 as the best indicator for therapeutic outcome, If you read the study design they used the old RIA for laboratory TSH. The new RIA-TSH has a much greater accuracy and precision rating which correlates better with a positive predictive value than the test available between May 1984 and July 1997. Furthermore, in regards to this resource I have to side with the current American Thyroid Association Guidelines for Detection of Thyroid Dysfunction as of 2000 which states:
"Serum TSH measurement is the single most reliable test to diagnose all common forms of hypothyroidism and hyperthyroidism, particularly in the ambulatory setting. An elevated serum TSH concentration is present in both overt and mild hypothyroidism. In the latter, the serum FT4 concentration is, by definition, normal. While serum TSH measurement confirms or excludes the diagnosis in all patients with primary hypothyroidism, it will not reliably identify patients with central (secondary) hypothyroidism, in whom serum TSH concentrations may be low, normal, or mildly elevated. When there is suspicion of pituitary or hypothalamic disease, the serum FT4 concentration should be measured in addition to the serum TSH concentration."
In addressing the topic of TSH secretion and the circadian rhythm (which is present in all hypothalamic-pituitary hormone secretion except prolactin) in disease processes the cyclic pattern of hypothalamic release is not upheld; the fact is, that TSH secretion is both stimulated by TRH from the hypothalamus (causing the circadian rhythm) and suppressed by hypothalamic dopamine, hypothalamic and free somatostatin, and free T4 (FT4). In the absence of FT4, the lack of suppression (negative feedback) is great enough that hypothalamic TRH stimulation is not needed in order to stimulate TSH secretion. For this reason, prolonged and severe hypothyroidism can induce a TSH secreting pituitary adenoma
In addressing the thyroidmanager.org source, I have a few things to say regarding the figure you are looking at is regarding suppression of TSH with levothyroxine supplementation. They are comparing FT4 with TSH to show the negative feedback control of hypothalamic suppression. If one were trying to correlate disease state with therapeutic outcome you would need to use total T4 (TT4). The serum concentration of TT4 as a result of TBG abnormalities, or drugs competing with T4 binding to TBG, have no effect on the level of serum TSH and serial evaluations and thus serves as a better independent indicator of actual therapeutic levels (in fact, when a physician order T4 the results reported are TT4) Furthermore, I believe that you are misinterpreting the figure and are making gross assumptions based upon a sample size of 3 people. They state a coefficient of determination (r^2) ranging between 0.875-0.902, this correlates to a negative correlation coefficient (r) of 0.935-0.949 (93.5%-94.9%) which is not large enough to be considered statistically different considering n=3 and thus CANNOT be extrapolated to as a reference for the general population (especially since this is not a population wide study). This being said, the data means that there is practically a 1:1 inverse relationship between plasma [TSH] and [FT4] even in this relatively small population in which co-morbidities are not known (i.e., we don’t get better tests in medicine!)
Also, it should be noted that FT3 is measured in the urine and is directly dependent upon hepatic and renal Type I iodothyronine deiodinase, but biological activity is dependent upon Type 2 iodothyronine deiodinase found in the CNS, heart, fat, muscle, skin, heart, etc.. Therefore, any hepatic disease, renal disease, or 199 of the top 200 prescribed drugs in America, which may affect the liver or kidneys, can alter the power of this test. (N.B. >99% of all drugs are metabolized by the liver &/or kidneys and thus affect them in one way or another.)
Before I begin on my review of your citation of British Medical Journal, Sept. 1986,.which is based upon 2nd generation TSH testing, I want to state that higher doses of T4 (>150 mcg/day) carries a significant risk of cardiac arrhythmias and atrial fibrillation which cause thromboembolic strokes in 30% of all a-fib patients. The quote that you cite is no longer the valid as it is outdated. The current belief is that the sensitive thyrotropin (TSH) test is the preferred method to monitor therapy because it agrees with physiologic measures of thyroid hormone EFFECT. Among clinically euthyroid patients who take 100 to 150 micrograms/d of levothyroxine, the probability that the sensitive thyrotropin will be undetectable is close to 50% (i.e., 50/100 with hypothyroidism will not have detectable TSH) . These patients are most likely to benefit from testing. Patients who take over 250 micrograms/d are almost certain to have undetectable sensitive thyrotropin levels; in these patients, the dose may be lowered without testing.. Ann Intern Med. 1990 Sep 15;113(6):450-4.
To be frank, the vast majority of patients’ that have continued symptomatology (greater than 3 months) despite clinical euthyroidism are dealing with low level depression or anxiety and actually benefit from prolonged SSRI therapy rather than increased T4, especially in light of the fact that at higher doses of T4 there is a serious risk of side effects. So in the case of hypothyroidism, the goal is not necessarily symptom relief as it is correction of [TSH] since the vast majority of residual symptoms tend to be psychosomatic if they are persistent for 2-3 months after treatment. According to an article in Psychiatry Investig. 2010 Dec;7(4):264-9 “There was a significant association between lower (hyperthyroid) serum TSH levels (<0.5 mIU/L) and cognitive impairment after adjustment [odds ratio 7.12 (95% confidence interval 1.35-37.5)]. However, no association was found between TSH levels and depression.” Therefore, depression and anxiety symptoms (sweating, fatigue, sadness, guilt, palpitations, tremor, fear, etc...) are better treated with antidepressant/antipsychotic drugs rather than dangerously high doses of levothyroxine. In fact, one of the best things a hypothyroid patient can do reverse the ‘residual’ symptoms is to exercise (which causes endorphin release and relieves stress!)
In regards to your reference to thyroid-info.com, the opinion of one person that does not show data supporting his claim cannot be taken at face value. The multiple problems associated with the full hearted belief that one man’s feelings about an issue is indeed fact, even when that belief is in gross opposition with the concurrent consensus found in multiple peer reviewed journals and multinational health organizations is very dangerous. For example, who knows how many children have died due to preventable disease when one man, Dr. Andrew Wakefield, misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study linking the use of childhood vaccines with autism. The fact is simple, without data to support your claims; a claim is just an opinion NOT fact
You must be an awful good student if you have so much time to spare writing that reply, instead of studying. LOL Please let me clarify that I had no intention of putting you down in any way. My only reason for responding was to question some of the assumptions underlying things you are being taught. My questioning is based on seeing the stories of hundreds of thyroid patients who have been subjected to the "Immaculate TSH Belief" and still suffer with severe hypo symptoms. Or if they have been lucky enough to have been tested beyond TSH, they ran afoul of the tyranny of the so-called "normal" ranges for the thyroid hormones, and continue to be improperly diagnosed and under medicated.
I think that a good place to start is with the agreement that we would all like to be euthyroid. By definition of course this means having sufficient thyroid hormone levels to be neither hypo nor hyper. The state of being neither hypo nor hyper should be defined by the lack of symptoms of either. It cannot be defined by thyroid/pituitary tests that are so variable that studies have shown to have huge areas of overlap among the three groups (hyper, euthyroid, and hypo) for all the three major thyroid tests.
Yes there are symptoms due to other causes that mimic some hypo or hyper symptoms. That should only necessitate additional testing or clinical treatment. It should not be a reason to ignore symptoms and declare that if the TSH and (if tested) FT3 and FT4 levels are within the "normal" ranges, that the symptoms are not thyroid related, but must be psychosomatic in nature. That logic is the reason that the majority of our members are here, looking for help.
I fully understand how the range for TSH was originally established, and also the rationale for the significant change 8 years ago. Unfortunately most labs and doctors have not even adopted this long overdue change that at least would make it a better indicator of thyroid function. Even more unfortunate is that there hasn't even been any consideration for changing FT3 and FT4 ranges, yet the data bases used to establish their ranges are similarly flawed.
Since FT3 is the thyroid hormone that is biologically active and largely regulates metabolism and so many other body functions, it stands to reason that we need to know the level of FT3. Since the advent of adequately accurate FT3 testing, why is it so difficult to get doctors to even test for FT3? The rationale given is that if they know FT4, then they can estimate FT3 adequately. Unfortunately for those patients that do not convert T4 to T3 adequately that is not the case. Neither is it the case when a patient is taking T4 meds, and the conversion is affected and the FT3 is much lower in the range than FT4. In that case, just prescribing more T4 meds does not relieve symptoms.
I am fully aware that testing for TSH has progressed over the years; however I have been unable to ever find any data that statistically validated the accuracy and repeatability of TSH tests. How much inherent variability still exists? Obviously the same question would apply to FT3 and FT4.
Since FT3 is the most biologically active thyroid hormone and has been shown to have the greatest effect on symptoms, why would we want to rely on TSH to diagnose a thyroid patient, unless it can be shown that TSH correlated well with FT3 or correlated well with FT4 and T4/T3 conversion was normal. So how is TSH the "best indicator of positive clinical outcome"? I have looked long and hard for data that support the utility of TSH, without success. So far all you have provided is your personal assurance that TSH is the most sensitive and best test for thyroid. How about providing some statistical evidence of the correlation of TSH with symptoms, or even to FT3, or even to FT4 for the general population of patients?
There are other questions you have raised that need a reply, but let's hold that for future discussion.
Best to you.
I am a 31yo M, I had a total thyroidectomy 2 years ago along with the removal of all lymphnodes from the left of the neck, all para-thyroid glands were saved. I recieved I-131 in 2 capsules. Currentlly I am taking 400mcg of levothyroxine a day and my last lab results are - T3 Total 124.1 ng/dL [70.0-190.0] TSH 13.900 mcIU/mL [0.360-3.740] T4 Free 1.01ng/dL [0.76-1.46]
I sweat all the time from my head,shoulders and chest, am always fatigued and feeling like I need to sleep, no amount of sleep is refreshing. I gain weight in my abdominal area only and my diet is very healthy and portions are small to the point of always feeling hungry and I snack on fruit, vegies and grains along with plenty of water, I have cut out red meat, salts sugars, fats and most carbs and yet I gain about 6-10lbs/week.
Please help anyone - Noah S.
Hi Noah. Welcome to the Forum.
From your symptoms it sounds like you may not be adequately converting T4 to T3. This is very common when taking large doses of T4 meds. To confirm that you need to be tested for Free T3. Free T3 is the most important thyroid hormone test because FT3 largely regulates metabolism and many other body functions. Scientific studies have shown that FT3 correlated best with hypo symptoms, while FT4 and TSH correlated very poorly.
You should also be aware that even if your FT3 and FT4 tests are within the reference ranges, the ranges are far too broad. FT3 test results that fall in the lower end of the range are frequently associated with being hypo. If you find that your FT3 is in the lower end of the range, just increasing your T4 med is not likely to achieve what you need. Instead, you would need to add a source of T3 to your meds. Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to around the midpoint of its range.
Many hypo patients find that they are deficient in other areas as well, so you should ask to be tested for Vitamin A, D, B12, zinc, selenium, and RBC magnesium.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. If you want to read about clinical treatment, this is a link to a letter written by a good thyroid doctor for patients that he consults with from a distance. The letter is sent to the PCP of the patient to help guide treatment.
Oh my word... The fact that you just said continuing thyroid symptoms are more likely to be from depression or anxiety just shows the kind of doctor you'll be.... Wow that saddens me....
So how do you get a diagnosis? I have been told that I am positive for Hoshimoto's, but that there is nothing wrong with my gland. I went to one Dr. who said I did not have it a specialest, but the Dr. who did the test did it twice. So I don't understand, I have no energy, I can be fine one minute and dripping sweat the next, I had a total hysterectomy when I was 26, I am 53 now so I am over the hot flash stage, and this is new. Anyone have any thoughts?
This is a very old thread, and few of the participants are still active on the forum; your question would get more/better attention if you start a new thread with only your own information.
You can start a new thread by clicking on the orange "Post a Question" button at the top of this page. You will get a blank form to fill out with your information and questions, then click the green "Post a Comment" button.
Be sure to include all tests, results and reference ranges in your new post, along with symptoms and any treatment that's been initiated.
Hey Chris, just wondering if you ever got to the bottom of your underlying problem with the armpit sweating. Your description of your suffering and situation were exact words taken out of my mouth. I too had a thyroidectomy and partial parathyroidectomy just over 2 years ago. I was diagnosed with Hyperparathyroidism which was originally diagnosed due to my body creating large amounts of kidney stones for 7 years. I since no longer have kidney stones, but have had a time, trying to level out my synthroid levels. I continue to go to the doctors and have lab requisitions for my TSH levels and occasionally PTH. my current requisition is also checking my ft4, but don't see anything listed for ft3? I hope there is someone out there who has experienced this and found treatment. Dating back to my original diagnosis, I was certain it was my Pituary Gland or perhaps Hodgkins disease due to other symptons expecially depression and mood swings and fatigue, along with IBS symptoms. I was also 134 lbs and since my surgery I am a whopping 153 lbs and not happy. I haven't changed my diet at all or eating habits, so not sure why the weight gain. It too is concerning as it seems to be creeping up about 10 lbs a year. I keep active and not sure what else to do.
Someone please tell me they have answers.
I am 28 years old and i had my thyroid removed 7 years ago. I was suffering from hyper hydrosis since the age of 8 years old and it stopped a few months after my thyroid was removed. Since two months my hyper hydrosis came back accompagnied by severe anxiety crisis...please help if you have any idea of what's happening to me.
Thanks a lot
You've attached to a very old thread. You question might get more attention if you start a new thread of your own. You can do that by clicking on the orange Post a Question button at the top of this page, type your question, then click the green Post a Comment button.
What are your current thyroid hormone levels? Please post results, and be sure to include reference ranges, which vary lab to lab and have to come from your own report.
What medication/dosage are you on and how long have you been on it?
Why did you have your thyroid removed?
Same with me, I am always sweating and hot. If I bend over to pick something up all of a sudden I'm sweating profusely, it's so embarrassing! When my Dr. diagnosed my hypothyroid he asked me if I was cold intolerant, and I told him that the cold didn't bother me, I was always hot. He said that's something we'll talk about next visit.. I'll have to remind him about that the next time I see him.
HI.. I HAVE BEEN TOLD THAT I HAVE HASHIMOTOS THYROIDITIS, HYPOTHYROIDISM, BUT MY THYROID FLUXUATES, WHEN THE DOCTOR WANTS TO PUT ME ON A SMALL DOSE OF MEDICINE MY THYROID GOES BACK TO NORMAL.
RECENTLY I HAVE BEEN EXPERIENCING EXCESSIVE SWEATING HAS ANYONE EXPERIENCED THIS NOT BEING ON MEDICATION?
As has been noted above, a couple of times, you have attached to a very old thread and most of the previous posters are no longer active on the forum.
Your question might get more attention if you start a new thread of your own. You can do that by clicking on the orange Post a Question button at the top of this page, type your question, then click the green Post a Comment button.
If you post a new thread, be sure to post your current lab results and be sure to include reference ranges as those vary lab to lab and have to come from your own report.
In addition, I'm sure you don't mean to, but typing in all capital letters is equivalent to yelling at people, plus it's very hard to read.
Thank you, i type in all caps because i am not too good at typing.. i will try what you suggest...best wishes and health to you
It's okay that you don't type well. We can work around typos. Regular sentences and paragraphs works great. Hope to see a new post.
I have the opposite. I can't/don't sweat so I can't tolerate the heat at all but I do get body odor.
It's not pleasant either. Makes it very difficult to be outside in the summer.
I stay hot and sweaty most all the time. If I do the slightest thing my head sweats profusely it's horrible and I'm so tired of it. I'm 62 and so tired all the time, embarrassed by the sweating it can be 0 out and I have sweat dripping down my face and my hair gets soaking wet at my temples, under my hair line, top of my head, it's living hell and I'm so worn out from it. I feel so miserable most all the time.Any suggestions please?