Do you have a copy of lab report, showing abnormal thyroid levels? If so, please post your thyroid test results, here for us to better assess your situation. Be sure to include reference ranges, because those vary lab to lab and have to come from your own report.
It's not unusual for symptoms to worsen or new ones to appear when starting on a thyroid hormone. The symptoms you mentioned are those of hypothyroidism.
When our thyroid slows down or stops working, our adrenals kick in to pick up the slack, which is probably why you had no thyroid symptoms. As you get on the medication, your whole body has to rebalance.
It's also possible that you could be reactiing to fillers/binders in the levo. Sometimes, when one switches to a brand name or a generic by another manufacturer, symptoms are relieved.
Thyroid hormones control metabolism, body temperature, heart rate and other body functions, so if you'd been born with a thyroid condition, you would have exhibited symptoms as an infant.
I first went to the doctor on a non-related issue, and was diagnosed with Hashimoto's disease. My TSH was 3.58 on 4/8/13. By 5/8/13 after taking Levothyroxine it was 2.63. I was originally taking .012 mg. prescribed by my physician. The endocrinologist increased it to .025, and until recently, I still had no symptoms. I have been taking the medication for 3 and 1/2 months (before this I might have indigestion once or twice a year), and now I am experiencing heartburn two to three times per week, bloating, and more pronounced balance problems. Should I decrease the Levothyroxine to the original dosage or talk to the doctor about increasing the dosage?
You should never adjust your dosage without your doctor's blessing; self medication gets a lot of people into trouble.
Your symptoms do not indicate that you are over medicated; however, your doctor is not testing all of the right things, either. TSH is a pituitary hormone and does not necessarily correlate with either symptoms, or actual thyroid hormone levels.
You need to ask to get tested for Free T3 and Free T4. Those are the actual thyroid hormones and will determine whether or not you have symptoms. Free T4 is the storage form of hormone and must be converted to Free T3, which is what the cells actually use. It's possible that you aren't converting properly (some of us don't)
TSH of 3.58 is higher than the recommended level, which, even though your lab report may say differently, is 0.3-3.0. Even your 2.63 is at the very top.
Hashimoto's is "progressive" in that the antibodies are continually causing the thyroid to produce less hormones; eventually, it will produce none and you will be totally dependent on the replacement hormones.
You need to get tested for FT3 and FT4, before you'll know how to adjust your dosage. If those levels are too high, you'll want to decrease, and if they are too low, you'll need to increase. I'm betting that you'll need to increase.
As I noted above, it's very possible that you are reacting to the fillers/binders in the medication. Some people even react to the dyes present in different dosages.
The first thing I'd recommend is talk to your doctor or pharmacy and see about getting your pills from a different manufacturer, since each manufacturer uses different fillers/binders. If changing manufacturers doesn't help, ask to get on a brand name medication, such as Synthroid or Tirosint.
Above all else, though, get tested for FT3 and FT4; I can't stress enough how important those are. And always be sure to get copies of your labs, for your own records. I note on each of mine, what med/dosage I was on at the blood draw, as well as what symptoms, if any, I had. This lets me look back and see, at which levels I felt the best.
Do you know what antibody tests were done to come up with the Hashi dx?
I was tested for Free T4, and from 2/8/2013 until 5/8/2013 it went from 97 to 100 while on medication. According to the normal range from 0.82-1.77, I seem to be in a mid range. Even though, you said I should not self medicate, before I saw this reply, I lowered the dosage back to 0.12, and I feel much better...no heartburn so far. I will be going back to my home in Arizona in 6 weeks, and I will return to the doctor at that time, and be re-tested. If the heartburn and other symptoms return, I will go back to the 0.25. How is the TSH different from the Free T4? I don't fully understand that. As I said before, I had absolutely no signs of a Thyroid dysfunction before I started taking these pills, and that has happened only recently. I have researched the symptoms, and I had none of them. The blood tests were the only way the doctor was able to determine what he thought was a Thyroid problem, and they say I have a goiter, but it doesn't need surgery and is not cancerous. Since I had no symptoms, I still question if I really have it, or that it is a problem.
What was the reference range for those FT4's. Ranges vary lab to lab and have to come from your own report. That was before medication?
How long ago did you reduce your dosage? It takes a dosage change approximately 4-6 weeks to take full effect, because of the long 1/2 life of the levothyroxine.
The difference between TSH and FT4? TSH is a pituitary hormone. When everything is working properly, as the pituitary finds thyroid hormones too low, it produces TSH (Thyroid Stimulating Hormone) to try to get the thyroid to produce more thyroid hormones. If the thyroid responds and makes more thyroid hormones, TSH will drop back down. If the thyroid doesn't respond, the pituitary continues to pump out TSH, so TSH typically continues to go higher, while thyroid hormones go lower. FT3 and FT4 are the actual hormones produced by the thyroid.
The thyroid produces mostly T4, some of which will be bound by protein and is unavailable to the body. That's why we specify FREE T4, because that's the portion that's available. FT4 is not used directly by the cells. It's a storage hormone and must be converted to T3. As with T4, some of the T3 will be bound by protein and unavailable for use. Therefore, we specify FREE T3, because that's what's available for use by the individual cells.
With Hashimoto's, the body sees the thyroid as foreign, and produces antibodies to destroy it. Hashimoto's is progressive, in that it will destroy healthy thyroid tissue, until eventually, there's none left and your thyroid can't produce anything. As the destruction progresses, thyroid function deteriorates and T4 and T3 production drops off, until finally, you are totally dependent on the thyroid hormones.
You need to get tested for Free T3, as well as Free T4, because FT3 is the hormone that correlates best with symptoms.
Do you know what tests, the doctor based his Hashimoto's diagnosis on? There should have been some antibody tests, otherwise he wouldn't know you have Hashimoto's. Did you have a thyroid ultrasound? Do you make sure you get copies of all labs, each time you have them done? It's very important that you get copies for your own records. Often symptoms precede labs indicating a thyroid condition, but sometimes, it's found prior to symptoms. Often, if medication is started earlier, you can keep the symptoms from getting out of hand.
A goiter is simply a swollen/inflamed thyroid and is very common. It's a typical characteristic of Hashimoto's. Thyroid cancer is relatively rare. Do you know if you have nodules on your thyroid? Those are also very common with Hashimoto's.
While Hashimoto's is, typically, associated with hypo, it can be characterized by swings back and forth between hyper and hypo, in the beginning stages.
Yes, I did have an ultrasound, and I do get copies of my labs. The ones I have show testing for T4, but not for T3. That is something I will ask about when I go to the doctor next time. Yes, there were two nodules on the thyroid, and they were tested, and found non-cancerous, and the Endrocrinologist said they didn't need to be removed.
FYI, I am very sentitive to medications. For instance, my allergy tabs say to take two every four hours...I take one, and it lasts all day. If I took what they recommend, I would be in a coma so I am thinking perhaps the 0.25 dosage may be too much. If I go in for any kind of operation, they use half the normal dosage for anesthesia. I am neither underweight nor overweight so this has something to do with my system not tolerating most meds.
I have only been down to the .012 two days, but I can already tell a difference. I think at this time, I will continue on this dosage until I see my regular doctor. Unless, as I said before, the heartburn returns. I appreciate your helping me to understand some of this. I'm still trying to put it all together. At least now, I have some things to ask my doctor.
I have had the exact same thing. Started Synthroid 3.5 months ago and within a few days was constipated every day and around 3 pm would get horrible gas like pains that wouldn't go away until I woke up the next day. Now I have gained 6 lbs in 3.5 months. I'm miserable and considering stopping the Synthroid altogether.
Sounds very similar. At first when I was on the .012 I couldn't see any change. It's just been recently, after being on the .025, that I have been experiencing these problems. I was told that after I started the thyroid meds that I would lose weight. Haven't lost an ounce, and my upper stomach seems to be bloating. I have been taking a probiotic, so maybe that is why I haven't had any gas pain in that area. However, the heartburn has been terrible in the last week. Now, after being off the Levothyroxine for two whole days, I don't have it. What is your dosage? So far, backing off the dosage is working for me. I'm surprised that with your symptoms that you have stayed on it as long as you have.
This is my second reply to you. I have been constipated too, but didn't relate it to the Levothyroxine. I am still on it, but am back to the .012. Since I didn't have any symptoms in the beginning, I wish I had just said that I wouldn't do anything or take anything unless I started having symptoms. So what are you going to do?
Constipation and heartburn are both symptoms of hypo, as is inability to lose weight.
As explained above, t's not the least bit unusual for symptoms to worsen or for new ones to appear once started on a thyroid medication, because it takes time for the body to balance again, with the hormones.
Surely, it shouldn't take 3.5 months to worsen. If you are taking medication for that long you should be getting better. It doesn't make any sense to me at all. However, I will check with my doctor when I get back home for the winter in September. Again, I really do appreciate your help. Thanks.
There are a couple of things that could be going on... first off, the body is "odd" in how it handles certain things, so while we'd not think it would take 3.5 months, it could, because it takes time for the body to re-balance.
The other thing that could be happening, is that the Hashimoto's has increased destruction of your thyroid, so it's making less hormones than it was 3.5 months ago. The antibody destruction can take months or years to complete.
I agree that you should see your doctor when you get home and get retested to see if an adjustment in med is in order. You're having hypo symptoms, now, so it may be time for an increase.
Hey when I was on Levothyroxin, it was awful, I too had bloated upper stomach, I couldn't take deep breaths because of this, when I did, my stomach would inflate more. I couldn't take brisk walks because I would get out of breath. My legs felt like led and I was so constipated. I was on a high dose of Levothyroxin, took myself off, it was too much. Then doc put me on levoxyl 75 I believe, same syptoms, didn't stay on it too long, had lots of syptoms. I finally got on Armour 30 problems subsided, still had syptoms of hypo, so after 6 weeks and blood test she increased to 45mg feling even better, but yet still some hypo syptoms, so after 6 weeks and another blood test, she increased it 71/2mg . I feel levothyroxin and levoxly my doc started me off too high a dose, plus I don't think these meds agreed with me, Armour works for me. You sound like your hypo maybe and maybe your sensitive to the binders and fillers in the meds your taking, that might have been my problem too, plus the way to high a dose.
I thank you for your response. I travel full-time so I am sometimes unable to respond in a timely manner. I will ask my doctor about the Armour. I decreased my dosage to 12 1/2 mcg, and my symtoms have been reduced. It's hard for me to believe that a medicine actually makes you worse while it is supposedly helping you. I still have some mild heartburn when before taking the Levo, I had none. I wish I had not ever taken anything until I actually had symptoms. I just find it hard to believe that when you are feeling fine, and only find that you have a problem with a blood test, that there is really a problem. I didn't have even one symptom, and felt wonderful. I will, however go back to see my doctor in September and find out what is going on. Thanks again.
I found this site after being on generic Levothyroxine 50 mcg for a couple of days. Why in the world do I have to stay on this if I had very little symptoms. I had, however, a tsh of 6.26, but the T's were normal. Cholesterol 287 with high LDL of 177. They found an ultrasound showed 2-3 tiny nodules, but no masses. Talked to 3 dr friends who think an endo is not needed. I DON'T KNOW WHO TO BELIEVE. Should i get off this thing and go natural or request an organic form before my blood pressure gets higher, i have a detectable slight mitral valve issue, 107 glucose and dont want any permanent damage. Anyone advises me?
Your TSH is too high and indicates that you are hypo and need replacement medication. What are the actual results of your FT3 and FT4? Often, even if they are "normal", they are low in the range and symptoms will be present. Please include reference ranges with any results, since ranges vary lab to lab and have to come from your own report.
You say you have "very little symptoms" --- those will only get worse, if stop taking the levo.
High cholesterol is a a symptom of hypothyroidism.
Do you know if you have Hashimoto's? This is an autoimmune disease in when the body determines the thyroid to be foreign, and produces antibodies to destroy it. Hashimoto's is progressive, in that it continually destroys thyroid tissue so it produces less and less hormones, until eventually, there is no more healthy tissue and your thyroid will produce nothing. At this point, you will be completely dependent on the replacement hormones.
Hashimoto's is the most common cause of hypothyroidism in the developed world. It's diagnosed with 2 simple blood tests for antibodies. Those are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAB). You need them both because some people only have one of them and you have no way of knowing which one you will have. Some people have them both.
There is no organic for of thyroid hormone replacement. You can opt for a desiccated form, which is derived from pigs and is called "natural"; however, I've never thought it natural to eat pig thyroid. Desiccated hormones can be found in Armour Thyroid, NatureThroid, ERFA, etc. Pigs produce about 4 times as much T3 as humans do and many can't tolerate that high level.
You can ask for Tirosint, which is a gelcap and is considered hypoallergenic, since it contains only 4 ingredients; those are the levothyroxine sodium, water, glycerin and gelatin. The levo in synthetic hormones, such as generic levo, Synthroid, Tirosint, Levoxyl, etc is identical to what your body would produce, if it could.
All options for medication should be considered.
might not help and i am newly diagnosed but my doctor prescribed Lansoprazole 30mg when he prescribed Levothyroxine to indigestion/heart burn/acid that may occur. i have not had any trouble with my stomach at all, but think my dose is to low as my hypo symptoms are still the same.
This is an old thread and BettyLou is no longer active on the forum. Many of us have had acid reflux/heart burn with hypothyroidism and it goes with away with adequate amounts of thyroid hormones, so we don't need to take acid reducers.
Many of us also find that our reflux/heart burn is not a result of too much acid, but of too little and that adding more acid, such as pickle juice, vinegar, etc to our diet can alleviate the symptom.
You know what I do not believe in these thyroid medications I think that they fool the body into thinking that it balances out your levels. Obviously from that statement I do not have a medical background but I read a couple articles about synthetic thyroid medications and it makes a lot of sense to me. I was diagnosed about six years ago with hypothyroidism and as of the last year I feel worse and worse every day my skin is so dry that I feel like it’s leather, I have horrible facial acne my hair is dry my nails are dry, And my eyes are dry. I cannot sleep at night and I am just fit to be tied I have no answers for you but you are not alone.
I also have Hashimoto's, Celiac, Sjogren's, and Lupus Autoimmune Diseases. I have Tremors from a past brain injury. This is a lot to take in for one person. Hashimoto's is serious. It is an autoimmune disease and should be taken seriously. Take your medicine and have a little faith in your physician. He knows more than you do about your health. Don't pout, talk to him about your concerns. After all, he works for you.
5% of the population are NOT within the normal range. Meaning, 5 of every 100 will feel better higher or lower
If my shoes goes below 3 I feel awful and get dizzy. It may be that you are one of the 5% someone has to be. Btw, those with ashkenazi Jewish heritage are even more likely to have this problem.