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Request_GravesLady

My question to Grave_lady or anyone who can answer. In my last couple of questions , i have received response from Graves_lady to check adrenal fatigue also , my doctor has DHEA and cortisol level , they both came back in lab reference range (Cortisol 7.6 , ref range 3-12 and DHEA was also in mid range).
My Endo recently changed my Levoxyl from 75mcg to 50mcg , i have been taking for last 25 days , he will test in next 20 days to get better result. I was struggling with thyroid (Hashimotos postive TPO ab) for last one year. Since March my TSH is really bouncing due addition of T3 5cmgx2/day. Before my doctor changed my Levoxyl to 50mcg my TSH level was . 0.51 and FT4 0.0916 after not taking any Levoxly for 17 days as before that my TSH was 0.004.
My current symptoms
1. Shortness of breath even with small physical work.
2.Muscless cramp in Calfs,Muscless weakness in arm, With little work feel tingling in Arm.
3. Fatigue after whole day of office work (computer engineer), after 6PM tired to death.
4 Hives  in chest/back and some time in face ,including bump in lips due to heat in summer.
5. Gain 8 ibs in 1 month.
Question:
How long Levoxyl takes to resolve muscles cramp/weakness issue.
Should i have to maintain my TSH to1.0 for few months in order to feel better.
8 Responses
Avatar universal
What meds and dose are you taking now .  And, what was your levels from last test - all three please, with Labs. reference range.

However, medication, especially T-3 is not a cure all.

One out of the five symptoms you mentioned just might have to live with or at least treat separate from thyroid.  Hives could be T-3 medication or you are   hypo. In some cases, Hives are autoimmune.

One thing you must take into consideration is that once you arrive at the correct level for you, it will take time to heal, in some people a year or so, depending how long your body was sick with thyroid.

Due to a low FT-4, I'd adjust meds. according to the FT-4 and  suggest to aim for a FT-4 at the upper mid range, TSH will follow, hopefully more to the mid range or maybe at 1.00.  

What I do if my levels are off, is redo test in another 3 months before any med. dose change,  to see if both test confirms level being off.  There is so many things that can interfere with levels, and, on might be the Lab error as well.  So to make sure nothing was/is interfering, two test three months apart should be done.  Then if doctor feels levels are still in question suspecting Lab, then using another Lab would be suggested.

The most important three issues are  - don't rush med. dose changes let your body get use to being at levels and make sure two test confirms;
and don't rush healing process, it takes a while for our body to heal; meds are not a cure all and when levels are at optimal and we are still having symptoms it probably not thyroid/level issue but something else going on - another health issue - and therefore each symptom might have to be treated separately and separately from thyroid.

I hope you arrive to your level soon - Good Luck - Hope I helped - thank you for your faith and confidence. I'm not a doctor nor am I prescribing or treating, just suggesting.  Your treatment is between  you and doctor.

GL
Avatar universal
Thanks again for your detail response.

May 27th  Result

TSH 0.51 (0.4-4 )
FT4 0.916 (0.6-1.8)

Current dose 50mcg Levoxyl.

So that means once my level get adjusted , i have to wait another 1 or 2 test to make sure level sustain and still feeling same way before start digging to other medical issues based on symptoms, correct ?
Avatar universal
Your first post miss lead me to believe that your FT-4 was way out of Labs FT4 at 0.0916, so if not the case, then TSH is used to adjust dose, with FTs  adjusting accordingly.

    
No, not necessarily.  As far as symptoms, once levels are stable, go by how long you think that you were sick with thyroid (before diagnosed) to levels being stable.  Give your body a far shake as far as healing. Give your body as long to heal as you were sick.  If this is along time and your symptoms are sever, than treat each  as a separate health issue.

I would expect shortness of breath and hives to improve as levels improve.
Although, as far as shortness of breath, have you been checked for MVP?

Fatigue, weight and muscle cramps may last where you might be better off treating them each separate and not expect levels to heal them.

TT for cancer with TSH supression is a different situation.


GL
Avatar universal
Thanks again for your response. Can you explain MVP test ?.
If my level get normal soon what i should do for symptoms of fatigue,weight loss and muscles cramp /muscles pain.Shouldn't they fix once level get normal and stay normal for few months.

Is it common to have Hypo in male ?. Should i use selinum to lower down my AB TPO.

Thanks again for all your guidelines.
Avatar universal
MVP = Mitral Valve Prolapse. MVP is the most common heart valve abnormality where one or both valve flaps are enlarged. When the heart contracts or pumps, the flaps don't close smoothly or evenly. Instead, part of one or both flaps collapses backward into the left atrium. This sometimes allows a Mitral Valve Prolapse small amount of blood to leak backward through the valve and may cause a heart murmur.
There is a connection between mitral valve prolapse and thyroid conditions.
I for one have have this.
A Major Symptoms of MVP include are:
Pounding, fast heartbeat  (the medical term is "tachycardia").
Irregular heart beat "Palpitations"
Fatigue
Weakness
Low tolerance for exercise
Chest pain
Panic attacks, anxiety attacks, and depression
Headaches, migraines
Sleeplessness
Dizziness, fainting,  lightheadedness
Intestinal problems,  such as irritable bowel syndrome
Shortness of breath,
Chronically cold hands and feet
Problems with memory or a feeling of fogginess, difficulty concentrating.
Numbness or tingling of the arms or legs.

If you are one of the few lucky ones, perhaps fatigue, weight and muscle cramps will go back to normal once normal levels are achieved, which professionals state. I'm not a believer for being in this for 11 years I still suffer with all three. I think they just come with and stay with the territory of thyroid...but I am autoimmune, which could be the difference.

For fatigue I rest a lot and get at least 8 hours of sleep per night.

Weight, I deal with in the normal way - food control and diet.  

Muscles I take calcium with Magnesium, V-D and potassium.   I put a bar of wrapped soap under my bottom sheet and replace it with a fresh bar once a year. Lack of proper fluids, resulting in a mild case of dehydration can cause muscles to cramp or not getting enough blood circulation can cause cramping. So I dry to drink lost of fluids and do a little exercise.

Hypothyroid is more common in men than hyper, but hyper is seen in men as well.  Are you a male?

I have read where others say selenium lowers antibodies, however I have never read anything to confirm this from reputable sites such  as Government, Medical or Thyroid Orgs, etc.  however it doesn't mean such sites don't exist, it just means I haven't come across them as yet.

I have read and I do take Selenium in case of conversion problem and thyroid health in general.  However its more involved than just selenium alone. Iron deficiency, iodine deficiencies or excess protein intake (high protein, low calorie diets) takes a part in conversion problems. Selenium, Chromium,  Zinc (copper - Iron) and magnesium are required for this conversion, as well as other nutrients.
And must be taken in the proper dosage to each other or one will deplete the other. Then its different requirements for hypos and hypers.
Your physician can check to see if you have a problem by monitoring your free T3 levels.    
                    
However a study showed that persons;
"with thyroperoxidase antibody (TPO Ab) levels of 600 IU/mL had a mean serum selenium of 83.6 IU/L, while those with TPO Ab levels lower than 600 had mean serum selenium levels between 92.9 and 95.6 mcg/L."  
"Adequate selenium is necessary for normal functioning of the immune system and thyroid gland. Selenium deficiency has been associated with thyroid disease and a variety of cancers. In numerous animal studies, selenium has demonstrated cytotoxic activity against tumor cells and significant immune-enhancing properties. Selenium is the basis of several key selenoprotein enzymes that have antioxidant effects. The doses of selenium used in animal and human chemoprevention studies have been greater than doses necessary for the maximal production of these enzymes, and it has been hypothesized the activity of selenium at these levels is due to other selenium compounds such as Semethylselenocysteine, selenobetaine, and Seallylselenocysteine. The benefit of using selenium in conjunction with chemotherapy or radiation therapy in specific cancers appears worthy of further investigation."

I don't know what else to say.  I have said a lot, yet, possibly nothing at all ;)

GL



Avatar universal
Once again i really thankful for your detail responses , i really love reading those .
Yes i am 35 years old male , suffering this thyroid issue since last May 2006 , it started with fatigue and muscles cramp/tingling in arms/legs .Initially doctor did not pay attention as my TSH was 3.6 which based on new reference it should be treated if one has symptoms. My neurologist diagnosed that he did thyroid panel  test in Sept and found my TSH was 12.7. I went to Stanford Endo and she did TPO AB and Thyoglobium , TPO was elevated to 285 so she concluded Hashimotos.

Since last year i am struggling with my numbers and symptoms , MY symptoms went better for week or two but my doctor didn't perform test as she wanted to wait for another 4 weeks and when we tested those numbers are out of wack.

My heart rate in resting is around 90 or sometime 95 even in HYPO when i went to Hyper it was 120/min in resting .As i do have family heart condition , i would check with doctor to make sure MVP is fine although my Lipid test is normal it went up due to TSH was high (Hypo) but when it came down to less than 2 Lipid came back okay .

It seems like i have to live with these symptoms whole my life because of my thyroid issue i am so nervous and in lot of depression i am thinking negative all the time which started me thinking that i will not live longer and doing all kind of stupid things to protect my family if i am not around  my wife wants to have another baby but i am pushing because i think this it and i am going to die which sounds stupid but quality of life i am having is really worst. No energy as soon as i get home , can't give time ti my daughter because of no energy, gain weight. Can't life my daughter long enough started having muscles pain . Can't drive or write on paper longer started having pain in my palm/fingers.

I am hoping to feel better one day so i can live my life back.
Thanks again for your responses.
Avatar universal
For one thing I personally think your levels are too low for a male.
The so called "new reference range" is for a target range/optimal goal  once treated, not for diagnose. Your TSH 3.6 would have been fine.  Men's levels and Labs reference range run higher than women.

Lipids have nothing directly to do with MVP.

You are not going to die from Hypo/Hashi - you have test done on regular bases (every three months until you find your level to where you feel your best and they are stable for a year) and adjust meds when they are called for, you will be just fine.
Your quality of live doesn't need to go down either. You can live with this condition and live a normal  happy life.  People live with worse.  We have to be positive in life or its going to get us down. This thyroid is not a scary thing and I don't know what you have read to make you believe that it is. So we have a couple of health issues.  We deal with them by treating them  separate.  If you are depressed, antidepressants are great tools to help us get through the rough spot.  Doesn't mean we are weak or that it has to be forever, but just until we get better.

Feeling fatigued is not that uncommon. Our bodies take a beating  from our thyroids being off and our body needs time to heal at normal levels of hormone, perhaps even months. Strength and stamina return but over time, maybe months. We need to help things along by getting good nutrition, appropriate rest, and exercise. Other conditions could cause your fatigue such as,  Chronic fatigue, or Chronic Fatigue Syndrome in which this fatigue is not the kind of tired feeling that goes away after you rest. Instead, it lasts a long time and limits your ability to do ordinary daily activities and experience other problems such as muscle pain, pain in multiple joints, sleep problems, etc.  Have doctor check this out as well.
Also fatigue goes hand in hand with depression, so once depression is under control it could automatically correct your fatigue. Of course there are many other health conditions that causes fatigue.

Pain in palm/fingers Carpal Tunnel Syndrome-- tingling, weakness, achiness or numbness in the wrist, fingers or forearm. It is due to swelling of membranes that compress a nerve in the forearm.

Weight gain diet/exercise,  diet/exercise,  diet/exercise.  Or, normally all men have to do is cut down consumption and/or stay away from certain foods or drinks ( beer ;) ).

All the above are related to thyroid, but each might need to be treated separately. You and doctor need to go through each symptoms and discuss treatment options for each one - you deserve it as well as your family deserves a 100% husband and father.
  

You are a bright  intelligent young man who has  a future with a beautiful family. Don't accept less.  Don't let a little 2 inch, 10/20 gram dieing thyroid organ win over you - you have control, you are the boss.  I know you are sick, but I also know you are going to feel better!  Your family is counting on you and so am I. You are going to be fine!  Let me know results and how you are doing.

GL

Avatar universal
Thanks again for all your support and responses . It is really feel good when you share your feelings and thoughts with some one who are also going through or know what exactly other person is going through.
When my TSH was 3.6 in Last May i was not feeling good less energy ad compare to Jan07 when my TSH was 1.38 so that means my TSH must be require some where around 1.0 or Higher , One thing i notice in June 07 Ist week that i have good energy and feel good all day , i am not sure my level but i felt good.
My fatigue is better than before compare to last year but muscles cramp /muscles/joint pain is more than last year .

My doctor first want to keep my TSH to 1.0 or around and than if i still have symptoms , she is thinking to send me Rheamatologist  to rule out FM and CFS.
But i would check MVP next week as i do have heart issues in my family  but not thyroid to my immediate family although my mom's brother has it.

Please keep me in your prayers.
Thanks again for your response.
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