Avatar universal

Water retention, Naturthroid & Hashimoto's

My newest endo put me on Naturethroid 1/2 grain in August 2015.  Diagnosed with Hashimoto's & osteoporosis 19 years ago.  After 5 years & 8 endos (including 1 that took me off my thyroid meds when I had major symptoms) that told me my numbers didn't indicate treatment.  My antibodies are through the roof.

Test                         Low Normal High Reference Range Units
T4,Free(Direct)          1.17          0.82-1.77 ng/dL

Test                                   Low     Normal High        Reference Range Units
Tsh                                       2.220       0.450-4.500 uIU/mL

Test                                   Low       Normal High Reference Range Units
Triiodothyronine,Free,Serum 3.3           2.0-4.4 pg/mL

I went back to see her in the beginning of November still complaining of tiredness, a lot of water retention (up 15 pounds since August 30 plus pounds in the last 5 years),exhaustion, brain fog, joint pain, & loss of appetite.  She said she doesn't want to increase my meds b/c she's afraid my heart rate will increase too much, my osteoporosis would get worse, & that I really didn't need an increase b/c my numbers are fine & am better than the last time.  She was all about symptoms when I first started to see her but now she's all about numbers.

I know this is water weight b/c if I weight as much as the scale says I would be wearing much larger clothes, I would look much larger, & I'm not.  I'm up 30 pounds mostly in my abdomen, chest, my legs & hands are swollen.  After a couple of hours of standing or walking I feel like my legs are made of concrete & I can't move.  I have a lymphodema machine that moves the fluid around my legs & I feel much better after I've been on it.  My gyno & pcp say it's endo's problem. They've run all sorts of blood work but nothing showed anything that could explain these symptoms.  The endo said it's not her problem & meanwhile I'm retaining water like crazy & feel miserable.  My pcp said to drink a lot of water to flush out my body but that's not working & keep my legs elevated.  The diuretics that my gyno prescribed did nothing. One study from a good source said that it should be 1.3 mcg. per pound & that I should be taking much more Naturethroid than I'm currently taking but I can't get the doctor to listen.

Has anyone else had these symptoms?  I feel like Goldilocks.

4 Responses
Avatar universal
Unfortunately doctors don't understand that being just anywhere within the so-called "normal' ranges does not mean all is well, because the ranges for Free T4 and Free T3 are far too broad.  So when trying to evaluate test results, a good thyroid doctor told me the following.

"The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

A good thyroid doctor will treat a hypothyroid patient by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  So you need to find a good thyroid doctor that will treat you clinically, and adjust your Free T4 and Free T3 levels as needed.   Free T4 should be at the middle of its range, at minimum, and Free T3 should be adjusted into the upper part of ts range, as needed to relieve symptoms.  Do you think you might be able to get your doctor to treat clinically as described?  If not, then if you will tell us your location, perhaps we can suggest a doctor that has been recommended by other thyroid patients.

Also, hypo patient are frequently too low in the ranges for Vitamin D, B12 and ferritin.  Low levels can cause symptoms.  Low D or low ferritin can also adversely affect the metabolism of thyroid hormone.  D should be about 55-60, B12 in the upper end of its range, and ferritin should be about 70 minimum.  After testing you can supplement those on your own to optimize.  

Sone other possible contributor to your problems is cortisol.  Have you tested for that?  If not, the best test is a diurnal saliva cortisol test done at 4 times during the day.  Doctors don't agree with that and usually only will test a morning serum cortisol test.  Cortisol needs to be roughly in balance with thyroid hormone.  Low or high cortisol can contribute to hypo problems.  

You did not tell us what dosage of NatureThroid you are taking.  Also, you mentioned high antibodies.  Please post those results.  
Avatar universal
Thank you gimel.  Naturethroid dose is 32.5 & she won't raise it afraid it will race my heart.  Still having issues with brain fog, swelling, cold intolerance, tiredness.

Thyroid Peroxidase (Tpo) Ab
Test                           Low Normal High Reference Range Units
Thyroid Peroxidase (Tpo) Ab 173 0-34 IU/mL

Antithyroglobulin Ab
Test                 Low Normal High Reference Range Units
Thyroglobulin, Antibody 5.1 0.0-0.9 IU/mL

Avatar universal
Test            Low Normal High Reference Range Units
Cortisol - Am 12.6         6.2-19.4 ug/dL

Vitamin D3 is 45 a little below the Labcorp range

I'm in central NJ, been to 8 endos in the last 5 years & they all say they are not numbers people then they turn into numbers people when the test results come in within "normal" ranges & I'm still having symptoms which they keep ignoring.  My PCP & gyno feel this is all thyroid related & the endo keeps testing various issues like a rheumatology panel but nothing is flagged.  Getting very tired of feeling like crap.
Avatar universal
Sorry for all the questions, but need more info.  How long have you been on the 1/2 grain of NatureThroid?  If you have test results from right before starting on that dose, please post them, along with ranges.  

Your Vitamin D3 is a bit low.  It would be better at 55-60, but that is not a big contributor to your issues.  Have you ever been tested for Reverse T3 and also ferritin?  If not, do you think you could get your doctor to do so?  
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