Why the sudden change??

[Jules82566]

I was diagnosed with Hypothyroidism back in May of 2012 and my Doc and I are still trying to get the right dose of Levothyroxine.  About 6 months prior to being diagnosed, I was having incredibly painful & heavy monthly cycles.  Since being on Levothyroxine (starting in May 2012) it has brought my monthly cycle back to normal ie (very light and 4 days).  I've been on a new dose (100) for just over 6 weeks now and this last cycle was horrific!  I had a headache for 2 days and the heavy bleeding is back like it was when I first developed hypothyroidism.  I'm confused as to why, after 6-7 months of normal cycles, would it go back to the way it was before the Medicine?  Thanks in advance for any info!

[goolarra]

Elevated TPOab indicates that the cause of your hypothyroidism is Hashimoto's thyroiditis.  Hashi's is an autoimmune disease and the most prevalent cause of hypo in the developed world.  

However, it's not the antibodies themselves that cause symptoms.  Symptoms are caused when the antibodies attack the thyroid and cause it to malfunction.  So, the symptoms come from being hypo or hyper as a result of the antibody action on the thyroid, but not directly from the antibodies.  

We can have antibodies for years, or even decades, before they do enough damage to cause symptoms.

Your heavy period is most likely being caused by an imbalance in your thyroid hormones.  It's good to know the cause of your hypo, but I don't think your elevated TPOab sheds much light on the cause of your current symptom.  

Only by looking at FT3 and FT4 from the same draw can you determine if you are overmedicated or if you convert slowly and have to add some T3 to your meds.  

[Jules82566]

I actually got another lab result that the Endo ordered.  I've researched it and I now believe it's because the levels on this one are so high.  It actually says the symptoms of high TPO are heavy periods and a few other things.  Here is the level and the range.  

Thyroid Peroxidase AB

My level is 470 and the range is only 0-33

[goolarra]

Somewhere way back up there, you asked me what led me to believe you might be overmedicated.  

It's a combination of your realtively high FT4 and your heavy period.  Do you have any other symptoms?

I agree with everyone else about FT3.  When people don't convert well, doctors often increase T4 meds until FT4 is too high, causing some hyper symptoms and some hypo (from the low FT3).  

Yes, you can tell them to humor you; you can remind them who is paying for these tests (gently).  Another approach is to circumvent the doctor completely and order FT3 online.  Insurance won't pay for self-ordered tests, but the results will go directly to you, and YOU will know if FT3 is an issue or not.  With results in hand, you might get your doctor wo sit up and take notice.  

[courtney48]

Oh, dear.  To this community, I am so sorry that I said a word that had to be blurred.  I apologize for any offense.  I will guard my tongue in the future.  :)

[gimel]

Here is the link again.  Looks the same.  

http://www.ingentaconnect.com/content/routledg/cjne/2000/00000010/00000002/art00002

[kevieb]

Just ask them to humor you and run it, even if they don't think it is important.  i had to talk one of my docs into running it for me.  I think he thought it was unnecessary, but he was willing to humor me.

[Jules82566]

I was amazed that they brushed it off as they both did, especially the Endo.  I am going to be a bit patient and see what the Endo does with the latest labs, see how I continue to feel and go from there.  While I am not one to sit quietly and let dr's "tell" me how I should feel, I've been a bit overbearing with my still having symptoms though the numbers are "in range."  

I'm having trouble with the link you sent me, perhaps you could send it again?  I really hate to **** off the people who I am looking to make me feel better but.  If the FT3 is really "that" important, I need to make a point out of it to them, for sure.

[Jules82566]

Courtney,

Thanks for your post!  I am always open to different thoughts and opinions so....I suppose that could very well be it.  What I've learned in the past year that I've been sick is that, anything IS possible. I will just have to wait and see if this continues to happen and go from there.  I wish you the best of luck with getting yourself well and feel free to email me if you have any questions on the Levothyroxine experience.  It has been interesting ;)

[gimel]

You should give a copy of this abstract from a scientific study, to your doctors that think Free T3 is not important.  Maybe it might wake them up to reality.  Free T3 largely regulates metabolism and many other body functions.  Just because patients take large doses of T4 meds does not ensure that they adequately convert T4 to T3, so it is important to know and adjust the Free T3 level.  In the study note the conclusion that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.

http://www.ingentaconnect.com/content/routledg/cjne/2000/00000010/00000002/art00002

[courtney48]

Hi Jules,
My doctor treats hypothyroidism as yours does looking at standard protocol labs only and not going an integrative route. There are a number of doc's who treat differently and patients for whom that works best as well. My sister follows treatment protocols similar to a lot of members on this particular board do. At any rate, I am new to the diagnosis, started levothyroxine 100 mid-January and go back for new labs right at eight weeks after beginning the medicine.  Like you, I've always been quite fit/trim, but over the past few years put on 30 non-budging pounds. I thought this must be perimenopause and that it *****! Anyway, since starting the medicine, I have lost one pound. Seems almost insignificant, but I am very, very pleased and am hopeful I will see a slow and steady turn around.  I hope you start to see some changes too.  Also, is it possible you are in perimenopause? Maybe between that and hypo, your cycles are changing? Hopefully correcting your thyroid will help and that if it is 'life changes' that will just be temporary (albeit a few years of temporary). Sorry if you aren't nearing menopause and I blabbed on about it.  

[Jules82566]

I mentioned the FT3 to both my general practitioner and the endo, neither think that its important, I'm not sure why as I've read that it is very important.

I started with 75 then went to alternating 75 & 88 and finally went to all 88's because my tsh was still high.  When I was bumped up to the 100's, some of the symptoms I was having, went away so my thought was, it was working. I suffered from the severe cold intolerance most of the winter, it's much better at this time.  I'm still struggling with the weight gain and had that totally out of the blue, horrible monthly cycle.  

I think he wants to bump me up to 125 so we can get my tsh down to .35 area.  This is where the endo likes the numbers to be.  What leads you to believe it's over medicated?  Thanks again!

[goolarra]

Your FT4 is a little bit on the high side.  Midrange is the rule of thumb for FT4, and yours is is up at 75% of range.  You could be a little overmedicated.

Your doctor isn't testing FT3.  FT3 is the most biologically active of the thyroid hormones and correlates best with symptoms.  You should request he add that next time.  Both FT3 and FT4 have to be adjusted properly for us to feel well.  I'd ask your doctor about reducing your meds slightly.  What were you taking before the increase to 100?

[Jules82566]

I just got my test results today so I will post them below.  I did fail to mention as well as the "very" abnormal period, I've been having one heck of a time losing 1 pound.  I've always had it easy, being into body building and eating very healthy.  At any rate, any info you are able to relay is most greatly appreciated!  These tests were ordered by an endocrinologist.

TSH   2.05 (0.27 - 4.20)
Free T4 1.5          (0.9 - 1.7)
Vitamin B12 1592 (211 - 946)

[Jules82566]

I just got my test results today so I will post them below.  I did fail to mention as well as the "very" abnormal period, I've been having one heck of a time losing 1 pound.  I've always had it easy, being into body building and eating very healthy.  At any rate, any info you are able to relay is most greatly appreciated!  These tests were ordered by an endocrinologist.

TSH   2.05 (0.27 - 4.20)
Free T4 1.5          (0.9 - 1.7)
Vitamin B12 1592 (211 - 946)

[Jules82566]

I've actually been tested every 6-8 weeks since May.  I had blood taken this past Monday and am just waiting for the results.  I will post them once I get them.  Thanks!

[Jules82566]

I had blood work done Monday and am just waiting for results.  Will post them as soon as I have them.  Thanks!

[Barb135]

What are you current thyroid hormone levels?  You should be getting tested periodically, for TSH, Free T3 and Free T4; medication should be adjusted based on symptoms and actual thyroid levels.

It sounds like you might be over medicated.  Please post whatever thyroid related test results you have so we can better assess your testing/treatment. Be sure to include reference ranges, which vary lab to lab and have to come from your own lab report.

[goolarra]

Have you been retested since your increase to 100 mcg?  What was your previous dose?

Please post your most recent labs, including date and reference ranges (they vary lab to lab and have to come from your own lab report).