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Under-active Thyroid
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Mava - I know what you mean about wanting the diagnosis. It's easier when someone says 'this is what's wrong and this is waht we'll do'. If it's not your thyroid it will be something else and they'll find it. It seems as if your GP is taking you seriously at least.
One of my symptoms of Hypothyroidism is dodgy blood sugar, so this might be of interest to peeps:
I have seen some research linking glucosamine with insulin resistance. That said, the study infused glucosamine straight into the blood, rather than providing it orally. I don't know if oral glucosamine supplements would have any negative effect when used for several months. For someone with diabetes (or any other problem with blood sugar control, such as metabolic obesity) it might be a better idea to use chondroitin instead.
Not to sound mean or anything, but I'm so glad there are other people getting the sweats also. I thought I was heading for a really early menopause - I'm not even 30 (at least not for another few months!) Very interesting about the muscle stuff also. I have a test in a few months so it'll be interesting to see what that shows up.
Please everyone, don't get sucked in by the 'your in the normal range so it can't be your thyroid' lark. The normal range is massive. Apparently most people feel best when their TSH is between 1 and 2 - some tests go up to 4 or 5! I have a lovely doc who knows that I need to be well under 1.5 to feel normal.
Little Miss Happy - do you have your B12 shots because of your thyroid, or is that just unrelated? Just wondering if it is something I should be checking at my next blood test.
Pernicious anaemia can go hand in hand with hypothyroidism, especially the autoimmune variety.
25mcg is a pretty useless starting dose. What is often observed in this ultra-conservative approach is that your natural hormone production decreases by a greater amount than your exogenous hormone. Read what the British National Formulary says about Levothyroxine sodium:
"The initial dose should not exceed 100 micrograms daily, preferably before breakfast, or 25 to 50 micrograms in elderly patients or those with cardiac disease, increased by 25 to 50 micrograms at intervals of at least 4 weeks."
If you are still not 100% you need to exercise some assertiveness with your GP. First question to GP should be - is your goal to get my blood tests in the normal range or is it to get me well? Assuming it's to get you well (if not - change doc ASAP), make this suggestion. Let me try an increase of 25 mcg for 8 weeks. If I develop any unusual symptoms I will cut back down to 25mcg and come and see you immediately. Give me another blood test at the end of 8 weeks and we will review what to do next.
This scenario is based on the assumption that the only test you are getting is TSH. What could happen on the increased dose (although IMHO unlikely because your dose is v. small) is that your TSH becomes suppressed - either right at the low end of the range or perhaps even undetectable. This is not a problem. Your doc may try to tell you that you have become over-medicated/hyper. Not so. TSH is not a thyroid hormone - it does not tell you anything useful about where your actaul thyroid hormone numbers are. If you end up with a low/suppressed TSH the next step to negotiate with your GP is to get some useful testing done. FT3 is the best to go for - if it is not routinely done along with TSH in your area, your GP needs to write on the lab slip "Patient on thyroid replacement. FT3 test required." I could go on with this but maybe better to wait unitl you need to, else I'll be writing that book Hippo was talking about!
Tricky question about hot flushes. Hypothyroidism is most common among menopausal women - so, of course, hot flushes are commonly reported as a symptom.
If you are not menopausal but do have thyroid disease, you may be experiencing the heat intolerance of TD. The old-fashioned way to diagnose TD was by taking basal (axillary) temperature first thing in the morning before getting out of bed. Un/undertreated hypos show a low basal temperature which may cause the difficulty in dealing with heat/cold that they have.
The other theory is that thyroid hormone is the hormone that regulates everything else in the body. No thyroid hormone = death. So if your thyroid is not functioning correctly, there could be a knock-on effect with all the other endocrine systems.
In your shoes, I think I'd be asking for female hormone testing. Early menopause is common amongst hypo women - I was younger than you when mine hit, but if it turns out you don't have TD, you need to know anyway.
There is one form of glucosamine - the hydroiodide form - that is contra-indicated for thyroid patients. Most OTC glucosamine is the sulphate form. The iodide form is contra-indicated for thyroid patients because it is iodine based and all iodine supplementation is contra-indicated for thyroid folks.
Maybe the problem you are having could be from the fillers/dyes in the pills or else is unrelated. Check the ingredients and see if anything looks suspect. Lactose is a common filler that upsets some folks.
I had a look at the stuff on insulin resistance and the research is based on animals and lab cultures. It doesn't seem to have been carried through into human studies but is probably worth being careful with if you do have a blood sugar problem.
Miss Piggy - B12 is for perniscious anaemia which came after the hypothyroidism but is, as Shirl says, more common in people with a thyroid problem. Obvious symptom was being TATT when thyroid function was in the 'normal' range so GP looked for another cause.
Shirl, I'm going to get to my GP as soon as I can (I have a lovely one but she's due to go on maternity leave soon). I don't fancy taking it up with any of the others in the practice, one of them told her I 'probably had a psychological dependency' on my B12 cos I reported being TATT on the standard 12 weekly jabs. She sent me to the heamatologist who said my levels weren't high even on 8 weekly intervals so that sorted that.
My natural body temperature at rest seems to be below normal although I sweat absolute buckets when I'm training - embarrassingly so!
Ho hum. Well, if I manage to remember to call the doc's surgery tomorrow I should get the results. I need to insist that they don't just say it's all normal but actually give me the levels.
I'm working at home on Monday so I may pop round in the afternoon to see if I can't actually get a copy of the piece of paper (my doc's surgery have a habit of saying results are normal without actually showing you the report - but that's entirely another story which I can bore people with another time!!!)
Time to head home...
Definitely worth playing the athlete card. I would also ask your doctor for your actual test values and reference ranges from last time. If you know what they are and what the reference range is, you have more information to negotiate with. If e.g. your TSH is somewhere in the middle of the reference range, you have a lot of 'wiggle room' for an increase that will still keep you in the normal range.
It would be completely unreasonable for the GP to refuse a trial under these circumstances and if he does you should have him describe to you exactly why he is refusing. You should then explain that you are not satisfed with his treatment of your thyroid condition and that you wish to have a referral to an endocrinologist.
Your test results cannot be withheld from you. The Data Protection Act is the relevant legislation and has a section on patient records. The practice can make you jump through a few hoops first but ultimately you will get your records.
I've got lots of research and papers, recommendations etc. about optimal values for TSH/FT3/FT4 etc. But to be honest, if you take that kind of stuff to docs most of them either a) get a glazed look in their eyes or b) get angry or c) put it in your file never to see the light of day. And NEVER mention the internet! I wouldn't risk antagonising them - I've found it's more effective to be well-informed and for them to realise you are well-informed and therefore can't be fobbed off.
Good luck - just shout if you need anything.
Wouldn't have done it without you lot!
Will try to ensure that I actually get a copy of this next set of results.
Big big thanks.
Mava - will be waiting on Monday.
A while back when I was seeing my gp about something - can't even remember what - he asked me about how many times a week I exercised. When I said 4 to 6 depending he said 2 was enough! I should have asked 'enough for what'. The doc I've seen this time is a different one and she does seem a little more sympathetic so we'll see. It may be there's nothing wrong with my thyroid function at all
That's one of the best bits of GP garbage I've ever heard. The reason so many thyroid impaired people remain tired is because they are pretty much all under-medicated because doctors don't look past TSH and 'normal ranges'. He can't really be serious that someone who runs, watches their nutrition and hydration to be able to run, rests and recovers etc. has a lifestlye issue?????? B****cks. Rant over.
Fingers still crossed mava.
Since childhood, I've had bad astigmatism. Always wore glasses / contacts. About 12 or 13 years ago, my eyesight started deteriorating steadily - at every annual eyetest I got a new stronger prescription.
I'm now 50 yo and my failing eyesight has reversed - each annual test since starting thyroid replacement has seen a significant improvement in my eyesight. Today was the biggest - 30% in my right eye and 20% in my left. My optician (same one I've had all these years) is completely clear that this is healing from the TD. He said that it is unfortunate I have the astigmatism because otherwise he would be holding a 'throw away the glasses party' for me!
Can I ask for some clarification? From my posts are you thinking I might have an under or over active thyroid? That my irregular periods might be caused by this? Is it likely that the appalling PMS symptoms I get are also tied in?
Cheers me dears...
Oh boy, isn't it fab that it's friday?
Nah - can't blame TD for astigmatism. I think that's down to my parents!
I think if you were to have TD you would be under-active/hypo. Confusingly, some symptoms do crossover and disturbed periods/PMS seem to be features of both.
But if you were over-active/hyper you would probably have one or more of fast heart rate/palpitations, anxiety, fine tremor, loose bowels, inability to sleep, racing thoughts....... I'm told that hyper is much more unpleasant than hypo but never been there so can't speak personally.
Hopefully you'll get a clear answer on Monday.
If the increased dose will make a difference when am I likely to notice?
I think I got him on the lifestyle issue when I told him I'd just gone down to a four day week at work cos I was so tired I couldn't cope.
Shirl - sounds like I might be more likely to by hypo rather than hyper. we'll see.
LMH I see you're going to the Trailplus weekend on 11-13 Feb. See you there! But of course, a training weekend is just a lifestyle issue which makes you tired <g>
Just done long run and even though I had porridge for brekky and drank sports drink on the way I just ran out of gas (pardon me! not what I meant). And that was only 9 miles.
off to do the shopping. where are all the red cabbages? I've been trying to buy one for a week (there's an existential question for you...)
Looking forward to Trailplus. It's going to be a bit of a party as I got engaged to a guy I met on the First 1/2 Marathon thread in November and a lot of us will be together for the first time at Trailplus to celebrate (seems like as good an excuse as any).
This is my first post! I normally lurk, because I am a bit of an on and off runner, but this is something I can actually comment on!
I take 150mcg of thyroxine and it took about 5 years to build up to this level...I have regular blood tests and make sure my TSH is < 0.01 not many GPs will allow this! But even at this level I feel tired, fat and have the usual issues - dry skin, hair loss etc....
Thyroxine has a half-life on one week so you should feel something after a week, but it could take up to 3 months. Many doctors believe in blood tests no more regularly than every 3 months....also make sure you don't take you tablets before your blood test on that day - not everyone tells you that! Good Luck.
PS I have taken up running again recently and found I have so much more energy - I am also trying to eat more healthily. I don't think I personally will ever feel 'normal' but I hope continuing running helps me feel a little more like it.
If you are still unwell with your TSH suppressed, have you tried asking to have your FT4 and FT3 tested? Once your TSH is suppressed it can't go any lower but you might find that your FT4/FT3 are still bumping along at the bottom of the range and that you still have room to add more T4 or even T3.
The half life of a week unfortunately doesn't mean you'll notice benefits in a week. The half life relates to how quickly the drug leaves your body.
I'm a bit of a sceptic about attempting to manipulate test results by skipping / delaying doses. As far as thyroxine is concerned, because it is so slow-acting delaying or skipping one dose will not have any significant effect on a test outcome IMHO.
The time of day of a test is probably more relevant to a test result because of the pulsatile circadian rhythym of TSH and thyroid hormone secretion.
Skipping or delaying a dose of T3 or a T3 containing substance might on the other hand show up in a test result.
Good to hear you're running again. My experience was that it definitely made me feel better, physically and psychologically. Why do you think you will never feel normal?
Shirl, what time of day do you think is best for the test?