Thyroid/Thyroxine Question

[Pupsiecola]

Posting here for traffic. My thyroid has been very sluggish for at least 17 years. TSH levels good, but the uptake levels are sub optimal. I e just come back from an appointment at a Hormone Clinic in London. All this time I've avoided thryoxine because I understand you can't stop once started. But I wonder if now is the time to try. Anyone else got a similar story? (Also having symptoms: losing hair, cold etc).

The reason you can’t stop thyroxine once you’ve started it is that once you aren’t making enough of your own you’re never going to spontaneously start making enough whether you take the medication or not. So if you’re hypothyroid then of course you should start taking the medication.

If your TSH is normal then you’re probably not hypothyroid and should look into other causes for your symptoms. A good start would be blood tests for b12, folate, ferritin and vitamin D because deficiencies in those can have similar symptoms.

What do you mean by your thyroid being sluggish? What makes you think that when your TSH is normal? Were your other thyroid tests abnormal? If you’ve been seeing a doctor about your thyroid have they not advised what they think you should do?

Look at Anthony Williams book about thyroid.

Thank you Just. I saw the doctor about bio-identical HRT. I am 49 and had a sub-total hysterectomy 10 years ago. Been menopausal a while but only taking oestrogen.

Free T4 and Free T3 (I think. In London on mobile) on just above reference range (less than 1 number above). Doctor said she would happily give me some thryoid medication, or we could try this new HRT, then see about the thyroid meds. She was empowering mentioned make the decision.

Sorry. Just checked my results. My TSH is 3.3. 2 and under is optimal apparently.

Thanks Oh.

When first diagnosed my TSH was 9 and my FT4 25.

After feeling shit and dreadful a while, approx 4 years after diagnosis, after being on thyroxine I stopped taking them. When I finally decided I ought to behave and take them, my TSH was 6. And I hadn't been taking them for months.

My level works best for me when suppressed - i.e. take as much thyorxine as I can to supress my body trying to stimulate production (That's what thyroid stimulating hormone is - when you don't have enough natural thyroxine, your bod kicks out TSH to make your body produce more. When you have enough, the TSH is duly knocked down).

I function best at under 1 although my GP aims for me to be between 1 and 2.

My TSH is 3.3. 2 and under is optimal apparently. This would indicate you need MORE thyroxine if you were medicating.

What clinical symptoms are you actually suffering, OP? And what was the 17 year diagnosis of “sluggish” thyroid based on?
If you are genuinely hypothyroid, then you in fact DO need to be on thyroxine for life. It’s not some sort of harmful drug, it’s a hormone normally produced by your own body, and given simply as replacement if you’re not producing enough.
If you’re feeling cold and tired all the time, constipated, hair thinning, slow pulse rate, poor exercise tolerance, as well as having a slightly elevated TSH, then it would be worth a trial of a modest dose of thyroxine. But you need to discuss this with your doctor.

I feel cold all the time, have lost a lot of hair am iron deficient and and am absolutely exhausted all the time. My Tsh was 4.7 and I was told that it was normal as under 5 is this not the case?

Optimum tsh is 2 and under for people on thyroxine but not necessarily for everyone else. The NHS offers treatment at a TSH of 10 or above for everyone and over 4 depending on the clinical picture.

Here’s a link to the NICE guidance on subclinical hypothyroid. cks.nice.org.uk/hypothyroidism#!scenario:1

If you’re symptomatic and being offered treatment there’s probably no harm in trying it. If you don’t feel any better you can always stop and only start again if your TSH rises.

Have you had your antibodies tested? If you have high antibodies you are more likely to become hypothyroid over time even if you aren’t already.

I lose quite a lot of hair. It's not obvious in that I don't look like I've got thin hair as I have a LOT of hair. But my DH has mentioned a couple of times that I lose a lot (most evident in the shower drain which I used to clear out every few days. Now I use a chemical).

I feel the cold. I exercise but I'm shattered. I have really bad brain fog (but then I am menopausal). My resting heart rate is low.

I put on 8st in my first (when bloods were first noticed. They suggested Thyroxine then but I wanted hormones to settle after delivery) and 5st in my second. I wouldn't say I have clinical depression but I definitely have periods of low mood but then who doesn't plus did I mention I'm menopausal?!

festive my doctor would have treated me with TSH over 3 -3.5, especially if you also have other symptoms. The very least you should have your T3 and T4 also checked. If you google recent studies about TSH range, many have come to conclusion that the upper range should be lowered.

Thanks I’ll go back hope you get sorted too pupsiecola

My resting heart rate is usually between late 50s and 61. She offered me thyroid meds AND the bio identification HRT. I'm taking the latter. We agreed to start that and redo bloods/follow up late January. She said some of my symptoms could even the menopause. Obviously that's not going to impact my borderline thyroid bloods. She recommended a Vit D/K2 supplement as I am Lowe half of range for vit D. I usually do use an oral spray this time of year but had forgotten what with our glorious summer and autumn. I've just ordered an oral spray from Better You.

Sorry for typos. I'm on the train home. I'm sat here in coat and scarf and feeling freezing. I don't think anyone else is feeling cold!