Swelling of goiter and thyroid glands whilst taking levothyroxine - Hashimoto's

[mattjam]

Hello all,

I was wondering if there are any sufferers or medical professionals out there who might be able to shed some light on some symptoms I am having in the early stages of taking levothyroxine.

I was diagnosed with Hashimoto's after having several tests. I have the results of the T level tests: T3 and T4 were normal. However my TSH level was 6.03. I also had TPO antibody levels of over 1300, which is obviously very high.

I also had an ultrasound and the results confirmed that I had an Hashimoto's, and an enlarged left thyroid (goiter), with multiple benign nodules in both left and right thyroid - the nodules covered 2.5 x 1.5 x 4 cm. Almost the size of the thyroids themselves.

The doctor and radiologist did not seem happy with performing a biopsy or drainage of the nodules. I was prescribed with 25mg of levothyroxine, which I felt was a too lower dosage (after reading many similar cases on forums, and from my own brother who has the same condition who was started on a higher dosage).

I have been taking the 25mg for the last four days, in the morning, 30 minutes before food. In the afternoon (4pm) I have felt a mild swelling sensation from the left goiter. This will come and go - swelling slightly and then reducing, several times over a period of 3 hours.

Over the last 48 hours, I decided to increase my dosage to 50mg, as I believe that 25mg is too low. I understand that I probably should not do this without the doctor's direction, but I didn't feel completely confident in their direction from the start.

My symptoms, of the intermittent goiter swelling have, however, got worse. It is now more frequent, and swelling is intermittent throughout the day (almost feeling like wearing a tightly buttoned collar around the throat), coming and going.

Please, if any has any experience of this, can you feedback to me, so I can try and assume whether this is normal in the early stages of taking levothyroxine, or more of a cause for concern that I should revisit the doctor.

Many thanks in advance.

[Mel1999]

I'm 19 I'm having thyroid issues... Popping noises on my thyroid.... There swollen I went to get it checked out the doctor doesn't seem care just told me do salt water.. it is probably a viral infection but it worries me

[Barb135]

It's not unusual for symptoms to get worse or for new ones to appear when first starting on a replacement thyroid medication.  It takes 406 weeks for the medication to reach full potential, so 4 days is not nearly enough time for the medication to work.

Many of us have problems when first starting a medication if we don't let our body get used to a smaller dose prior to increasing to a larger dose.  Self-medication is not recommended.  

I started out with a TSH of 55.5 and even at that, my doctor only started me on 25 mcg, increasing my dosage at 2-week intervals in order to allow my body to get used to the medication slowly.

All of that said, TSH is only an indicator of actual thyroid status.  What were your actual thyroid hormone levels, with reference ranges?  In addition, what symptoms do you have, other than the goiter, which may diminish once your body gets used to the medication and you get on an adequate dosage?

Patience is a virtue  :-) when it comes to starting a thyroid hormone medication, as we must give it time to work.  

[Barb135]

I forgot to mention that the dosage one person takes may not be right for another person... For instance, your brother takes a higher dosage, but you may never get to that dosage because you may not metabolize the medication in the same way he does.  

In addition, we are almost never started out on the dosage that we, eventually, end up on, plus our dosages often have to be adjusted periodically as we don't always metabolize them the same way within our own bodies.  T4 medications are dosed in mcg and my dosages have ranged from my starting dose of 25 mcg all the way to 112 mcg;  I'm currently on 88 mcg, after having been on nearly every dose in between...

[Red_Star]

I started medication with a TSH at 6 myself. I wish I had of started on much lower than 50 mcg as I was in a bad state for 5 weeks (worsened adrenals, hyper for a week, worse hypo for 4 weeks). I started on 50 mcg and I'm still on this dosage years later.  But that first 5 weeks...terrible!!

My TPOAb reduced with selenium (Brazil nuts...although price increased this year to $55 a kg grrr) and increased with hyperthyroidism and toxic mould.

[Mel1999]

I am 19 I have a clicking sound when I swollow I feel it on my thyroid... It is worrying me went to the doctor they told me it doesn't sound serious to just do salt water but they said my thyroid is swollow what should I do???