Aa
A few questions
Okay, so I'm new here and I'll try to give a bit of background information first. Long story short, I was diagnosed with hypothyroidism at 15 years old and was immediately put on Levothyroxine (I'm 28 now). A few weeks after starting the medication I did feel slightly better, but I never ever did get back to feeling like my original self, but the doctors insisted that my levels were normal and refused to investigate, so I just gave up. Fast forward to age 21 when my symptoms started getting much worse. Went back to the doctor. They did more blood tests, and found that my dose needed to be increased slightly. Didn't feel any better on the new dose. Told them I didn't feel better on the new dose, once again they insisted that my levels were normal and refused to look into it any deeper. Fast forward again to age 23, and this is where I ended up with a whole new list of weird (and some scary) symptoms that came out of nowhere...
I started having frequent heart palpitations, anxiety attacks, some digestive problems, a swollen/pressure feeling on the right side of my thyroid gland that feels like it's pressing inwards on my throat, slow healing wounds, some symptoms that come and go throughout the day, like general brain fog/stupidity, occasional vertigo, and the worst of all: extreme difficulties with sleeping. Just as I'm about to drop off to sleep I get these weird surges of adrenaline that 'zap' me awake, and once I get that burst of adrenaline I am unable to sleep at all. Occasionally I also get those adrenaline 'zaps' when I'm awake too, which seem to come along when I'm very fatigued and low on energy, or if I'm busy and stressed out, and if they are bad enough they usually lead to anxiety attacks and nausea.
Here are my questions: I've read that being under-treated for hypothyroidism for a long time can lead to those adrenaline bursts I mentioned, because the adrenal glands are trying to compensate for low energy caused by an inadequately treated thyroid. Is this true? I strongly believe that I am not being treated properly, because when I look at my blood test forms I notice that only my TSH is being tested, and I've read that only monitoring TSH isn't enough in most cases. Is it also possible that I could have Hashimoto's? I've read that the swollen feeling in the neck is a symptom of Hashimoto's.
The only other question I have: Is the brain fog/stupidity a common symptom of an underactive thyroid? That only happens to me on some days, and it's frustrating because I'm a writer (comedy/satire) and also a musician, and when I'm having a bad day with the brain fog symptoms my creativity goes right out the window and I completely lose my artistic 'spark' until I'm having a better day with less symptoms. Anyways, thank you very much in advance for your replies, and sorry for the long(ish) read.
I started having frequent heart palpitations, anxiety attacks, some digestive problems, a swollen/pressure feeling on the right side of my thyroid gland that feels like it's pressing inwards on my throat, slow healing wounds, some symptoms that come and go throughout the day, like general brain fog/stupidity, occasional vertigo, and the worst of all: extreme difficulties with sleeping. Just as I'm about to drop off to sleep I get these weird surges of adrenaline that 'zap' me awake, and once I get that burst of adrenaline I am unable to sleep at all. Occasionally I also get those adrenaline 'zaps' when I'm awake too, which seem to come along when I'm very fatigued and low on energy, or if I'm busy and stressed out, and if they are bad enough they usually lead to anxiety attacks and nausea.
Here are my questions: I've read that being under-treated for hypothyroidism for a long time can lead to those adrenaline bursts I mentioned, because the adrenal glands are trying to compensate for low energy caused by an inadequately treated thyroid. Is this true? I strongly believe that I am not being treated properly, because when I look at my blood test forms I notice that only my TSH is being tested, and I've read that only monitoring TSH isn't enough in most cases. Is it also possible that I could have Hashimoto's? I've read that the swollen feeling in the neck is a symptom of Hashimoto's.
The only other question I have: Is the brain fog/stupidity a common symptom of an underactive thyroid? That only happens to me on some days, and it's frustrating because I'm a writer (comedy/satire) and also a musician, and when I'm having a bad day with the brain fog symptoms my creativity goes right out the window and I completely lose my artistic 'spark' until I'm having a better day with less symptoms. Anyways, thank you very much in advance for your replies, and sorry for the long(ish) read.
What reason do you have for thinking your your negative side effects were from the med itself? It might well have been that your original dose really didn't raise your biologically active thyroid hormones, Free T4 and Free T3. That is a well know result when starting on thyroid med. Serum thyroid hormone levels are a sum of both natural thyroid hormone and thyroid med. When you start on med that causes TSH to drop, which results in less natural thyroid hormone production and thus no significant change in Free T4 and Free T3 levels, and no improvement in symptoms. Serum levels typically don't start to rise until med doses are increased enough that TSH is no longer a factor in serum levels. That is why it is very important to always get tested for both Free T4 and Free T3 every time you go for tests. Have you been able to get those tests done?
For the time being this is still in the experimental stages, and I don't think it was exactly meant to be an 'increase'. I think part of the reason I felt bad is I was experiencing negative side effects from the Levothyroxine, and possibly because I wasn't converting the synthetic T4 to T3. I think the doctor wanted to try me on a similar equivalent dose of Armour just to see how my body responds to it. I might not have been undertreated before. Maybe I just wasn't doing very well on synthetic medication.
Just wanted to make sure you are aware of the following. You were taking 75 mcg of Levo previously. If the doctor thought the 60 mg of Armour was an increase, then he was going by existing conversion tables that are somewhat confusing. The tables show 100 mcg of T4 = 60 mg of desiccated med like Armour =25 mcg of T3. The problem is that all three cannot be equal. If 100 mcg = 25 mcg of T3, then the ratio is 4 to 1. Since Armour contains 39 mcg of T4 and 9 mcg of T3, then that would be equivalent to only 75 mcg of T4. I get that number this way: 39 + (9 times 4) = 75. So by that conversion your 60 mg of Armour is only equal to the 75 mcg of Levo.
In addition, the ratio of T4 to t3 mentioned in the AACE/ATA Guidelines is only 3, not 4. So 60 mcg of Armour would be equivalent to only 66 mcg of Levo 39 mcg of T4 + (9 times 3) = 66 mcg of T4. By that token your new Armour dose is slightly less than your T4 dose before by 9 mcg. .
I am just putting you through all this to make sure you realize that your new dose may not be what you need. The reason you have noted some improvement may only be that you switched immediately from the Levo to the Armour. You dropped from 75 down to 39 mcg of T4 and added 9 mcg of T3; however, the old higher dose of 75 does not dissipate immediately. The half life is about a week, which means that for a week or two you will actually have more med in your body than you will in a month, on that same new dose.
So if your doctor was trying to increase your meds to alleviate symptoms, he really did not accomplish an increase. I think that is worth a discussion with the doctor to see if your Armour should be increased to 90 mg instead of 60.
In addition, the ratio of T4 to t3 mentioned in the AACE/ATA Guidelines is only 3, not 4. So 60 mcg of Armour would be equivalent to only 66 mcg of Levo 39 mcg of T4 + (9 times 3) = 66 mcg of T4. By that token your new Armour dose is slightly less than your T4 dose before by 9 mcg. .
I am just putting you through all this to make sure you realize that your new dose may not be what you need. The reason you have noted some improvement may only be that you switched immediately from the Levo to the Armour. You dropped from 75 down to 39 mcg of T4 and added 9 mcg of T3; however, the old higher dose of 75 does not dissipate immediately. The half life is about a week, which means that for a week or two you will actually have more med in your body than you will in a month, on that same new dose.
So if your doctor was trying to increase your meds to alleviate symptoms, he really did not accomplish an increase. I think that is worth a discussion with the doctor to see if your Armour should be increased to 90 mg instead of 60.
Thank you again to everyone who replied.
I actually had numerous appointments in the last three weeks. I was checked for autoimmune diseases. Apparently I don't have Hashimotos or Graves. One doctor suggested that I might be one of the people who doesn't respond very well to Synthetic T4 medications like the Levothyroxine I was on. He was willing to prescribe Armour so that I could give it a trial run.
I was previously on 75 mcg of Levothyroxine. The doctor put me on 60 mg of Armour. I stopped taking the Levothyroixine and immediately went on the Armour. I felt nothing at first except dizzy spells every now and then, which could just be because my medication was changed suddenly. After 5 or 6 days, however, I started noticing a few slight improvements. Some of my cognitive clarity came back, my heart palpitations stopped, I can sleep a little easier than I used to, anxiety attacks are very rare now, some of the adrenaline 'zaps' are still there (but not as frequent and somewhat less intense), the hot flashes seem to be completely gone. My energy level is still kind of low, but I've definitely noticed an increase in mental sharpness and I have a little bit of my 'zing' back, and have also noticed a slight improvement in my memory (it took a long time to recall certain things before.)
It has been 9 days now and If I've already started to feel some slight improvements already, will it get any better? I've read stories about other people who started on Armour and noticed little differences at first, but apparently took 6-8 weeks to feel the full effects of being on it. Is that true?
One last question. It might seem strange, but the one and only negative thing I've noticed in the last few days is urethral pain when urinating (not really severe, just annoying.) Could this just be my body adjusting to the new medication and/or the lack of the old medication?
I actually had numerous appointments in the last three weeks. I was checked for autoimmune diseases. Apparently I don't have Hashimotos or Graves. One doctor suggested that I might be one of the people who doesn't respond very well to Synthetic T4 medications like the Levothyroxine I was on. He was willing to prescribe Armour so that I could give it a trial run.
I was previously on 75 mcg of Levothyroxine. The doctor put me on 60 mg of Armour. I stopped taking the Levothyroixine and immediately went on the Armour. I felt nothing at first except dizzy spells every now and then, which could just be because my medication was changed suddenly. After 5 or 6 days, however, I started noticing a few slight improvements. Some of my cognitive clarity came back, my heart palpitations stopped, I can sleep a little easier than I used to, anxiety attacks are very rare now, some of the adrenaline 'zaps' are still there (but not as frequent and somewhat less intense), the hot flashes seem to be completely gone. My energy level is still kind of low, but I've definitely noticed an increase in mental sharpness and I have a little bit of my 'zing' back, and have also noticed a slight improvement in my memory (it took a long time to recall certain things before.)
It has been 9 days now and If I've already started to feel some slight improvements already, will it get any better? I've read stories about other people who started on Armour and noticed little differences at first, but apparently took 6-8 weeks to feel the full effects of being on it. Is that true?
One last question. It might seem strange, but the one and only negative thing I've noticed in the last few days is urethral pain when urinating (not really severe, just annoying.) Could this just be my body adjusting to the new medication and/or the lack of the old medication?
Yes brain fog is extremely common symptom of low thyroid. So is anxiety and sleep disturbances. While some of these are symptoms of both hyper and hypo. They certainly suggest a thyroid issue.
Hasimotos can in the early stages swing between hypo and hyper. so again makes sense to test for the TPOab and TGab.
Absolutely insist and do NOT take no for an answer and demand that they test you for BOTH: Free T4 AND Free T3. Insist on the free test as otherwise you will likely get the "total" tests which are outdated and of little value.
After you get these tests post your results along with the reference ranges here and we can help you make heads or tails of them.
Do NOT let them tell you that you are "fine" simply because you fall within the ranges. In order to feel well, most people need to be at or above 50% of the range.
Hasimotos can in the early stages swing between hypo and hyper. so again makes sense to test for the TPOab and TGab.
Absolutely insist and do NOT take no for an answer and demand that they test you for BOTH: Free T4 AND Free T3. Insist on the free test as otherwise you will likely get the "total" tests which are outdated and of little value.
After you get these tests post your results along with the reference ranges here and we can help you make heads or tails of them.
Do NOT let them tell you that you are "fine" simply because you fall within the ranges. In order to feel well, most people need to be at or above 50% of the range.
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It's true that when the thyroid fails or is under treated, the adrenals try to take up the slack. Once on adequate thyroid hormone medication, the adrenals will usually settle back to normal.
The only way you can tell whether you are under medicated is to have regular blood tests... you should be getting tested for Free T3 and Free T4, which are the actual thyroid hormones that your body uses, along with TSH, which is a pituitary hormone that "tries" to stimulate the thyroid to produce more hormones... when one is hypo, the TSH will, typically, rise in an effort to stimulate the thyroid. It doesn't always work this way when one is on adequate amounts of thyroid hormones, though.
You've been hypo for a long time... were you ever tested to find out the cause of your hypothyroidism? Hashimoto's Thyroiditis is the most common cause of hypothyroidism in the developed world. You should get tested for the proper antibodies, which are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb) to determine if you have Hashimoto's. Hashimoto's is progressive, in that it's constantly destroying thyroid tissue, so your medication will have to adjusted periodically, to keep up with the destruction, until eventually, your thyroid produces nothing on its own. Often, if TSH is completely suppressed, your thyroid will stop producing on it's own anyway, because there's nothing to stimulate production.
You should always get copies of your blood work, for your own records. These should become the running record of your condition...Once you get the blood work, please post the results with reference ranges, and we can guide you further.
The only way you can tell whether you are under medicated is to have regular blood tests... you should be getting tested for Free T3 and Free T4, which are the actual thyroid hormones that your body uses, along with TSH, which is a pituitary hormone that "tries" to stimulate the thyroid to produce more hormones... when one is hypo, the TSH will, typically, rise in an effort to stimulate the thyroid. It doesn't always work this way when one is on adequate amounts of thyroid hormones, though.
You've been hypo for a long time... were you ever tested to find out the cause of your hypothyroidism? Hashimoto's Thyroiditis is the most common cause of hypothyroidism in the developed world. You should get tested for the proper antibodies, which are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb) to determine if you have Hashimoto's. Hashimoto's is progressive, in that it's constantly destroying thyroid tissue, so your medication will have to adjusted periodically, to keep up with the destruction, until eventually, your thyroid produces nothing on its own. Often, if TSH is completely suppressed, your thyroid will stop producing on it's own anyway, because there's nothing to stimulate production.
You should always get copies of your blood work, for your own records. These should become the running record of your condition...Once you get the blood work, please post the results with reference ranges, and we can guide you further.
Thanks for the reply :)
I'm actually seeing the doctor tomorrow, so I'm going to request a blood test. About what you said regarding the anxiety, for me it's actually the other way around. I have these adrenaline 'bursts' which usually don't cause anxiety attacks, but if they are big enough they can result in a small anxiety attack. I've heard that the adrenal glands can compensate for under-treated hypothyroidism by releasing bursts of adrenaline to compensate for lack of energy, so I was wondering if anybody here could shed some more light on that.
I'm actually seeing the doctor tomorrow, so I'm going to request a blood test. About what you said regarding the anxiety, for me it's actually the other way around. I have these adrenaline 'bursts' which usually don't cause anxiety attacks, but if they are big enough they can result in a small anxiety attack. I've heard that the adrenal glands can compensate for under-treated hypothyroidism by releasing bursts of adrenaline to compensate for lack of energy, so I was wondering if anybody here could shed some more light on that.
Check your results for TSH, free T4, free T3, thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb).
Anxiety is a symptom of many conditions including both hypothyroidism and hyperthyroidism.
"Adrenaline rush: Many people will note that when they first experience anxiety, they can feel adrenaline coursing throughout their body. Adrenaline is produced by the adrenal glands, located above your kidneys. When anxiety becomes very extreme, you may experience constant adrenaline rushes, and in some cases could develop adrenaline addiction." - Mental Health Blog - Physical Symptoms Of Anxiety And Stress
Anxiety is a symptom of many conditions including both hypothyroidism and hyperthyroidism.
"Adrenaline rush: Many people will note that when they first experience anxiety, they can feel adrenaline coursing throughout their body. Adrenaline is produced by the adrenal glands, located above your kidneys. When anxiety becomes very extreme, you may experience constant adrenaline rushes, and in some cases could develop adrenaline addiction." - Mental Health Blog - Physical Symptoms Of Anxiety And Stress
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