I took the radioactive iodine treatment almost 20 years ago and I've been on .125 mg of Levoxyl ever since. I've thought I was doing ok on it, but I'm kind of rethinking that.

Here's the deal. I've lost about 35 pounds on Atkins. Really only found I could lose if I restricted calories. I've easily got another 20-30 pounds to go before I could be considered normal for my height and frame. My body fat % is pretty high, at least 35% maybe more. So there's no way I'm at a "normal" body weight. Now I find I can't even lose restricting calories, at least not to a level I can maintain without gnawing on my fingers.

I'm cold quite a lot. I have dry skin (who doesn't though). I feel a bit lazy, hard to motivate myself. And I seem to require a minimum of 8 hours of sleep. Even that doesn't really feel like enough.

Last time I had my TSH checked it was "normal". But now I'm reading various things and thinking that that might not really mean anything. I've got an appt to see my doctor and discuss this with him next month, so I need to be prepared with what I want him to do, etc.

Has anyone gone through this process and what was the outcome? Do you think changing meds helped you? Any advise you can give me?

I guess if my doctor doesn't help me I'll look into finding a doctor that will, even if I have to pay for it myself. Any recommendations for the San Diego area? I've checked that thyroid doctor's list but didn't see anything in my area.

Nancy, judging by the list of symptoms I would think you need an increase in meds or a change in meds to include some T3. If your thyroid has been shut off and you're only getting exogenous hormones then you would probably benefit from some T3 (Armour or cytomel). Some cells in your body can only use T3 that is not converted from T4.

Dieting stresses metabolism (it results in it being lowered). By increasing calories you might be able to stop this and help reset things, but being hypoT I don't think so. It's a whole other kettle of fish, but have you looked into carb / calorie cycling? It helps keep your body guessing and stops it from slowing down the way regular dieting does. There is also a link between being in Ketosis and lowered FT3 levels (anything that happens in the liver is going to take energy away from converting T4 to T3).

Have you looked through the Armour website for anyone in your area who prescribed natural desiccated thyroid (you put your zip code in and get Drs in your area) ? These are usually enlightened doctors who understand symptoms and treat much better than regular GPs.

Nat

It sounds as if somehting is causing your metabolism to be really slow, which sounds like thyroid to me.

That is the way mine is...my DH swears I have no metabolism. I have to stay down to under 1200 a day to even budge my weight, even on low carb.

new doctor is checking eveything right now, won't know results until next week, but boy your symptoms sound just like mine. I can only add my brittle, breaking, not growing hair! When I wear a black jacket to work, I have to take it off several times a day to remove all the broken pieces of hair!

Yes, definitely, but by dieting further you exacerbate the situtation - it's a lose lose scenario and it sucks. Research estimates the hypoT can diminish BMR by as much as 25%, which would bring your TDEE calories down as well (more than 25% IMHO because when you're that tired you just can't do much, so your Total Daily Energy Expenditure really doesn't go up much). It's pretty much impossible to actively lose FAT while dieting and being untreated/medicated for your hypothyroidism - and the worst part is trying to can actually make it worse.

Nat

Nat,

Are you saying I should stop dieting until I go back to the doctor? Had been wondering about this.

Thank you all for the advice and support.

I've tried carb cycling (moderately higher carbs and calories 2 days a week) and no, that didn't work. I just gained weight every weekend. I think that was before my thyroid absorption really took a nose-dive (which I think happened around November) so I'm a little terrified of trying to do that again.

I was almost wondering if there's something wrong with my levoxyl, I doubled checked the pills, same dose as ever (125mcg).

Right now I can maintain my weight on 1200 calories and gain on 1400. It's absurd!

Definitely something has happened in the last 6 months to make this even worse because I was always able to lose on 1200 calories before.

And I really realized this week just how tired and rotten I feel. I took my temperature last night, 97.2 degrees. No wonder I'm cold... I'm practically a reptile.

I've been exercising, really watching the calories and either gaining or maintaining.

My last blood test (in April I think) TSH was 1.93, Total T3 was 1.5? and Thryoxine was 1.something.

I just made an appt to see my GP but it's a month off so I think I'll look for another doctor and try to get seen earlier, even if I have to pay for it out of my own pocket it'd be worth it to feel better.

Meanwhile I think I'll keep up the exercise, add a bit of fruit to my diet (I do eat quite a lot of veggies already) to keep out of ketosis and concentrate on maintaining -- pfft! As if I have a choice.

I'd temporarily start taking a additional half of a levoxyl but I'm afraid that'll skew my numbers when I see the doc, so I guess I'll just slog (boy, that word seems so appropriate to how I feel) away at my current dose.

Thanks for the tips, folks! I appreciate the support. I have a feeling I've been hypoT for quite awhile but its just gotten quite a lot worse lately.

BTW: I've been on low-carb for 2 years now and have had a devil of a time losing any weight, even from the get-go its been a struggle. And I'm such a non-cheater! I think I've had exactly 4 times I've gone off plan, not even entire meals, just little treats.

Does anyone else feel grouchy when they're hypoT? I just feel so tired much of the time that I also feel pretty cranky.

Ah! Another thought occurred to me. I never paid attention to when I took my thyroid meds before, I used to take them just before bedtime, but that was also when I took my other supplements and I wondered if perhaps the supplements might interfere with the thyroid.

So I switched the thyroid to morning about 2 hours before I eat. Does that sound reasonable?

It's what I did, Quietone, and what I'd recommend, yes. Simply not stressing over that aspect of everything made life a lot easier to handle. I kept the cals below what I'd normally keep them so as not to gain a lot, but by not working out I could eat less and not be hungry. I only just began working out and watching diet recently - and frankly I needed the break.

Ah! Just found this tidbit in another post of yours. I think I'll try to find somewhere to get checked ASAP. I bet my Freebies are AWOL.

Is there any sort of medical publication or abstract or something that would state the best way to treat thyroid? Something I could hand my doctor and he'd accept it as credible?

Yeah, I know.. been there, done that - not pleasant.



I suspect two things happened; one, your body has done what it's designed to do, it's adapted to that level of calories, it's reset your metabolism, lower than it used to be. Part of this is just from dieting, the rest would be a function of your hypoT. Frankly that dose you're on is pretty damned small for someone w/o a functioning gland. I'm on that much T4 myself (along with T3) and my thryoid is still alive and kicking (although very gently!).

Also, if this change happened recently you can bet it was partly due to weather. Seasonal changes can necessitate a change in dosage; Winter typically causes TSH to rise, signaling the body needs more thyroid hormones to cope with the increased metabolism the cold weather causes.


That is low. Wow.


In your case, Nancy, I'd drop the exercise and focus on eating clean and healthy. I'd use some good slow burning carbs to keep you out of ketosis, not fruit. Sweet pototes, brown rice, steel cut oats.. the odd apple isn't a bad idea, but to get the bulk of your carbs from fruit is doing yourself a disservice - if you're going to eat carbs at least use the ones that help your muscles, right?


I'll bet that TSH is higher now. 1.93 was even 'high'. Do you have the ranges for the other two? I'm seeing your T3 and thinking 'low, low, low'.


I heartily agree - it's what I ended up doing and I couldnt be happier. Unfortunately you get what you pay for...


I am sure if you call around to doctors on the Armour site you can get in to see one rather quickly - explain the situtation to them. Most of them are very sympathetic.



Sure, I bet your sex hormones are out of whack too. For thyroid to work well you need progesterone and vit D. When thryoid is low they too will be out of balance, allowing estrogen to soar. Think PMS. Think 24/7 PMS.



What supps are you taking? Calcium, iron and fiber will all inhibit the absorption of T4 meds. They should be taken 4 hours apart if your meds are taken orally. What many of us do is take our thyroid hormones sublingually - put it under your tongue and let it disolve. You may now eat or take supps w/in 30 minutes. Much easier, IMHO.

BTW, if you're not already get some magnesium (min 600mgs), some B12 (2000mcgs), some Vit D (D3, not D2; 400 - 800 IU) and some selenium (200 mcgs for the first month, 100 for the remainder of your days!). These can make a huge difference in how you feel.

Nat

You can get your TSH, FT4 and FT3 done with www.healthcheckusa.com for 75$, Nancy - that way you know you get the right tests and you get them fast (48 hours). (use promotional code 12345 for a discount)

Give me a few minutes; I might have something for you that helps with dosing, but treatment is something that differs for all of us - some people can't do natural, some can't do synthetic - others do fine on T4 and others dont - the key to a good doctor is they understand the treatment has to be suited to the patient, and we are all different.

Well, maybe i could try maintaining right now instead of going at it so hard. Doesn't seem to be working very well anyway, just don't want to gain.

When I went to the dr. last Friday, my temp was 96.4

Which I found especially interesting because my BP was so high. I would have thought that in itself would have kept my temp up higher, but perhaps one has nothing to do with the other.

Nancy, switching your time of your thyroid meds does sound like a good idea, but I thought thyroid production went into high gear at night??? Do you have any side effects from it?

Quietone, if you're dealing with thyroid then your BP can be high or low as a consequence. Mine would go from one end to the other. My HR was super low, though - and so were my BBTs. The thing with signs and symptoms is you don't get all of them, and often there are cross overs from hypoT to hyperT (like anxiety attacks which are typically thought to be hypErT but many hypOT's get them).

Taking thyroid meds a night can make for some really peaceful and deep sleep - this is when T4 is naturally manufactured by the thyroid so taking yours then would mimic the natural pattern.

Here are some studies about TSH levels as I suspect yours will be above 2 but many doctors would say "hey that's GOOD":

http://www.altsupportthyroid.org/tsh/tshmedrefs1.php

Medical journal references w/ respect to using T3:
http://www.altsupportthyroid.org/t3/t3medrefs3.php

Information on conversion issues T4 --> T3:
http://www.altsupportthyroid.org/t3/t3medrefs2.php

With respect to having FTs in the upper third of the range, this is the recommendation of The National Academy of Clinical Biochemistry, which is part of the Academy of the American Association for Clinical Chemistry (AACC), and it can be found in their Laboratory Medicine Practice Guidelines: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease: (PDF file)

"It is likely that the current upper limit of the population reference range is skewed by the inclusion of persons with occult thyroid dysfunction."

"In the future, it is likely that the upper limit of the serum TSH euthyroid reference range will be reduced to 2.5 mIU/L because >95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L."

"A serum TSH result between 0.5 and 2.0 mIU/L is generally considered the therapeutic target for a standard L-T4 replacement dose for primary hypothyroidism."

"Thyroxine requirements increase during pregnancy. Thyroid status should be checked with TSH + FT4 during each trimester of pregnancy. The L-T4 dose should be increased (usually by 50 micrograms/day) to maintain a serum TSH between 0.5 and 2.0 mIU/L and a serum FT4 in the upper third of the normal reference interval."

"A serum FT4 level in the upper third of the reference interval is the therapeutic target for the L-T4 replacement dose used to treat central hypothyroidism due to pituitary or hypothalamic dysfunction."

It is now well documented that hypothyroid patients have serum FT4 values in the upper third of the reference interval when the L-T4 replacement dose is titered to bring the serum TSH into the therapeutic target range (0.5-2.0 mIU/L) (219,220).

HTH
Nat

Well, I don't think I really have a functioning thyroid gland so I don't think that would be a factor for me. They pretty much killed it with the radioactive iodine.

Maybe I'll switch back to taking it at night time. I haven't noticed any difference in sleep since I switched to morning. Are there any issues with taking thryoid with supplements? I have a terrible time remembering to take my supplements in the morning but I do have a good ritual going of taking meds before bed.

Thanks for the references Nat! Good stuff. Gonna get my aresenal ready and storm the doctor's office! Operation 'Roid has begun!