# Recently diagnosed hypothyroid - should I care about the cause?



## chasing_angels (Jun 28, 2016)

My story started this year, after giving up smoking in February with the aid of Champix/Chantix. Among many other symptoms including crazy mood swings and anxiety, my hair was very dry and falling out, I was depressed, very tired and felt the cold more than normal. After being a consistent weight for many years (50kg) I also put on 4kg in 2 months, even though I was eating fewer calories.

After reading that giving up smoking may be linked to hypothyroidism, I asked the doctor to check my thyroid. The results came in as hypo, and I was put on 50mcg of Eutroxsig/Thyroxine (this was 6 weeks ago). I had a follow up blood test last week and I'll get the results tomorrow. I'd previously had thyroid tests a couple of years ago and it was normal.

These were my results 6 weeks ago:

Free T4: 8.5 (9.0 - 19.0)

TSH: 30 (0.3 - 3.5)

I was wondering though... should I be concerned or asking about why my thyroid levels are off, or just medicate until they are normal without understanding what might be causing it, if anything?


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## joplin1975 (Jul 21, 2011)

Yes, you should care!

Those are very hypo results. I'd be surprised if 50 mcgs was enough.

You should have thyroid antibodies tested and a thyroid ultrasound.


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## WhatHappened (Nov 12, 2015)

Smoking never helped anything (I am a smoker) but I think that giving up smoking highlights the loss of energy associated with being hypo. No more nicotine. I think it's a firm 9f self medicating if you are both hypo and a smoker.


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## Lovlkn (Dec 20, 2009)

You really need to make sure your hypo state is not because you have cancer - nodules.

An ultrasound would be helpful as would thyroglobulin antibodies.


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## chasing_angels (Jun 28, 2016)

Thank you so much for your replies, I saw the doctor today and she has included antibodies for my next round of tests in 6 weeks' time. I guess my next step will depend on the outcome of that test... I'll probably ask for an ultrasound as suggested.

Today's results show improvement but still not great, so I'll be increasing thyroxine from 50mcg to 100mcg and see how it goes 

Free T4: 10.4 (9.0 - 19.0)

TSH: 23 (0.3 - 3.5)


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## joplin1975 (Jul 21, 2011)

I did the jump from 50 to 100. Just to forewarn you, it can be rough. For me, it lasted about three weeks or so. And by "it," I mean unpleasant digestive issues. If I ate something, I had to make sure I was near a bathroom...


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## Octavia (Aug 1, 2011)

That's a pretty big jump all at once. You might want to ask your doctor about easing into the new dose, such as....


This week: Five doses of 50 mcg, two doses of 100 mcg
Next week: Four doses of 50 mcg, three doses of 100 mcg
Third week: Three doses of 50 mcg, four doses of 100 mcg
...and so on...alternating days...you get the idea


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## visc (Feb 22, 2014)

I had a TSH of 15 at diagnosis... I didnt even know the T4T3 were.. My doctor wanted me to start on 112 mcg.. I was like no 50mcg please.. Best decision ever! My TSH dropped down to 1.7 on 50mcg! Then over three years I worked my way up to 100mcg.. Ive never gone into a dangerous hyper state.

If i were you id get the antibodies done.. Just so you know you have Hashimotos and not the rare but serious Hashimotos+Graves disease..

Also you will want to get a therough neck ultrasound.. I know people get just the thyroid, but I also know people who go the neck that and it showed a cancerous lymph node.

Then at least for me I get blood work twice a year and ultrasound one every year.


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## chasing_angels (Jun 28, 2016)

joplin1975 said:


> I did the jump from 50 to 100. Just to forewarn you, it can be rough. For me, it lasted about three weeks or so. And by "it," I mean unpleasant digestive issues. If I ate something, I had to make sure I was near a bathroom...


Uh oh... I'm on other meds (Zoloft, which I also need to increase) that can have this effect. Could be interesting times ahead...

My plan is to gradually increase both of them over the next couple of weeks to make it a bit easier.


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## WhatHappened (Nov 12, 2015)

Sometimes, those with hashis or hypo find that their depression and irritability fades once medicated. It's possible that your depression was a symptom of being hypo. Something to discuss with your provider.

http://www.health.harvard.edu/newsletter_article/when-depression-starts-in-the-neck

And there seems to be some discussion, if you search for it, that extra care needs to be taken when levo is taken with zoloft (they somehow impact each other)


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## chasing_angels (Jun 28, 2016)

I had read about links between thyroid an depression, and was originally hopeful that all of my problems were due to being hypo (including mild depression). But my main issue is actually anxiety which is why I'm taking Zoloft. The doctor said anxiety is generally associated with hyper, not hypo and that thyroid meds likely wouldn't help. I hope I never go hyper in that case...

I'd not heard about the Zoloft/levo impacts, thanks for the heads up, I will check it out.


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## joplin1975 (Jul 21, 2011)

My anxiety was directly related to my thyroid disorder, despite being hypo.

I had TSI, a thyroid antibody that can cause anxiety, among other things. Once that was gone, my anxiety issues normalized. Just a FYI!


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## chasing_angels (Jun 28, 2016)

Hrmm that's interesting, I'll mention it to the doctor when I get my antibodies test results. It wouldn't surprise me because all of my symptoms came out of nowhere for no reason. It would make sense to me that it's all related to one thing (i.e. thyroid).


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## chasing_angels (Jun 28, 2016)

Update...

New results are in including first test for antibodies, I've added all results to my signature (plagiarised from WhatHappened).

TSH: 4.4 (0.3-3.5)

FT4: 12.7 (9.0-19.0)

TPO: >1000 (<6)

TGAb: 303 (<4)

I'm currently on 100mcg of thyroxine and the doctor has asked me to increase this to 150mcg and retest in 3 months. This sounds high compared to what other people are on? Currently, when I drive within a few hours of taking my meds (ie going to work every day), I feel ill and very tired for at least 2 hours afterwards. I imagine this would only get worse on 150mcg...


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## joplin1975 (Jul 21, 2011)

Whooo boy...don't "probably" ask for a thyroid ultrasound....demand one ASAP.


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## jenny v (May 6, 2012)

I would start demanding a Free T3 test, too. If that's very low, it could explain your symptoms, as well.


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## chasing_angels (Jun 28, 2016)

You know I didn't even think about asking for an ultrasound yesterday - I was too busy thinking about having to take even more pills...

I went back today and got a referral for an ultrasound which I'll have done in the next couple of days.

She also referred me to an endo which I've booked for October and will ask them about getting FT3 tested.

Thanks for the advice, this is all still very new for me.


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## joplin1975 (Jul 21, 2011)

Good! You should make sure you don't have thyroid cancer mixed in there (and the ultrasound will help sort that out).


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## chasing_angels (Jun 28, 2016)

I haven't been back to the doctor yet, but I do have the ultrasound report and images...



> Marked heterogeneity of thyroid echo pattern with diffuse increase in vascularity through both lobes. Correlation with thyroid blood test would be indicated. Findings may be in keeping with some active thyroiditis. There is no goitre and no focal thyroid lesion otherwise identified.


I can only guess but it sounds like there's nothing bad going on - it's just not a pretty thyroid. Good news if that's the case, but at the same time it's almost a shame... I feel like absolute crap with both hypo & hyper symptoms and I was hoping for an excuse to have it removed (other than cancer of course).


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## BurntMarshmallow (Feb 26, 2016)

Something very similar happened to me when I gave up tea. So your story made me do a quick search and I found this:

http://bja.oxfordjournals.org/content/91/6/800.long

Nicotine increases serum fluoride concentrations. Fluoride is known to lower TSH, T3 and T4. It was once used to treat hyperthyroidism in the early 1900s, but since it caused more problems than it helped, they stopped using it.

Fluoride is pretty much everywhere, in our water, our food, but it is especially high in tea, mainly as aluminum fluoride. For three years I drank a lot of tea, and strong tea, instead of coffee. I had many hypothyroid symptoms, but not all of them, and I had a normal TSH. When I quit cold turkey, everything went haywire. Kind of similar to what happened when you quit smoking. I felt better in some ways and much much worse in other ways. My blood work said I was very hypothyroid. My numbers are in my signature below, so you can see the progression, which went very quickly from normal 2.9 to 9.5 in only six weeks. That was basically all because I stopped drinking tea.

Fluoride and iodine are chemically very similar. They share the same number of valence electrons which means they can bond to the same things. Fluoride can interfere with the function of iodine in the body for that reason.

One hypothesis with your situation is that the nicotine affected the metabolism of fluoride. You have something more like secondary hypothyroidism. While you were smoking, the fluoride was taking the place of iodine, and your pituitary thought everything was great. When you stopped smoking, the fluoride levels went down and the pituitary realized things were not great, and is now telling your thyroid to pick up the pace, raising TSH.

If I were you, I'd take a TON of B vitamins, and some iodine. Calcium is helpful for bonding to excess fluoride. Calcium and fluoride love each other and fluoride is pretty safe as long as there is plenty of calcium.

I did not take thyroid medication. Looking back, I probably would have recovered much faster had I started on thyroid meds right away, as well as taking all the vitamins. But I did eventually recover without the meds.


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