# Symptoms



## jabrown8 (Jun 22, 2012)

Hello everyone. This is my first post on the forums. Because of that, I'd like to give a little background on myself. I'm a 24 year old male grad student going for a MPH. I'm athletic (workout 4-5 days a week and play sand volleyball every other day)and eat healthy (although I do enjoy my desserts/butter/sugar from time to time).

On both sides of my family, there are thyroid problems. My mom's mom has hypothyroidism, my mom's sister and her daughter both have Hashimoto's disease, my sister has hypothyroidism with bouts of hyperthyroidism (hyperthyroidism symptoms might be caused by the wrong dosage of her medicine), my mom has hypothyroidism, and my dad's sister has Grave's disease.

I've been dealing with symptoms which I believe are related to my thyroid over a period of 5 years. As time has progressed, more symptoms have appeared and so has the severity of these symptoms.

I've been to the doctor a number of times to get my TSH and free T4 and T3 levels checked. Each time I've went, I've had different results. I've had elevated TSH levels and normal T3 and T4 levels, and then other times, they've all been normal.

My symptoms come and go, as well, as if it's a cyclical occurrence; however, like I've said, I've noticed that they have been getting worse over the past 4-5 years. When I have symptoms, I usually have a sensitivity to cold (hands and feet are cold to the touch, too), extremely tired regardless of the amount of sleep I get (sometimes I can sleep for 14 hours if I take a "nap"), slow healing if I have a wound, my voice goes quickly (hoarse), my good cholesterol is always low even though I eat lots of poly- and monounsaturated fats, dark circles under eyes, fissures (in a not so fun area), tachycardia (I can sometimes hear my heart in my ears, especially if I tilt my neck downward) and shortness of breath as if I have a weight on my chest when I take deep breaths (especially if I climb a flight of stairs or immediately stand up after sitting/lying down - heart also feels like it will skip a beat randomly - very scary at times and will more likely occur during the semester when I'm stressed out), irritability, random bouts of anxiety for no reason (like when I'm jogging), brain fog, dizziness (sometimes vertigo to the point where I have thrown up), hypoglycemia (this sensation can also occur after eating), and recently (starting last fall), I've been dealing with random bouts of urticaria (usually on my hands and feet and only occur when I'm cold) - alcohol based hand sanitizers can make this occur, too. An endocrinologist also stated that my thyroid gland was slightly enlarged whenever they palpated the area.

The problem is that I've been to the endocrinologist once this year and all he did was check my TSH, free T3, and free T4 levels; however, they came back normal as opposed to when my primary doctor did thea TSH (Elevated - above a 5.0), T3 (normal), and T4 (slightly high) tests. When I received the phone call from my endocrinologist about this, he said I could come in and get other tests done, but I didn't know what else to do because everything came back normal and my doctors kept telling me that there was probably nothing wrong with me because 1) I'm a male and 2) I'm a stressed out student who isn't getting sleep on a routine basis.

Now that I have free time and it's summer, I'm wanting to fix this. These symptoms are ruining my life because I have NO energy. It's killing me when I do physical activity because I get out of breath from moving 5 feet, climbing a flight of stairs, or transitioning from sitting down to standing up. I can't study effectively and I have no motivation to get things done.

I'm getting an appointment lined up very soon, but in the meantime, I'm just curious about other people's experience(s) with symptoms similar to mine. I contacted my mom's sister and she said my symptoms sound similar to hers prior to treatment. Hers went undiagnosed for a long time because the doctors improperly treated her case. One even thought she needed to be committed to a psychiatric ward. In truth, her thyroid was almost burned out because it went untreated for so many years. I don't want to ever get like that if this is related to a thyroid disease.

Anyways, do my symptoms sound like they are related to my thyroid? Has anyone else experienced urticaria with their thyroid? Has anyone else's symptoms progressed from mild to worse over the years? Any specific tests I should get whenever I go to the doctor?

My mom's sister, who is also a nurse, suggested that I get a TPO test, an antithyroglobulin test, possibly a reverse T3 test, and have my Ferritin and 25-Hydroxy Vitamin D levels checked (since they play a major role in how the body converts T4 to the active T3 form).

Forgive me for my novel, but I wanted to provide everyone with as much detail as possible.


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## webster2 (May 19, 2011)

Hello & welcome! Sorry to hear that you are not feeling well. Never apologize for giving your story, info is good! Your mom's sister gives good advice as well as an ultrasound of your thyroid. That would be my suggestion as your next step...however, I think others will chime in with some great advice/ suggestions too. I do think you need to get these tests done ASAP.

Best to you!


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## shellebean (Oct 12, 2011)

Welcome! Sounds like you actually have some great advice from your aunt and it is really good that your last Endo tested for the free T3 and free T4 in addition to the TSH. It's hard sometimes to get a Doc to run the Free's. TPO would be a good one, too and an ultrasound can enlighten you even more if there are some thyroid issues. Many labs come out normal but there are other issues happening in there. You are on the right track, I'd see how quickly you can start getting answers!

I didn't have ANY family thyroid issues that I am aware of, but an ultrasound really opened the floodgate to multiple issues I didn't know I had like Hashimoto's-TPO over 800, multinodular goiter, enlarged, heterogeneous thyroid, blah, blah, blah. Confirming that there is a reason why you feel so horrible is a relief and gets the ball rolling towards a positive progression.

Good luck, this board is fabulous! Ask lots of questions and keep us posted about your future appointments.


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## Andros (Aug 26, 2009)

jabrown8 said:


> Hello everyone. This is my first post on the forums. Because of that, I'd like to give a little background on myself. I'm a 24 year old male grad student going for a MPH. I'm athletic (workout 4-5 days a week and play sand volleyball every other day)and eat healthy (although I do enjoy my desserts/butter/sugar from time to time).
> 
> On both sides of my family, there are thyroid problems. My mom's mom has hypothyroidism, my mom's sister and her daughter both have Hashimoto's disease, my sister has hypothyroidism with bouts of hyperthyroidism (hyperthyroidism symptoms might be caused by the wrong dosage of her medicine), my mom has hypothyroidism, and my dad's sister has Grave's disease.
> 
> ...












Hyperthyroid patients typically present with low lipids/cholesterol. So............this is a huge hint. Other symptoms mentioned also suggest to me that you may be hyper.

These tests are highly recommended and also, I personally strongly recommend an ultra-sound or RAIU (radioactive uptake scan) because males are more prone to cancer and when you factor in the possibility of hyper, that makes it even more important to rule that out.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

Do you have your most recent thyroid lab results that you can post here with the ranges? That would be most helpful.

Antibodies attacking the receptor sites can cause your thyroid panel to look okay when in fact things are not okay.


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## Jennifermfogg (Jun 25, 2012)

It sounds like you are having a really hard time. I feel bad for you!

I have Hashimoto's and am Hypoglaucemic. I have been treated for a few months now. I can relate to some of what you are experiencing. My husband often tells me I am sleeping my life away because I am still So tired. I can only imagine what your day to day is like from your explanation. At 24, you should be able to enjoy your life.... (at any age, but you are young and should be able to enjoy).

I agree with your Aunt and with the members regarding you getting a sonogram. I too want a sonogram.

This is a great site to get support and information. Everyone is super nice and super helpful.

I hope you are going to walk into the endo office loaded with requests and questions. See if you can have someone go with you for an extra set of ears. Or, ask the endo to give you a print out of your discussions. There are too many symptoms for you to not get treatment. I am not on the up and up with the tests names...etc but everyone here has great info.


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## CA-Lynn (Apr 29, 2010)

Your aunt gives good advice. Go back and reread Andros' advice, too.

Best of luck to you.


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## jabrown8 (Jun 22, 2012)

Thanks everyone for the support and info.

I'll try to find the test results from when I went to the endo and post the info on here.

I've thought about this being hyperthyroidism, but I feel like the thyroid gland is fluctuating between different levels before it burns out. My aunt is a trim woman just like myself; however, she experienced these symptoms, too, and she ended up being diagnosed with Hashimoto's disease. My other aunt has Grave's disease with hyperthyroidism; however, she is overweight. Either way, I'll inquire about this possibly being hyperthyroidism.

I'm actually going to print out my aunt's message that she sent to me and take it to the doctor just for a bit of reassurance. I've been to the doctor so many times trying to figure this out - I thought I was developing type 1 diabetes, I thought there was something wrong with my heart, etc. It wasn't until this past year until I started thinking about my thyroid. When I presented the idea to my doctor, he was like, "Very unlikely since you are a male...You're probably just stressed...you need to eat more to keep your blood sugars in check..blah blah blah." It's just frustrating because it seems as if they're not even interested. They would rather generalize ailments and symptoms.

Anyways, I will keep everyone post and dig through these forums some more. Once again, thanks!


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## Andros (Aug 26, 2009)

jabrown8 said:


> Thanks everyone for the support and info.
> 
> I'll try to find the test results from when I went to the endo and post the info on here.
> 
> ...


Symptoms can be confusing; many w/Graves' have gained weight and many w/hypothyroid lose weight. That is why lab tests are soooooooooooooo important.

Keep us in the loop.


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## Jennifermfogg (Jun 25, 2012)

Don't get discouraged. Ask around for a referral to a doctor. Keep us posted on your health and results.


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## jabrown8 (Jun 22, 2012)

I have my appointment tomorrow for the endocrinologist. Hopefully, I'll get some answers.

In the meantime, I have a question about my throat. It feels like there's a dull burning sensation on my right side near my thyroid. I also feel like a small hard nodule of sorts. It seems to flare up at times. For instance, right now it doesn't hurt; however, it will flare up at night or in the morning. Has anyone else had an experience like this?


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## Andros (Aug 26, 2009)

jabrown8 said:


> I have my appointment tomorrow for the endocrinologist. Hopefully, I'll get some answers.
> 
> In the meantime, I have a question about my throat. It feels like there's a dull burning sensation on my right side near my thyroid. I also feel like a small hard nodule of sorts. It seems to flare up at times. For instance, right now it doesn't hurt; however, it will flare up at night or in the morning. Has anyone else had an experience like this?


Many have and it would be a good move on your part to insist on an ultra-sound.

Good luck tomorrow and please let us know.


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## jabrown8 (Jun 22, 2012)

Update: I went to the endocrinologist yesterday and figured I would give some people an update.

The doctor was amazing - he took a genuine interest in me as a patient and assured me that he was going to find out what was wrong with me. He had already taken the necessary steps to secure my medical records from my previous endocrinologist and my primary physician. He said that I had a strong case for hypothyroidism because my TSH was a 6.0 when I was checked last fall by my primary physician and because of my family history where thyroid disease runs rampant on both sides. He checked my thyroid for nodules and swelling and noted that there were no nodules (thank God); however, he said that my thyroid gland on the right was was slightly swollen. He ordered a TPO, Thyroglobulin, TSH, and free T3 and T4 test. He also wanted to check my cortisol levels, so I have to go in Monday and do that after a wonderful night of fasting.

Anyways, I feel completely better knowing that I have a doctor who is genuinely interested in my case. It's a huge relief. Thank you everyone for the feedback and support thus far.


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## Andros (Aug 26, 2009)

jabrown8 said:


> Update: I went to the endocrinologist yesterday and figured I would give some people an update.
> 
> The doctor was amazing - he took a genuine interest in me as a patient and assured me that he was going to find out what was wrong with me. He had already taken the necessary steps to secure my medical records from my previous endocrinologist and my primary physician. He said that I had a strong case for hypothyroidism because my TSH was a 6.0 when I was checked last fall by my primary physician and because of my family history where thyroid disease runs rampant on both sides. He checked my thyroid for nodules and swelling and noted that there were no nodules (thank God); however, he said that my thyroid gland on the right was was slightly swollen. He ordered a TPO, Thyroglobulin, TSH, and free T3 and T4 test. He also wanted to check my cortisol levels, so I have to go in Monday and do that after a wonderful night of fasting.
> 
> Anyways, I feel completely better knowing that I have a doctor who is genuinely interested in my case. It's a huge relief. Thank you everyone for the feedback and support thus far.


This is definitely a step in the right direction. When you get lab results and if you wish to post them for us to see, please include the ranges as well.


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## Jennifermfogg (Jun 25, 2012)

What a relief knowing you found a doctor that listens and cares! 
I'm glad you are more comfortable and are going to get results soo. Please keep us posted!


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## jabrown8 (Jun 22, 2012)

So I received a phone call from my endo this past Wednesday and he said that at the time my test was conducted, my levels were "normal." I'll be going tomorrow to get the printout of everything since all he said for my free T3 and T4 was that they were normal and that my TPO antibodies were negative rather than giving me their numbers and ranges. He also said my TSH, which was a 3.3, was normal; however, according to the American Association of Clinical Endocrinologists, the target TSH level should be between 0.3 and 3.0 μIU/mL (https://www.aace.com/files/hypo-hyper.pdf). My 25 hydroxy vitamin D test was a 31 (normal range between 30.0-74.0 ng/mL). This is borderline low, so I should probably start taking a supplement to increase this number. My aunt with Hashimoto's who is also a nurse recommended that my levels be towards the higher end of the spectrum in order to feel better.

The main issue is my TSH level of 3.3. I had that one reading about a year and half ago that was over 5.0 and I can't remember the one I received at the other endocrinologist (I'm actually going to get that tomorrow, too). I really believe that he should put me on a low dosage of medicine to see if that improves any of my symptoms. Any advice? Should I bring this up to him? How do I convince him that I should be put on a small dosage of medication?

Anyways, I'll get my other numbers and previous lab reports tomorrow and post them.


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## jabrown8 (Jun 22, 2012)

Anyone? :X


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## CA-Lynn (Apr 29, 2010)

We're here. I guess we were waiting for the lab results.


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## jabrown8 (Jun 22, 2012)

Oct. 2011
TSH levels from primary Doc: 6.433 (.35-5.50)
Free T4: 1.49 (.6-1.6)

Nov. 2011
TSH: 1.58 (.35-5.50)
Free T4: .95 ng/dL (.6-1.6)

July 2012
TSH: 3.36 (.34-5.60)
Free T4: 1.07 (.58-1.64)
Free T3: 2.84 (2.50-3.90)
TPO: 16 (0-34)
Vitamin D (25-Hydroxy): 31.9 (30-100)

It seems all endos go by different guidelines. I'm rather confused -all I know is that my symptoms come and go. I feel my right thyroid swell every now and then which causes my voice to go hoarse. I talked to my endo today and he wants to continue monitoring things and he's going to do an ultrasound on my thyroid at the end of this month.

Any advice? Comments?


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## Octavia (Aug 1, 2011)

Many doctors would prescribe a low dose of Synthroid at those levels. I don't think you're out of line making such a request.


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## jenny v (May 6, 2012)

I agree, I don't think you're out of line to ask for a prescription for a thyroid replacement at those levels. Did he say he wouldn't prescribe anything until the ultrasound or can you call and request a prescription?


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## Lovlkn (Dec 20, 2009)

jabrown8 said:


> Oct. 2011
> TSH levels from primary Doc: 6.433 (.35-5.50)
> Free T4: 1.49 (.6-1.6)
> 
> ...


How do your feel?


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## jabrown8 (Jun 22, 2012)

I'm actually irritated with the endo. I asked for a least a low dosage, but he wouldn't budge. He said the insurance company would be confused as to why they prescribed medication to me based on the labs; however, my symptoms, family history, and the fact that my TSH levels have been elevated and are slightly elevated now should guarantee me a small dosage. I showed him the AACE report and he said that between .3 and 3.0 should be target levels WITH treatment; however, I keep rereading that article and I don't get that message from the text. I also read on other sites that anything above a 3.0 is considered hypothyroidism. I just think he said that to quiet me down. He's willing to monitor it and he's going to do an ultrasound at the end of this month...but I'm a graduate student! I'm extremely busy during the semester. I don't have time to mess with this and no one is listening. The other thing he said it could be is Addison's disease, but the only symptoms I have that would meet that disease criteria are changes in blood pressure/heart rate and extreme weakness and fatigue. I honestly don't care about insurance - I'll pay for the drug out of pocket - all I want to do is see if it does help. The worst that could happen is I develop tachycardia and I just stop taking the drug.


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## jabrown8 (Jun 22, 2012)

Andros...do you have an opinion?


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## Andros (Aug 26, 2009)

jabrown8 said:


> I'm actually irritated with the endo. I asked for a least a low dosage, but he wouldn't budge. He said the insurance company would be confused as to why they prescribed medication to me based on the labs; however, my symptoms, family history, and the fact that my TSH levels have been elevated and are slightly elevated now should guarantee me a small dosage. I showed him the AACE report and he said that between .3 and 3.0 should be target levels WITH treatment; however, I keep rereading that article and I don't get that message from the text. I also read on other sites that anything above a 3.0 is considered hypothyroidism. I just think he said that to quiet me down. He's willing to monitor it and he's going to do an ultrasound at the end of this month...but I'm a graduate student! I'm extremely busy during the semester. I don't have time to mess with this and no one is listening. The other thing he said it could be is Addison's disease, but the only symptoms I have that would meet that disease criteria are changes in blood pressure/heart rate and extreme weakness and fatigue. I honestly don't care about insurance - I'll pay for the drug out of pocket - all I want to do is see if it does help. The worst that could happen is I develop tachycardia and I just stop taking the drug.


You know I do! ROLF!! You don't need an endo. Seek out a GP, a Naturopath or DO. This is ridiculous. Also call your insurance company and have a chat. LOL!! See if your endo is telling the truth. Maybe yes, maybe no. That would be interesting to know if the insurance company is "really" controlling your health care THAT much!

As you well know and have read a thousand times on here; "Most of us feel best w/TSH @ 1.0 or less with the FREES at about 75% of the range given by your lab.

Bottom line.

Also, there is such a thing as a therapeutic range. Real or imagined. TSH waxes and wanes. It could be higher on "other" days. Or lower; but when you feel the symptoms you know it is not where it is supposed to be. And yes, there is a lag time between what you feel and what the lab test reports.

Have you had any antibodies' tests run?


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## Octavia (Aug 1, 2011)

Addison's disease? That's pretty rare. Hypothyroidism is fairly common and easy to treat...and your labs show a low-level hypothyroidism going on. Why not treat what's in front of you (and see if it works) rather than searching for other problems? My 2 cents. You said you're in graduate school...full time? Do you have access to a health clinic at school? If you bring in your labs, maybe the doc there would prescribe? I hope you have better luck soon...

???


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## jabrown8 (Jun 22, 2012)

Yeah, I am in graduate school, but I've been to that health clinic before and they're adamant on sticking to the basics of testing and NEVER listen to the patient - not a fan. However, I did make an appointment with a doctor back home for next Tuesday who is willing to listen to the patient and try a low dosage of medicine to test the waters. He's also wanting me to do an ultrasound. So, we'll see what happens.


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## Jennifermfogg (Jun 25, 2012)

You have really had a tough time and I am sorry to hear this. That's too bad that you have been put in this position. Hang in there and let us know what the sono shows as well as your doctor back home.

Don't give up! You will get with the right doctor and he or she will listen and will help you.


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## Andros (Aug 26, 2009)

jabrown8 said:


> Yeah, I am in graduate school, but I've been to that health clinic before and they're adamant on sticking to the basics of testing and NEVER listen to the patient - not a fan. However, I did make an appointment with a doctor back home for next Tuesday who is willing to listen to the patient and try a low dosage of medicine to test the waters. He's also wanting me to do an ultrasound. So, we'll see what happens.


Very excellent news and I am glad about the ultra-sound also! Let us know when you can and good luck.


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## jabrown8 (Jun 22, 2012)

Hello everyone. So I went to go see a new primary physician and he put me on 25 mcg levothyroxine to see how I respond to it. I took my first pill this morning - so we'll see how it goes. We put off the ultrasound because I'm scheduled for one at the end of this month with my endocrinologist.

Once again, thank you for the support and information. It's helped me a lot in my appointments!

I have another question: How long will it take for this medicine to take effect?


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## Andros (Aug 26, 2009)

jabrown8 said:


> Hello everyone. So I went to go see a new primary physician and he put me on 25 mcg levothyroxine to see how I respond to it. I took my first pill this morning - so we'll see how it goes. We put off the ultrasound because I'm scheduled for one at the end of this month with my endocrinologist.
> 
> Once again, thank you for the support and information. It's helped me a lot in my appointments!
> 
> I have another question: How long will it take for this medicine to take effect?


8 weeks. Then you should get labs and doc should do a small increase. This pattern continues until you feel totally well. (euthyroid)


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## jabrown8 (Jun 22, 2012)

Hello everyone. Just thought I would give an update. I've been on levothyroxine for 6 days. I've had some improvements the past couple of days such as increased amounts of energy and not running out of breath as badly. Some symptoms are still present such as some anxiety, sluggish heart, and some brain fog; but, I can live with those for right now because I at least have more energy. Sometimes I think the anxiety persists because I get nervous when I climb a flight of stairs or when I stand up because I expect to get out of breath and really tired - it's like learning how to walk all over again.

Is it atypical to see some improvements a little later in the first week of treatment?


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## Andros (Aug 26, 2009)

jabrown8 said:


> Hello everyone. Just thought I would give an update. I've been on levothyroxine for 6 days. I've had some improvements the past couple of days such as increased amounts of energy and not running out of breath as badly. Some symptoms are still present such as some anxiety, sluggish heart, and some brain fog; but, I can live with those for right now because I at least have more energy. Sometimes I think the anxiety persists because I get nervous when I climb a flight of stairs or when I stand up because I expect to get out of breath and really tired - it's like learning how to walk all over again.
> 
> Is it atypical to see some improvements a little later in the first week of treatment?


So glad to hear this and depending on how bad your body needs the Levothyroxine; I would say it's atypical to "feel" improvements. If you are really tuned into your body, that helps.

Hope you are scheduled for labs at the 8 week mark for further titration upward as needed?


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## jabrown8 (Jun 22, 2012)

I'm probably too tuned to my body. I just have more energy, which I'm not accustomed to. That's the thing I notice the most. It didn't start right off the bat - I just don't get that urge to take a 5-8 hour nap in the afternoon like I used to.

And yes, I am scheduled for a visit in 6 more weeks.


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## Andros (Aug 26, 2009)

jabrown8 said:


> I'm probably too tuned to my body. I just have more energy, which I'm not accustomed to. That's the thing I notice the most. It didn't start right off the bat - I just don't get that urge to take a 5-8 hour nap in the afternoon like I used to.
> 
> And yes, I am scheduled for a visit in 6 more weeks.


Very excellent!!! Life will soon be good again!!!


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