# Is levothyroxine the problem?



## bbdailey (Sep 29, 2011)

Hey everybody this is my first post on here....I've got a lot of personal history so ill try to keep it short. I am 23 and male and was diagnosed with hashimotos in April this year(my antibodies were around 200. My TSH had fluctuated from 2 to 5 but my symptoms were AWFUL.). I went on a gluten free diet starting in may(I am uncertain whether or not I have celiac) and started to feel better slowly. I was feeling better but still not normal. In july i went through a breakup and wanted desperately to get better so I began taking 50mcg levothyroxine and cut out soy and dairy as well. Within the next month-month and a half I began feeling much better until I had a colonoscopy. About a week after the colonoscopy(6-7 weeks after starting levothyroxine) I became very depressed and felt like I did at the beginning of this nightmare. I stopped taking the medication and the severe depression left after the first week but I have been off now for a month and still dont feel well. My question is could the medication have started to help then started to increase the attack on my thyroid since it was too small of a dose? Also, If the medication did cause a flare up in my attack how long will it take for the attack to cool down? Like i said its been a month with little to no progress and Im starting to wonder if i need to be on the medication at a higher dose.(had my labs done last week and they were normal though? tsh-2.2 FT4- .97 FT3- 3.1) Anybody have similar cases? Any thoughts or suggestions would be greatly appreciated!!

Sorry this post is so long!!!


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## webster2 (May 19, 2011)

bbdailey said:


> Hey everybody this is my first post on here....I've got a lot of personal history so ill try to keep it short. I am 23 and male and was diagnosed with hashimotos in April this year(my antibodies were around 200. My TSH had fluctuated from 2 to 5 but my symptoms were AWFUL.). I went on a gluten free diet starting in may(I am uncertain whether or not I have celiac) and started to feel better slowly. I was feeling better but still not normal. In july i went through a breakup and wanted desperately to get better so I began taking 50mcg levothyroxine and cut out soy and dairy as well. Within the next month-month and a half I began feeling much better until I had a colonoscopy. About a week after the colonoscopy(6-7 weeks after starting levothyroxine) I became very depressed and felt like I did at the beginning of this nightmare. I stopped taking the medication and the severe depression left after the first week but I have been off now for a month and still dont feel well. My question is could the medication have started to help then started to increase the attack on my thyroid since it was too small of a dose? Also, If the medication did cause a flare up in my attack how long will it take for the attack to cool down? Like i said its been a month with little to no progress and Im starting to wonder if i need to be on the medication at a higher dose.(had my labs done last week and they were normal though? tsh-2.2 FT4- .97 FT3- 3.1) Anybody have similar cases? Any thoughts or suggestions would be greatly appreciated!!
> 
> Sorry this post is so long!!!


Welcome, don't worry your post is not too long! Do you have the ranges that your lab uses? It is very helpful to those that understand them to see the ranges. Sorry, I am not one that can do that. I, too, went gluten free to try to keep the antibodies calmed down. I do think it helps. Again, welcome...someone more knowledgeable than I will be along soon. Best wishes to you.


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## bigfoot (May 13, 2011)

Welcome to the boards from a fellow newbie! :anim_32:

Can you provide any previous thyroid-related labs, and also provide the ranges? Without the ranges we are left guessing at where you stand.

You say you were diagnosed with Hashimoto's -- it sounds like the doctor prescribed you 50 mcg of levothyroxine. But you waited a while to start taking it, correct? Did you inform the doctor during your recent labs that you had stopped it? It makes a difference on how to interpret things.

I am under the impression from other folks here on the boards (as well as my current endo) that when you start taking a thyroid medicine such as levothyroxine, you will go through periods of feeling worse before feeling better. This has been my personal experience, too. So by briefly taking the 50 mcg of levothyroxine, then discontinuing it, my guess is your body is now confused.

This is the general idea for taking levothyroxine:

1) See doctor, get initial labs (TSH, Free T4, Free T3, antibodies, etc.) done.
2) Start with initial, smaller dose of levothyroxine.
3) Re-do labs in 4-8 weeks after starting levothyroxine.
4) Adjust medicine as needed (likely upwards) in 12.5 - 25 mcg increments.
5) Re-do labs again in 6-8 weeks after adjustment.
6) Etc... until your TSH is somewhere roughly around 1.0 or less, and your FT4 and FT3 are above the 75% range.

hugs3


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## bbdailey (Sep 29, 2011)

I am unsure what the ranges are at this point because i havent yet recieved the paperwork(i called for the results). But it was my understanding that my results were perfectly fine? like I said my TSH was a 2.2(I think the range is around .5- 5) My FT4 was .97(not really sure about the range on this one) and my FT# was 3.1(I think the range is around 2.5-4.5)


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## bbdailey (Sep 29, 2011)

Hey bigfoot my previous labs are as follows

TSH- has been inbetween 2-5 for the past year in no kind of order
TPO antibodies were 200 in April then 250 in July
FT3-3.1
FT4-.97

I was prescribed 50 mcg levo in late april and told by my endo that "it probably wont help". I started taking it for about 10 days and after much research decided to try the diet route first.(I had read that too small a dose could cause more of an attack on the thyroid....this is what I am thinking may have happened the second time I took it)

I understand that there are ups and downs with the medication but I just started to feel better(never worse)....I also cut out dairy and soy so that could have been a part of the help....So after around 6 weeks of taking the medication(2-3 weeks of feeling noticably better) it pretty quickly turned bad.(I felt just as I did before I was diagnosed)

I did let my Doctor know that I had stopped the thyroid meds(labs were 3 weeks after stopping meds). He seemed to think that I must have been feeling better because of the diet and not the levo.(bc labs were normal) It confuses me though bc Ive been off the thyroid meds for a month now and feel worse than I did before I started the medication 2 months ago. Could the medication have started an attack on my body that is lasting this long?


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## peacesells560 (Aug 9, 2011)

bbdailey said:


> Hey everybody this is my first post on here....I've got a lot of personal history so ill try to keep it short. I am 23 and male and was diagnosed with hashimotos in April this year(my antibodies were around 200. My TSH had fluctuated from 2 to 5 but my symptoms were AWFUL.). I went on a gluten free diet starting in may(I am uncertain whether or not I have celiac) and started to feel better slowly. I was feeling better but still not normal. In july i went through a breakup and wanted desperately to get better so I began taking 50mcg levothyroxine and cut out soy and dairy as well. Within the next month-month and a half I began feeling much better until I had a colonoscopy. About a week after the colonoscopy(6-7 weeks after starting levothyroxine) I became very depressed and felt like I did at the beginning of this nightmare. I stopped taking the medication and the severe depression left after the first week but I have been off now for a month and still dont feel well. My question is could the medication have started to help then started to increase the attack on my thyroid since it was too small of a dose? Also, If the medication did cause a flare up in my attack how long will it take for the attack to cool down?  Like i said its been a month with little to no progress and Im starting to wonder if i need to be on the medication at a higher dose.(had my labs done last week and they were normal though? tsh-2.2 FT4- .97 FT3- 3.1) Anybody have similar cases? Any thoughts or suggestions would be greatly appreciated!!
> 
> Sorry this post is so long!!!


Based on your labs, you may be undermedicated. Do you have the reference ranges from the labs? This would give us a much clearer picture of what's going on. I'm a year younger than you, and I also had depression issues, but they went away after I went on medication.


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## bigfoot (May 13, 2011)

bbdailey said:


> I was prescribed 50 mcg levo in late april and told by my endo that "it probably wont help". I started taking it for about 10 days and after much research decided to try the diet route first.(I had read that too small a dose could cause more of an attack on the thyroid....this is what I am thinking may have happened the second time I took it)


I am afraid your endo may not be up-to-speed on Hashi's treatment. Ideally you want your TSH value to be somewhere around 0.5-1.5, but every individual is different. Also, the top end of the TSH reference range was revised a few years ago and is now 3.0 I believe. You need to go by labs as well as your signs & symptoms. One is not exclusive of the other.

I have not heard that a small dose of levothyroxine causes an attack on the thyroid. I agree with peacesells560, you are probably under-medicated. I ran into this myself, with numbers similar to yours. I took 50 mcg for over a year, with my TSH hovering in the 2.7x range, and suddenly felt awful this spring. My doc kept telling me the labs were fine and I was just having a mood problem. Turns out I probably had Hashi's all along (two doctors later), and am now on the slow & steady path of increasing my levothyroxine dose bit by bit. As expected, my TSH has started to slowly decline, while my FT4 has slowly increased (which is what you want). This has been six months of doing this already, and I still feel crappy, but better than when I started.

Unfortunately, as I am learning myself, this is a process that takes a great amount of time for most folks. It doesn't happen overnight. There is no "cure"; it is an autoimmune disease that can flare up and also go into remission. The trick is finding a supportive doc that understands this.

Levothyroxine takes 3-4 weeks to build up in your body, and peaks at 6-8 weeks. If you were taking 50 mcg and at the six-week mark felt bad, this means it was probably time for a dose increase and further labs.


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## northernlite (Oct 28, 2010)

I agree with almost everything posted above. You really should give the plan the Bigfoot laid out a try. I have been at this since last November and am pretty sure where the numbers are perfect for me but having trouble with my doctor to get there.

You need to give your body TIME to adjust and heal, it is a very slow process. Stay gluten free, go back on the levothyroxine and work on getting your numbers better. Like someone said, the TSH max should be 3.0 not 5.0 and I personally, feel bad with my TSH at 2.0. I need mine to be down around 1.0 or below to feel well.


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## bigfoot (May 13, 2011)

Info on the updated TSH ranges: http://thyroid.about.com/cs/testsforthyroid/a/labs2003.htm


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## Andros (Aug 26, 2009)

bbdailey said:


> Hey everybody this is my first post on here....I've got a lot of personal history so ill try to keep it short. I am 23 and male and was diagnosed with hashimotos in April this year(my antibodies were around 200. My TSH had fluctuated from 2 to 5 but my symptoms were AWFUL.). I went on a gluten free diet starting in may(I am uncertain whether or not I have celiac) and started to feel better slowly. I was feeling better but still not normal. In july i went through a breakup and wanted desperately to get better so I began taking 50mcg levothyroxine and cut out soy and dairy as well. Within the next month-month and a half I began feeling much better until I had a colonoscopy. About a week after the colonoscopy(6-7 weeks after starting levothyroxine) I became very depressed and felt like I did at the beginning of this nightmare. I stopped taking the medication and the severe depression left after the first week but I have been off now for a month and still dont feel well. My question is could the medication have started to help then started to increase the attack on my thyroid since it was too small of a dose? Also, If the medication did cause a flare up in my attack how long will it take for the attack to cool down? Like i said its been a month with little to no progress and Im starting to wonder if i need to be on the medication at a higher dose.(had my labs done last week and they were normal though? tsh-2.2 FT4- .97 FT3- 3.1) Anybody have similar cases? Any thoughts or suggestions would be greatly appreciated!!
> 
> Sorry this post is so long!!!


Hi there and welcome. It is my opinion that the small starting dose (appropriate) took you to a place where you did not want to be. That is part and parcel of the titration process.

Your doc should have you in for labs every 6 to 8 weeks and slowly increase your thyroxine until you feel well.

Wonder if you could re-post your lab results with the ranges? Different labs use different ranges.

Have you had any antibodies' tests run such as those listed below?

TSI (thyroid stimulating immunoglobulin),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/


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