# Odd question about Levothyroxine



## tallgrrlMN (Nov 24, 2010)

I have been hypothyroid for 10 plus years and been taking Levo. Recently, 10/2010 I was diagnosed with Hashi's and having a lot of problems with fatigue, tachycardia, sore throats and headaches. The doctors thought I may have been getting too much levo for over a year. I went to Mayo clinic and they had me discontinue taking my levo, which I did. They also put me on a beta blocker for the tachycardia. After being off of levo for about 6 months, I felt pretty okay. A couple of weeks ago I had my TSH re tested and it was around 9.00 or 10.00. So he put me back on the levo. Here is my question - I have been on 50 mcg of levo for 3 weeks now and I am back to feeling like utter crap. I can barely stay awake, I have hot flashes, headaches etc. Has anyone else experienced such a thing?? My numbers are saying I should be taking levo, but I am starting to think I am better off not taking it. or maybe my thyroid can't convert T4 to T3 so I shouldn't be taking levo in the first place?? Help.

Melissa


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## Andros (Aug 26, 2009)

tallgrrlMN said:


> I have been hypothyroid for 10 plus years and been taking Levo. Recently, 10/2010 I was diagnosed with Hashi's and having a lot of problems with fatigue, tachycardia, sore throats and headaches. The doctors thought I may have been getting too much levo for over a year. I went to Mayo clinic and they had me discontinue taking my levo, which I did. They also put me on a beta blocker for the tachycardia. After being off of levo for about 6 months, I felt pretty okay. A couple of weeks ago I had my TSH re tested and it was around 9.00 or 10.00. So he put me back on the levo. Here is my question - I have been on 50 mcg of levo for 3 weeks now and I am back to feeling like utter crap. I can barely stay awake, I have hot flashes, headaches etc. Has anyone else experienced such a thing?? My numbers are saying I should be taking levo, but I am starting to think I am better off not taking it. or maybe my thyroid can't convert T4 to T3 so I shouldn't be taking levo in the first place?? Help.
> 
> Melissa


Your TSH indicates hypo but what does your FREE T3 and FREE T4 indicate?

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
http://www.drlam.com/articles/hypothyroidism.asp?page=3

And, have you had any antibodies' tests done and have you had a sonogram?


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## HeidiBR (Apr 4, 2010)

Did they test your free T3 and your free T4? The results of those tests would be an excellent indicator of what is going on. If those levels are in a good place, chances are your symptoms are from not getting enough Levo. With a TSH of 10, I could not get out of bed.

I'd ask for those tests. You really can't know what's up unless you do.

Good luck!


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## tallgrrlMN (Nov 24, 2010)

My T3 test came back within normal range and the T4 was slightly elevated. But these tests were taken 3 weeks ago before I started taking the Levo again. I am wondering if I should run into the doctors and have them run my labs today as I feel so crappy taking the Levo. I still think its odd that I went 6 months, no levo and a TSH of 10 and felt pretty darn good. Something else must be going on.


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## Andros (Aug 26, 2009)

tallgrrlMN said:


> My T3 test came back within normal range and the T4 was slightly elevated. But these tests were taken 3 weeks ago before I started taking the Levo again. I am wondering if I should run into the doctors and have them run my labs today as I feel so crappy taking the Levo. I still think its odd that I went 6 months, no levo and a TSH of 10 and felt pretty darn good. Something else must be going on.


T3 and T4 are not very good barometers. FREE T3 and FREE T4 are because this is the unbound hormone only available for cellular uptake.

And? Have you had antibodies' tests and a sonogram?


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## tallgrrlMN (Nov 24, 2010)

I can check to see if the tests were for the FREE or not. Also, my antibodies tests came back at TSI = 250 and TPO = 707. I had an ultrasound of my thyroid, is that the same as a sonogram? They said it looked fine except I do remember something about one half being larger than the other. Ugh, this is all so confusing.


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## Andros (Aug 26, 2009)

tallgrrlMN said:


> I can check to see if the tests were for the FREE or not. Also, my antibodies tests came back at TSI = 250 and TPO = 707. I had an ultrasound of my thyroid, is that the same as a sonogram? They said it looked fine except I do remember something about one half being larger than the other. Ugh, this is all so confusing.


Oh, my gosh! I sort of suspected that. That is why I was pressing you. Sorry about that but something told me to ask again.

About TSI, Thyroid Stimulating Immunoglobulin

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

And such high TPO Ab?

When did you have this ultra-sound?

TPO Ab
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

TPO Ab should be negative, 0
http://www.medlabs.com.jo/docs/Leaflet-17.pdf
(The normal thyroid has TPO but should not have antibodies to TPO)

How about asking for a Thyroglobulin Ab test?

cancer TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

And...............................this sore throat stuff; do you have that all the time? Do you have an earache as well? Do you have swollen lymph nodes in your neck/clavicle area?


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## tallgrrlMN (Nov 24, 2010)

The sore throat stuff and hoarseness seemed to be occurring when I was having all the issues of when they thought I was taking too much levo. I have a doctor's appt today to have blood work done. What tests should I have done? TSH, Free T3 and Free T4, and antibodies?


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## Andros (Aug 26, 2009)

tallgrrlMN said:


> The sore throat stuff and hoarseness seemed to be occurring when I was having all the issues of when they thought I was taking too much levo. I have a doctor's appt today to have blood work done. What tests should I have done? TSH, Free T3 and Free T4, and antibodies?


Yes to the TSH, FREE T3 and FREE T4 and see "if" they will do any of these. No point in repeating the TSH or TPO. Unless you are just dying to know if they "moved' up or down. You have a "baseline" now so you could tell movement.

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/

I am keeping my fingers crossed for you and sending good thoughts!


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## HeidiBR (Apr 4, 2010)

When I am in a hypo phase and my thyroid swells up, my throat gets sore and my voice gets hoarse.


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## tallgrrlMN (Nov 24, 2010)

I saw my primary doc yesterday and he was very concerned by the way I looked. He said I looked "dead". He was even checking me for tick bites. The tests that he ran were full metabolic panel, lymes, and the thyroid hormone panel. My previous tests in early August were Free T3 and Free T4. That was based on being off my Levo for 6 months and my TSH was around 10. My Free T4 was normal and the confusing part for the doctor at Mayo clinic was my Free T3 was elevated. I am starting to wonder if maybe my adrenals are fatigued. I will post results of yesterdays blood work as soon as I hear back.

Melissa


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## bigfoot (May 13, 2011)

Glad to hear you were able to see your primary doc and that he was concerned. Too often I think they see results as "within range" and pass things off. Hopefully the new labs shed some light on things! You might be hitting on a good point with the adrenals. I know with a TSH so high at 10.0 you must be feeling awful. Hang in there, things are gonna get better!

hugs3


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