Still have symptoms when on thyroxine? Here is why
When your doctor prescribes you thyroxine, you’re hopeful that your symptoms will vanish within weeks. But sometimes, this isn’t the case. Or perhaps it does help for a few months or a few years, only for your symptoms to return.
Why does this happen? There are 4 major reasons why you could be experiencing thyroid-related symptoms even when taking thyroxine. Let’s take a closer look at each.
4 reasons why thyroxine isn’t helping your symptoms
Your dose is incorrect
This tends to pop up in a few specific groups of people:
People who have just started on thyroxine
Anyone who has entered a new phase of life or experienced changes to their health e.g. pregnancy, a new chronic condition
Someone who has been on thyroxine for many years
Why do these people have an incorrect dose more frequently? Those who are new to thyroxine will be recommended a standard starting dose based on their condition, body weight, age and gender. But this starting dose is just that – a place to start. There are many other factors that may mean you need a different dose.
For those who have changes to their health and hormones, this has a ripple effect on what the body needs to function. As a result, you may need more thyroid hormone to support you.
And for those who have been on thyroxine for many years? This is two-fold. Firstly, over time you’re more likely to be lax around regular blood tests and monitoring, so your needs could change without you picking up on it. Secondly, your thyroid condition can worsen over time if not managed. As a result, you’ll have greater need for thyroid replacement.
Your doctor is basing your dose off TSH alone
This is a common problem for people to experience. Your TSH level is only a single piece of the optimal thyroid puzzle. There are even studies that found 15% of people with hypothyroidism still experience hypothyroid symptoms, even when their levels are within range.
TSH ‘normal’ ranges vary from lab to lab. So your TSH could be on the higher end of ‘normal’ and your doctor says it’s fine – but it’s high enough that it suggests your thyroid hormone dose isn’t cutting it.
In this case, you could look for a second opinion from a more experienced doctor – even an endocrinologist – or you could ask your doctor to trial you on a slightly higher dose and see how you feel over 3 months. It’s unlikely that increasing your dose by 25mcg will cause any serious health issues over that time if you don’t need it, and it could mean you feel much better!
You’re not absorbing or converting thyroxine properly
Thyroxine, or T4, is not something that your body can put straight into action. When taken as medication, your body needs to absorb the thyroxine into the bloodstream via the gut. Even when produced by the thyroid, thyroxine needs to be converted into the active form of T3.
But if you’re not absorbing enough of your medication, it means you’re only getting a fraction of the intended dose for your needs. This can be seen in bloods as low T4 and T3, as little is reaching your blood.
And if you’re not converting it properly, you might not be getting sufficient T3 to alleviate your symptoms and support your body functions. This may be seen in blood test results – your T4 levels are good, but your T3 is on the lower side. You could also see high levels of reverse T3, which is the other inactive form that thyroxine can be converted to.
For ideas on supporting the absorption & conversion process, give this article a read.
You’re experiencing cellular hypothyroidism
With cellular hypothyroidism, you have ‘normal’ thyroid hormone levels, but the hormones cannot get into your cells. And of course, we need the thyroid hormones to make it into the cell before we can reap all of the metabolic benefits!
If the thyroid hormones never make it into the cells, it is just as much of a problem as not having enough thyroid hormone. In fact, it’s often worse because it allows hypothyroidism to go untreated.
This can be an incredibly frustrating condition. You continue to be haunted by hypothyroid symptoms, but your doctor tells you that you’re fine because your TSH, T4 and T3 levels are fine.
Learn more about this condition and what can be done here.
Bonus reason: your symptoms aren’t just from your thyroid!
If you have chronic thyroid issues, there’s a chance that you have other health issues contributing. So your thyroxine might be taking care of your thyroid replacement needs – but you’re still experiencing additional symptoms from another cause.
This can be tricky to spot, especially if you’re not aware of the underlying issue. After all, many of the symptoms of low thyroid – weight gain, fatigue, aches and pains, hair loss, digestive issues – are general and can be caused by countless health concerns!
If you’ve considered all of the above suggestions and still not seen improvements? It might be time to work with your healthcare team to rule out other health issues.
YOU CAN FEEL GREAT EVEN WITH AN UNDERACTIVE THYROID!
When you receive a diagnosis of hypothyroidism, you might feel overwhelmed and powerless. It could even be that you’re not clear on what’s driving it at first!
But even if you’re still uncovering the cause, it doesn’t mean you need to suffer the symptoms forever! Your daily habits can make a massive difference – all you need to do is learn about your condition and empower yourself.