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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taking Thyroxine Long-term. Tired, Weight Gain. Swollen Legs And Ankles

Hi, I have been on thyroxine since the age of 10...that is over 40 years....the doses change from time to time, but recently (meaning over a few months back I was on 125mg, it did not seem to do anything for me so I put myself on 150mg and told the doctor I was doing this. She said ok. Now just had a blood test and results say its too much, now I am back on 125mg, will not know for 6 weeks whether its right amount for me as I said before it does not seem enough for me....ie still fill tired, over the last 6 months put on 2 stone in weight where I worked really hard to lost this last year and now feel sluggish and big (although I did give up cigarettes 6 months ago).....My real question on my thyroid is......which I keep asking the doctor is that although I have TSH/T4 blood tests they never really test me to see if the T4 is actually transfering it int T3 when it gets into my system, in six weeks time the doctor will be doing this as I have insisted on this particular blood test....Because if the T4 is not turning it into T3 what is the point of me taking the the thyroxine TSH I should be taking T3 Please can you advise me whether I am right or wrong.... ps I am also on a lot more medication ie asprin,statins and diltizam.....by the way I must say that over the last 3 weeks I my legs and ankles have swollen up and painful, having a eco cardiac test for that in a weeks time
posted on Wed, 24 Jul 2013
Twitter Wed, 24 Jul 2013 Answered on
Twitter Thu, 25 Jul 2013 Last reviewed on
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General & Family Physician,  's  Response
Hi, Welcome to HCM.

I understand your concern. When you said that you reduced the dose of thyroxine from 150mg to 125mg based on the available blood test, I assume that you are indicating T4 levels and not TSH levels. Because if your TSH levels are high then it means that your thyroid gland is under functioning (hypothyroidism). In this case you will need to increase your thyroxine and not reduce it. Regardless, your symptoms should also agree with your lab results. Based on the information you have given (weight gain, feeling sluggish and tired) these go in the direction of hypothyroidism meaning that you will need to increase your thyroxine. I will advise you to consult your primary physician for the same since the doctor will need to titrate the dose of thyroxine based on the clinical condition (lab results as well as symptoms).

In contrast, when your T4 is high it is assumed that it gets converted to T3 in peripheral tissues if blood levels are not available. In this regard, you are right and the only way to find out about the T3 levels is to get it checked. Majority of the times when we prescribe thyroid function test it includes T3 in addition to TSH and T4 levels.

You have also mentioned that you are on other medications particularly statins. Looks like your lipid levels are high. In this regard, I will advise diet control and exercise that will help improving your general well-being. However, I would wait until you are done with your cardiovascular examination and ask your cardiologist about the same.

Hope this helps.
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Taking Thyroxine Long-term. Tired, Weight Gain. Swollen Legs And Ankles

Hi, Welcome to HCM. I understand your concern. When you said that you reduced the dose of thyroxine from 150mg to 125mg based on the available blood test, I assume that you are indicating T4 levels and not TSH levels. Because if your TSH levels are high then it means that your thyroid gland is under functioning (hypothyroidism). In this case you will need to increase your thyroxine and not reduce it. Regardless, your symptoms should also agree with your lab results. Based on the information you have given (weight gain, feeling sluggish and tired) these go in the direction of hypothyroidism meaning that you will need to increase your thyroxine. I will advise you to consult your primary physician for the same since the doctor will need to titrate the dose of thyroxine based on the clinical condition (lab results as well as symptoms). In contrast, when your T4 is high it is assumed that it gets converted to T3 in peripheral tissues if blood levels are not available. In this regard, you are right and the only way to find out about the T3 levels is to get it checked. Majority of the times when we prescribe thyroid function test it includes T3 in addition to TSH and T4 levels. You have also mentioned that you are on other medications particularly statins. Looks like your lipid levels are high. In this regard, I will advise diet control and exercise that will help improving your general well-being. However, I would wait until you are done with your cardiovascular examination and ask your cardiologist about the same. Hope this helps.