New results, looks like it's going in the right direction?

Sure

calcichew - like sweets all day - usually one very first thing before coffee even

ranitedene - last thing at night (lets call it PM)

alphacalcidol - around breakfast / post coffee, depends on how rushed I am (AM)

levo' - PM

Pregabalin AM and PM

Propranalol AM and PM

Buscopan AM and PM

multivitamin AM

5HTTP AM

Vit B12 AM

Magnesium AM and PM currently (187mg each) running out of those and will have 1 x 350mg AM

last blood test TSH 0.45 Tg 3.7

Theres also a large element of cantbearsed in the cooking - when its just one, and im rubbish at it, why bother? Its XYZ chips peas/beans/broccoli for me. Tried making pies/stews etc, always bland or too much something. Ill stick to chopping thanks.

Interesting stuff Guy

First things first - you NEED to start tracking the FT4 - this is the thing that's making your heart race and causing you to need the beta blockers. I would guess you're probably up over 30. This really is important to fix with some urgency.

My old hairdresser wrecked his heart by taking illegally sourced thyroxine (above and beyond what his doc prescribed. He incorrectly thought it would keep him young and virile and give him the energy to keep up with the much younger women he was chasing. His FT4 topped 50 and he collapsed. This is a very extreme example but that stuff's dangerous.

There are some really easy wins on your tablet taking though.

You must NOT take calcium chews or alpha calcidol within FOUR HOURS of taking your thyroxine.  Not knowing what's in your multivit, that should probably also be delayed. I'm going to take a guess that magnesium is also one best kept away from the thyroxine. Are you self medicating with all these vitamin tabs or has your doctor advised? Just because you're eating poorly doesn't mean you necessarily need any of this over the counter stuff. 

So first thing in the morning take your thyroxine with a glass of water. Don't eat, don't have hot drinks for at least 30 minutes. Don't take any other tablets. I see you're taking at night - can I ask why? It's REALLY hard to have an empty stomach when you take a night and if your stomach's not empty the tablets don't work as well.

If you GP is disinterested, please ask your pharmacy if they can do you a medication review. They should be able to help you on what to take when and in what combination.

I don't think a guy your age should be taking so many tablets especially when some of them are counteracting the side-effects of others. If you were an 80 year old, I could imagine that cocktail might have built up but at the moment you must be a slave to the tablet dispenser.

To take 250 mcg and still only be suppressed at 0.45 suggests things really aren't working on the thyroxine front and most likely that's because of all the other stuff you're chucking into the mix. 

If you like chopping, how about some stir-fries - you can buy the sauces in pouches, no effort at all. Even my husband can crank out a good stir-fry.

One more thing to watch out for. If you're taking prescribed calcium and topping it up with OTC calcium, it's pretty easy to overdo it.

I had a colleague in the USA who LOVED a brand of chewy calcium tablets and ate them like sweeties - right up to the point that she had to pass a kidney stone because she's over-done the calcium to such a degree that it was depositing in her kidneys. PAINFUL stuff.

So if the doc didn't tell you to take the chews, please don't over do it.

Apparently Elvis thought that if one of anything was good, then two or three was even better - whether that was amphetamines or fried peanut butter and jam sandwiches, it didn't stop him dying on the loo well before his time should have been up.

So seriously, if there's anything on your list that the doc didn't approve, 'step away from the tablets'. It's really easy to overdo the tablets that seem to be innocuous and that you think will be fine because 'they wouldn't sell them in Boots if they were dangerous, would they?'

Sing like Elvis. Gyrate like Elvis. Don't pop pills like him!

I'm well aware of the danger of over doing the calcium I only take prescribed calcium approximately to the amount that the endocrinologist suggested and don't take any over the counter extra

I take a calcium tablet when I start feeling tingles in my fingers or toes or nose! I've had my calcium level tested fairly regularly and it's always on the mid to low range of normal

The magnesium is taken over the counter. Taking the magnesium immediately increased my energy levels andand reduced my tiredness

I asked my endo whether I should take levothyroxine in the morning or evening as there is some evidence to say evening is better he agreed that taking evening was better 

Free T4 as requested

This is very odd. Your FT4 is nice and low. If I saw that in combination with your TSH at 0.45 I would be increasing your dose. If you're getting heart problems at this level of FT4, then I don't think the thyroxine is the problem. Something else in that mix is messing with you. I don't know anybody on Beta blockers with FT4 'in range' like yours.

You are a bit of an enigma. 

So much so in fact, I'm going to tag to see if she can see from your meds if there's a problem, or maybe suggest something you could raise with your GP for investigation.

Lass

Xx

So you're saying it's not the thyroxine directly that is causing the palpitations but normally would be the free T4?

There's a sort of chemical see-saw.

As the TSH goes down, the FT4 'normally' goes up.

Palpitations etc tend to be a problem when the FT4 goes high 20s or over 30. Your FT4 is well within range, so the palpitations are probably caused by something else.

T4 is thyroxine - FT4 is how much thyroxine is floating around in your blood not getting converted to T3. Too much makes the heart race and can cause bone thinning over an extended time.

Heya,

Yes and no.

When thyroxine is absorbed into the body it shows in your bloods as T4. When you've had a TT after thyroid cancer, they normally want to inhibit and suppress your TSH, as this is what tells remaining thyroid cells - cancerous or not - to multiply. So they usually try to get your TSH down to 0.1. Getting the TSH to 0.1, usually pushes your T4 up to over 20 - which for some labs is the max they want it to get to.

For some people though, it takes a higher dose of thyroxine to get your TSH to that 0.1, which in turn pushes your T4 higher. Back in March, I ended up hitting over 28 with my T4, and I started getting palpitations. So my dose was reduced, but also because my TSH was <0.05.

Your T4 is currently sitting under 15, and your TSH isn't suppressed. So any weird heart things you have going on wouldn't appear to be thyroxine related because your T4 isn't high enough to create that effect.

However, the fact you're on 250mg a day, and only sitting at a T4 of under 15 also indicates you aren't absorbing the thyroxine correctly. Now, whether that is because you have food in your stomach when you take it, or the calcium is being taken too close to it, or one of the other things is sticking to it and stopping it from being absorbed - is not something I can say with certainty.

But as Barbara said before, I think it could be that it's a combination of the above, and it might be time to go back to the drawing board with how you take your medication, as well as what medication you take. 

But hopefully Geri will have more to say on that one!

Lass

Xx