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On Levothyroxine For Hypothyroidism. Started Heavy Menstruation And Back Pain. Are They Related?

Posted on Wed, 14 Nov 2012

Question: I am being treated for hypothyroidism. I'm on 100mcg of levothyroxine a day. I've had a lump in the front / very slightly to the right of my throat for 6 months. I had an ultrasound 4 months ago and nothing was found. The lump feels a bit bigger now and is a bit painful. I feel nauseous and as though I am gagging all the time. In addition, I am having very heavy menstruation that stops and starts so that each period is lasting 7 to 10 days. I get lower back pain with this. Is all this related to my hypothyroidism and what can I do about it? Thank you for your help.

Answered by Dr. Shehzad Topiwala (11 hours later)

I prefer to order a blood test for thyroid antibodies such as TPO and TG antibodies to ascertain chronic permanent hypothyroidism that necessitates lifelong levothyroxine replacement therapy. Positive result for either of these two typically indicates the presence of permanent hypothyroidism, although in some instances these can be negative and still the individual may well have a permanently underactive thyroid.

The lump in your neck was not detected on ultrasound. However given your symptoms, an evaluation by an ENT doctor is desirable.

If your TSH is in target range then your menstrual problem cannot be ascribed to the thyroid condition.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (9 hours later)

Thanks for your advice. My last TSH result was 4.9. This was taken 1 month ago and as a result my doctor agreed to try me on 100mcg (I had been on 75 mcg for 10 months). He agreed to increase the dose because I was still having symptoms but I think he feels the TSH is at an acceptable level.

Could TSH of 4.9 explain the menstrual problem or do I need to look at something else?

Is there anything I can do about the nausea and gagging sensation? I am waiting for an ENT appointment but this may take a while (I'm in the UK).

Thank you for putting up with my stupid questions.

Answered by Dr. Shehzad Topiwala (9 hours later)

Your doctor made an appropriate adjustment to the medication dose. It would be worthwhile to recheck TSH and free T4 in a couple months to ensure this dose is fair.

But a TSH of 4.9 is unlikely to cause a major menstrual disturbance.

I cannot advise you anything further on the nausea/gagging. Such symptoms require prompt assessment

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar