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Followup To
Question -
Greetings,
since my teens i have had troubles with swelling. The most severe is overnight- when I wake up my eyes and sometimes my face are swollen, very watery, very moonface. It is always worse if I eat salty food or restaurant food the night before. At times exercise like hiking, walking or jogging makes my fingers and hands swell. Also in the morings my hands and feet are swollen ie- my rings are tight shoes snug.... All of this swelling goes down during the day, but not entirely above & below the eyes.
I have been hypothroid for 12 years and take .125mg levothyroxin. I am very healthy with a healthy lifestyle (i teach yoga); I have had three children; I maintain a good wieght (5'4" & 115 lbs).
I have been looking for relief for years.
Thank you.
Leslie Hunter
Answer -
Hi Leslie,
I was going to ask you about your thyroid, but you already answered that question. Swelling can come from a number of things. Salt intake is an issue, hormonal imbalances, the possibility of a connective tissue disease, heart and kidney disease is also an issue.
The hand and finger swelling during walking, jogging and hiking is not unusual due to the dependent position of the arms. This occurs in just about everyone.
I'm more concerned about the edema that you have in the morning.
Your Hypothyroidism may be the source, especially if your supplementation is not enough or the Levothyroxine is not being converted to the active form of Thyroid hormone (T4 to T3).
Greetings Dr. Cusumano,
just one more question- how do I know if Levothyroxine is not being converted to the active form of Thyroid hormone (T4 to T3)? I recently has a blood test done but noticed that the order was only for T4. When I first went on this thyroid med the edema went down noticably (moon face reduction!) but over time it has returned.
AnswerHi Leslie,
The T4 only looks at the stores of Thyroid hormone available for use. It doesn't tell if it is being converted to the useable form. I always look at a T3 and T4 as well as a TSH when checking my patients to be sure that the hormone is being utilized properly. I would ask to have a TSH and T3 done to better assess this.
