u/Gold_Warning_8618

I could use advice from other systems with hypothyroidism who take thyroid hormone replacement.

Since starting levothyroxine (generic synthetic thyroid hormone) for my hypothyroidism, my persecutor (or maybe abuser interject? still figuring that out…) is just RIGHT THERE all the time. It used to take me a couple hours of other parts fronting to deal with a trigger, without success, before the persecutor would come out and it was usually self-directed or internalized.

Since starting the meds, I switch straight to persecutor, and it’s externalized. Violent, aggressive, angry. I say the the most horrible things in this part. And the whole time there is a clear voice in my mind saying what I should actually be saying and doing, but it can’t get control. It’s like it’s locked behind a screen door where I can hear it, but it can’t step in. This part has never spent so much time “out”, and it feels like it gets stronger every time it happens.

When I was hypothyroid triggers would generally go ANP -> young pleading/attach/cry for help-> persecutor to punish the vulnerability

Now it’s ANP -> persecutor

Do you experience destabilization of a part or system with thyroid meds? Did/does anything help with the aggression? I find any medication that shifts my neurochemistry is likely trigger an emotional collapse, but this behavior is unprecedented.

I had a partial thyroidectomy in October 2025 for multi nodular goiters. Thankfully pathology came back non cancerous. TSH prior to surgery was consistently 2.2-2.5. Probably had subclinical hypo but was functional.

TSH post surgery was 4.5, second draw was 3.4 (trending downward). Suddenly got really fatigued. TSH was about 6. Endo started me on 25 mg levo about 1 month ago.

I take in the morning on an empty stomach and do not eat for at least 2 hours. Supplements separated by at least 3-4 hours. I take famotidine at night before bed, but no other prescription meds. I also try to limit fiber to lunch or dinner.

Having to be up 2-4 hours before I can eat is worsening my blood sugar control. I am mildly insulin resistant but not diabetic. The hypothyroidism probably isn’t helping there. I also eat a low saturated fat diet and am moderate with carbs.

Since starting levothyroxine I am also experiencing:

Continued fatigue

Increase in weight gain (both fat and water retention). The fluid retention in my abdomen is pretty bad by the end of the day. It goes down after a nights sleep.

Increase in facial puffiness

Possible increase in muscle strength/stability in neck and legs-but I could be imagining this or it could be the result of something else

Does this get better/stabilize? Weight gain sends my blood pressure through the roof. I feel worse than before I was on the medication and it only seems to be worsening preexisting metabolic issues.

I might have to start taking PPIs for esophagitis treatment soon which means I have to wait a full 4.5 hours after I take my meds to eat. I honestly want to cry thinking about how I have to time everything around this, and how it’s probably making my glucose control worse in the long term.

Waking up at night to dose isn’t an option as I already struggle to sleep a full 7-8 hours. This would disrupt an already fragile balance. I almighty might need to resume taking carafate at night (it coats your stomach and esophagus). This would bind to the thyroid hormone from what I understand. So there is just no workable timing for evening or early morning dosing for me.