Thyroid UK

Usual symptoms?

Hi all, I have hashis . The hospital doubled my Levo yesterday to 50mcg after blood test of tsh 49 and t4 5.9 she couldn't remember ranges on phone! I was there for follow appt after being admitted a couple of weeks ago after being very ill and lost my balance and v high bp etc. I took 50 at 6 am, got up at 9 ish feeling very disorientated and shaky is his normal on increase?

5 Replies

I'm sorry to hear you are having such a rough time getting your thyroid sorted out :(

What you describe isn't a normal reaction but it's not uncommon. One of the most common causes of a reaction like this is low iron and ferritin levels. It is really important that you get these checked. Your serum iron needs to be well within range (i.e. not near the bottom) and ferritin above 70-90. If they are lower than this you need to supplement with iron, vitamin C and vitamin B2 to get your levels back up again.

It would also be wise to get your vitamin B12 checked (needs to be above 500 for good health) and your folate level. Vitamin D test would also be a good idea. It is actually a hormone that is used in over 300 metabolic processes.

You might also find that you feel better if you take your thyroxine at night, at least 2 hours after food. Many people find they are better taking it at night.

Another issue could be low cortisol, especially if you have been unwell for a while. If you do a search online for "adrenal fatigue" you should be able to find lots of information including things you can do to help your adrenals recover. This is the missing part of the puzzle for a lot of people.

See how you are over the next couple of days but if your symptoms continue you could alternate doses. One day 50mcg and the next 25mg for a short while and then try 50mcg a day once you are used to it.

25mcg is a low starting dose. The usual is 50mcg unless you are elderly or have a heart condition. I would expect that you will eventually need at least 100mcg daily and possibly considerably more. You will get there eventually but unfortunately it can take some time :(

Don't forget to look at the main Thyroid UK website for information on hypothyroidism. The menu on the left hand side has all the links to various information on thyroid health.

I hope that helps



Hi Carolyn thanks for reply , I have been anaemic for a few years and take lots of ferrous fumate but have been missing doses while ill! Will I be able to sleep if I take it at night? I have read the adrenal fatigue link that compares with thyroid and I have almost all of adrenal symptoms for last couple of years. Am waiting on endo appt should be in next few weeks. Have had thyroiditis for two months and thyroid has only just stopped hurting and is less swollen. Scan was ok no nodules or anything just irregular shape. Each day is nightmare as have no idea if I will be a now to function or not! Have been off work for two months so far!!


You should be able to sleep if you take it immediately before bed. I take my thyroid meds at night and actually sleep much better. It might be worth a try.

Remember to make sure there is at least 4 hours between your iron and your thyroxine for best absorption.

I hope you start to feel better soon.


Same here - I feel that taking levo at night helps me sleep. Good luck!


I think the higher your TSH, the harder the reaction to your new dose becomes. I had terrible pains when starting my Synthroid but somehow knew it was an improvement anyway.


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