I have increased my dose of thyroxine by 25 mcg from 100mcg daily to 125 mcg one day and 100 mcg the next.It is just the first day of

[susiebow]

increase(hypo) and I feel awful,should I continue?is this common to feel odd when increasing till things settle.

[Moggy1]

Hi Susiebow

I usually feel pretty awful for a few days following an increase before starting to feel the benefits. I think this is pretty normal, although not very nice.

[Jackie]

Hi One thing springs to mind,did you have a blood test for TSH T4 and FT3 before going up on the meds. Most Endo`s insist that is vital. When I was under a private doc, he just put my meds up according to how I felt etc, no bloods In my case my hypo symptoms were the same as hypo my Endo says this can be so.

Best wishes,

Jackie

[Parbrook]

In my case, I feel better very quickly when increasing the Levothyroxine dose.

Are you mixing two different brands of Levothyroxine to take 125mcg?

If so, I suggest that you only use one brand.

I stopped taking the Mercury Pharma 25mcg and replaced this with half an Actavis 50mcg in half in order to take 125mcg using a single brand.

It seems that some people have allergic reactions, or feel worse, when taking a specific brand (or mixing brands).

[TSH110 in reply to Parbrook]

Excellent suggestion on how to take 125mg of the same Levo tablets and avoiding wockhart 25mgs - I find them hideous!

[TSH110]

I do 100mg every day and an extra 25mg 4 days a week (I lay off on the weekend plus Monday cos it is easy to remember) but I don't think my body likes different doses very much. I have never felt that great since developing hypothyroidism, despite supposedly being 'optimised', I deffo feel more odd and I get a lot more hot sweats on the 100mg days, reaching a crescendo on the Monday evening! I also asked for Almus this time at pharmacy as suggested by someone here, but 25mg are only available as the hideous tasting Wockhart tablets (in the UK). It is a great suggestion to get Almus 50's and split them. I will do that next time I get my new prescription to avoid the bitter tasting 25mg tabs and to keep to the same type of Levo tablets to see if this helps. I seem to be very sensitive to even small alterations in dosage. I hope you find it settles for you on the higher dose. You could try blocking them like I do to see how that feels if things don't settle after a couple of months. I feel better overall even for one more 25mg tab a week. If I do 125mg everyday I feel much better but doc said I was hyper and insisted I drop the doseage.

[Parbrook in reply to TSH110]

For your info, Almus = Actavis.

Almus is the Boots brand name on the box, but you will find an Actavis patient information leaflet in the box.

Regarding your doc saying you are hyper on 125mcg, I have a similar situation. In my case, my T3 is too low unless I have 125mcg, but it puts my T4 too high, which seems to indicate that I am not converting T4 to T3 very well.

My current challenge is getting Liothyronine prescribed at the right level. My GP let me try 5mcg, but it was clearly not enough and he is not willing (yet) to let me try a higher dose.

[TSH110 in reply to Parbrook]

Oh thanks re the names. I am terrible for mixing names up that are simiIar! I knew it was one not made by Mercury Pharma. I had those previous and thought the Activis ones seemed better. I notice some people here saying the MP tabs are not working properly.

It is very interesting what you say. I have wondered if my continuing problems might be related to the T4 not being converted properly to T3. I would try NDT to see if there is any improvement (despite having been vegetarian for 30 years - that's how desperate I am to try and improve on how I feel on synthetic levothyroxine) but it sounds like it is very hard to get GP's to prescribe it at all in the UK which I think is bonkers. I am going to ask my GP even if it is a small dose with the Levo, but I suspect she'll say no way. She is very keen on TSH as her main diagnostic tool, she is not unsympathetic to my continuing symptoms and has tested for possible culprits but says all my tests are fine. I broke my ribs when I was on 125mg and she said it was because I had become hyper. Bone density tests I had later showed I had no sign of any problems, and were very strong indeed. I broke the ribs years ago in a bike accident and they just seemed to suddenly re-break. There have been no problems at all since then. I must ask for my next bt results and post them here for advice. The other problems I have is a faster heart rate by 20bpm since becoming hypothyroid, which is unusual, accompanied by heart pains. I have become breathless on mild exertion - probably because I have put on so much weight; I crave food (this also came on with the hypo I used to be very slim and had a normal appetite) The doc told me to stop running because I developed a Bakers cyst at the back of my knee. I felt so much better when I did some jogging. Sorry to rabbit - on this disorder has so many weird symptoms.

[Parbrook in reply to TSH110]

On 125mcg Levo, I have symptoms of both hypo and hyper. My feeling is that this is due to too much T4 (thanks to 125mcg Levo) and a low T3 (due to poor conversion).

Breathlessness on mild exertion is, for me, a hypo symptom. A heavy heart-beat is what I get when I am on a too-high dose of Levo.

Most docs seem to be keen on TSH, as this is what they are taught. TSH seems to be mostly important for an initial diagnosis. Once you are on medication, FT4 and FT3 are very important things to monitor.

It seems to be that there are a number of different and complex medical problems that are lumped-together under the banner of "hypothyroidism" that need different solutions, especially when the person has additional health issues. This does not seem to be widely recognised by the medical profession.

[TSH110]

Thanks for those pointers. I shall pay attention to the FT4 and FT3 on my next test result and see what they reveal. I think the breathlessness might be due to iron deficiency. The heart pains have afflicted me throughout when I was hyper and later hypo. I also had episodes of them in my late 30's and about 4 years before being diagnosed (I was diagnosed at 52). I had problems in one chamber of the heart and was tested at John Radcliffe hospital - they said it was something some women got due to changes in hormones and nothing more was done about it. If I tell the doc I am getting heart pains she immediately insists it is because I am hyper although I keep telling her I have had them all along no matter what my status. The higher heart rate came on as soon as I took Levothyroxine it is about 20 beats faster across the range except the top end is the same maximum ie my top rate is still 211bpm (I was a keen runner and cyclist and used to compete a lot. I used heart rate monitoring extensively as part of my training hence me knowing it is not the same now). Maybe it is caused by the drug or my heart could have got damaged with the huge increase in thyroxine as my thyroid died - I went into a crazed overdrive after having be virtually comatosed for about a year and then a massive drop to nothing or virtually nothing as I plunged into hypothyroidism - I only got treatment then and thought I had had it - I cannot describe how cold I felt and how hard it was to keep awake except with the nightmares, hallucinations and excruciating cramps in my feet and legs rousing me. God it was scary. I have moved on hugely since then but the constant tiredness and not feeling quite right are still frustrating. I met a lady in the park, dog walking when I was recovering, who had Graves' disease when she was very young and her story was truly terrifying. She was a real brick and helped me so much, it is easy to feel very alone with these thyroid illnesses.