6th day on 25mg levothyroxine' still not good.

[minus]

Its the 6th day taking 25mg of levo' still feel exhausted' slightly unreal and away with the fairies would like to get rid of fuzzy head thinking. Do I need to see endo, Dr never mentioned one to me, he just said blood yes for tsh 6 weeks time,??? Any advice? What supplements would help me and when to take them.

[shaws Administrator]

Go back to GP and ask for an increase in medication. Tell him you are feeling worse (that may be due to too low a dose). 50mcg is usually a starting dose (told to me by a Professor of Endocrinology). If you haven't also had a Vitamin B12, Vit D, iron, ferritin and folate, ask for these to be done as we need them at an optimum level, not just within range.

These are vitamins/minerals which are helpful:-

thyroiduk.org.uk/tuk/treatm...

Take them 4 hours apart from levo. When you get your next blood test for thyroid gland, don't take medication until after the blood test if you take it a.m. If you take levo at bedtime, miss this dose and take after blood tests.

[minus in reply to shaws]

I just have had phonecall with dr he doesnt agree with increase thinks it will make me go hyper. he said my t4 levels arent that low at 15 he wants to raise them to 20 not go over that. i have asked for renal test (adrenal) and about b12 folate etc he said he doesnt usually test those, but will do full blood count and if thats ok wont bother doing b12 or vit d.

[shaws Administrator in reply to minus]

He probably wants you to wait the whole 6 weeks on 25mcg levo. Unless you are extremely frail I don't know why he thinks you will go hyper on a minute 25mcg. I also have no idea what he means that he will only do a Vitamin B12 etc if your full blood count isn't o.k.

I hope someone is able to decipher what he is thinking as I cannot.

[Clutter in reply to shaws]

Shaws, my endo told me that as FBC was good my ferritin, vitD, B12 and folate would be too. I persuaded a registrar GP to test them and ferritin was high, vitD and folate deficient, B12 low. I think it's just a fobbing off exercise.

[minus in reply to Clutter]

thanks clutter, i did offer to pay through nhs if that made any difference he didnt respond to that just said lets take one thing at a time shall we. you've obviously read alot of conflicting stuff on the internet.

[minus in reply to Clutter]

p.s i think it bothers him (the internet research) however feel a slight victory as he said he will do fatigue test look at renal function and do FBC which he wouldnt have bothered doing if i hadnt been pushy about these tests being important to absorb thyroxine. he thinks 25mg will be like magic wand for me.

[minus in reply to Clutter]

Clutter, is there any medical journals or online info links anyone can post about the significance of vitamin levels and thyroid just so i can arm myself with ammmunition when i see him next if he blusters about doing anymore vitamin tests for me. if I have medical journal info he cant argue too much with that.

[shaws Administrator in reply to minus]

I don't know if this will help:-

thyroiduk.org.uk/tuk/treatm...

[Clutter in reply to minus]

Minus, 6 days on Levothyroxine is not long enough to feel any benefit. 7/10 days is more likely and it takes 3/4 weeks before it's worth retesting.

Look through the links below and highlight areas you think are pertinent. Your GP won't have the time or inclination to read screeds of printouts. I don't have anything on ferritin but the HU search and Google should turn up plenty. Private testing is available via thyroiduk.org.uk/tuk/testin...

vitamindcouncil.org/vitamin...

b12d.org/b12-signs-symptoms...

b12d.org/b12-and-folate

[shaws Administrator in reply to Clutter]

Considering the most important point too, is that if deficient you will have symptoms due to the deficiency. When do they prescribe B12, - when you have developed neurological symptoms!

[minus in reply to shaws]

i did think about ignoring his advice and taking half a tablet so it would be 25mg +half a 25mg tablet and see how i got on with that for a week.

[shaws Administrator in reply to minus]

I think he is out of his depth. This is an excerpt from Dr Toft who was President of the British Thyroid Association:-

But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up.

Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of its reference range. Levothyroxine in a dose of 75-100µg daily will usually be enough.

If you would like a copy of this article email [e-mail] and question 2 contains the advice.

[Parbrook]

It takes 4 to 6 weeks to feel the full effect of Levo, when starting or changing dose, hence the 6-week wait for the next blood test.

[Pink_Bear]

If you are over 50 they often start you on the lose dose of 25mcg initially to prevent any heart problems - but if your GP is experienced he should be OK to increase to 50mcg before the 6 week blood test. Just go back and ask. No one told me this at the start - and I wish they had - but you do have to be patient, there is no instant recovery. Think months not weeks or days.

[minus in reply to Pink_Bear]

have jusdt rang gp surgery and left phone message to dr requesting permission for increase to 50 mg hopefully he will say yes when he calls back.