Thyroid UK

Levo Dosage Adjustment Knowledge

I just wondered how the knowledge regarding the gradual uptake of thyroxine was acquired and whether it has been challenged?

From my own experience, I have felt relief from painful symptoms and a plummeting mood within 30 minutes of taking a small amount of levothyroxine. At the time of taking the extra amount I was very anxious about increasing it but couldn't bear the symptoms. Therefore, I was suprised to find relief as I thought something worse could happen.

Also, as T4 is a storage hormone and some people can take a weekly dose of more than 700, if the thyroxine is needed (in cases of hypothyroidism) then wouldn't it just be stored and utilised for T3?

As the uptake of one tablet a day is artificial and doesn't respond to increases in activity, isn't there a case for supplementing at times of extreme exertion? The author of 'Stop the Thyroid Madness' stated that she supplements at such times with Armour which is natural thyroid so how would this be different with Levo?

Many thanks for your insights :)

12 Replies

Hi Nade, How well is your thought process working? This website has some great explanations if you can keep up with them. The part about T4 transport probably has the information you are looking for. There are many links as well.


Hi Heloise

Thanks a lot for the link, I will read it later :)

This is an amazing site but I'm quite new to all this knowledge and find it hard to keep up with a lot of things as I have three small children and struggled with induced hypothyroidism, as I trusted a doctor despite expressing doubt.

It's great when someone can provide a link to a specific question and I do try to search the web and the forum first.


You have very good questions and though I have been reading articles and publications about thyroid for many years, I, too, wonder if anyone has an answer some of them.

I use that article to reference different questions but I know your life is too busy for a lot of research. Thyroid disease has a huge learning curve attached so you might have more success submitting short pointed questions.

I don't know if this would answer one of them but Armour being a natural extract from pigs contains T4 plus T3 and calcitonin which probably assimilates in a different way than a synthetic straight T4 like Levo.


Yes, I've nearly finished reading 'Stop the Thyroid Madness' but I think I will read it again. That is a strong advocate of Armour but I need to learn a bit more.

Thanks again :)


Some people with Hashimotos, get worse on Armour and other natural products. It is adding the Thyroid that the body attacks. Makes me very ill.

1 like

Interesting post! I have found that if I forget my dose on a morning then I can usually tell by lunchtime which is illogical!


Armour has t3 which works quickly and will give needed energy..t4 takes a week, to feel a partial effect, if at all. Some people don't convert well, like me and t4 meds don't work very well at all.


Your experience is not the same as everyone else. For example, I recently felt I was slightly under-dosed. And I started to take an extra 25mcg levothyroxine every other day. I noticed the very first tablet and, had I not been asleep, I'd probably have been very aware within an hour of taking it.

I have seen the impact of tiny amounts of levothyroxine on someone else - and they have been visible within ten minutes.

But even if these doses are detectable, only sometimes and in some people, the impact of a small changes on a more or less one-off basis is very different to that of the same change on a permanent basis. It is then that taking it carefully is important.



Yes, I don't notice my daily morning dose but only the extra small dosages when I have been symptomatic.


Hi Nade

An excellent question. I too experience the effects of levothyroxine quickly. As you know, the body converts T4 into T3 on an as needed basis. I think if your body has no problem with the conversion, it is very possible that your body says, "Well I'm in need of some T3 right now, so I'm going to convert this T4 that you've just supplied with your medication." There's a lot of talk about how NDT is better because it's natural but the T4 in levothyroxine IS bioidentical.


I have been harboring similar questions as well as wondering why sometimes taking a small dose of NDT at night often lessons pain and other weird symptoms and I sleep well on it. Other times I'll take a dose at teatime and it will keep me awake. That is a bit different to the T4 question you raise in that T4 loads in the system ready to convert and T3 shoots in straight away - or within 2 hours for me. But even I can feel brightening effects from that within half an hour. That said I am way of optimal dose and lots more research to do. Maybe I will always hover between over and under dosing. As for taking T4 all in one go...think I'd go off bang. I have a friend with no thyroid and she takes 400 levo every morning and has the shakes for a little while soon after taking it. Yes...go figure!

I'm a bit concerned to read that taking natural thyroid attracts antibody attack for hashi folks. But then, surely most of us are and many on NDT.


Thanks for all the replies, it's been really interesting to see how others feel, too :)


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