Levythyroxine - how long until it works?

[Gordella]

Hi, please can you help

~8 months ago I had a hemi-thyroidectomy, as a large goitre had been found on my thyroid. The surgery went as planned and all was removed.

Following the surgery I had a few weeks of feeling strange - the dizziness was the worst as I wasn't expecting it, however my GP didn't necessarily think the dizziness was related to my surgery?!

Just over 3 months ago - after a raft of blood tests, I was diagnosed with hypothyroidism and my GP started me on 100mg of levothyroxine.

Perhaps now I should mention that prior to surgery I had normal thyroid function and was fit and healthy. Since my OP, my weight has increased by just over 2 stone!

After 3 months of taking the medication I went back to my GP as my weight hadn't changed and while the foggy headed-ness and lethargy has lifted, my weight is still a huge issue (no pun intended!). Just 2 weeks ago my GP increased my levels to 150mg per day and I just wondered how long it might take for me to notice a difference?

I have of course asked the GP but to be honest the advice was vague and that "it can vary per person" (which perhaps that is the only real answer there is?). I have conducted many internet searches and to be honest have found the negative side & long term effects' stories very scary, especially as I understand I will be on this treatment for the rest of my life. The posts I have read are interesting but the experiences are slightly different to mine, so I wanted to share my experience and seek advice.

In case age/gender has an impact, I'm female aged 36. I eat and drink sensibly - like I did prior to my op, I exercise regularly and am not relying on the medication alone, however I'd be grateful if someone could advise how long it might take for me to see a difference please!

Many thanks in advance

[Clutter]

Welcome to the forum, Gordella.

Do you have thyroid results with ranges (figures in brackets after results) to help members comment?

50mcg increase is quite large. Dose adjustments are usually in 25mcg increments. It takes 7-10 days to absorb the increased dose and up to six weeks to feel the full impact.

When you are optimally medicated you should stop gaining 'hypothyroid' weight but may have to exercise and reduce calories to lose weight which built up.

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Gordella in reply to Clutter]

Dear Clutter, thank you for your response

I am new to this community and didn't realise I hadn't validated my email address, so apologies for the delayed response!

My latest bloods showed:

Serum TSH: 1.5 [0.55-4.8]

T4 level 18 [9.0-23]

Before my op, back in March, my levels were:

Serum TSH: 0.8 [0.55-4.78]

T4 level 16 [9.0-23]

Thank you once again for your help

Best wishes

[Clutter in reply to Gordella]

Gordella, Higher FT4 and lower TSH may help you lose stubborn weight if you can exercise. If TSH 1.5 and FT4 18 were when you'd been taking 100mcg you may be over replaced on 150mcg. Racing heart, palpitations, jitteriness and diarrhoea are signs of overmedication. Reduce dose to 125mcg if this happens and request a follow up thyroid test to check levels.

_______________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Gordella in reply to Clutter]

Thanks clutter

My next test is due in January and thankfully I haven't experienced any of those symptoms yet, but if I can take less meds safely im all for it! Could be a silly question but my pills are in 100 and 50 sizes. To take 25 should I try cutting 50s in half?

Thanks again

[Clutter in reply to Gordella]

Gordella, don't fix what ain't broke. If you feel well on 150mcg stick with it. If you feel overmedicated then do halve the 50mcg tablet and reduce to 125mcg.

_______________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Hidden]

Hello Gordella & welcome to our forum.

I am sorry to hear about your op and weight gain.

Thyroid hormone runs your body’s metabolism and when levels are low the BMR (bodies metabolic rate) becomes slow, burning less calories.

You have not been medicating very long and it can take a while for hormones to rebalance.

Once optimally medicated your weight issues should right themselves. Do you have recent thyroid hormone blood test results to post complete with ranges (numbers in brackets) for members to comment on your levels?

Elevated cortisol levels due to the op and subsequent hypothyroidism may have encouraged high cortisol levels which will encourage fat around the abdomen.

An unhealthy diet will encourage a dysfunction in the hormone leptin that is usually secreted to tell the brain there is adequate fat storage (similar to insulin resistance).

Leptin resistance makes the hypothalamus (brain) believe you are in starvation mode, slowing down your BMR, slowing thyroid hormone production and storing more fat.

Eating a balanced diet of carbs, protein and fats at regular meal times will encourage good blood sugar levels and stop insulin spikes.

Don't try dieting as a high TSH won't allow weight lose.

Flower

Why the BMR slows down

holtorfmed.com/tips-for-los...

The importance of supplement in people suffering thyroid issues

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

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Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal before applying any of these suggestions.

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[Gordella in reply to Hidden]

Hi Flower 007, thank you for your response

I am new to this community and didn't realise I hadn't validated my email address, so apologies for the delayed response!

my latest bloods showed:

Serum TSH: 1.5 [0.55-4.8]

T4 level 18 [9.0-23]

Before my op, back in March, my levels were:

Serum TSH: 0.8 [0.55-4.78]

T4 level 16 [9.0-23]

Thank you once again for your help

Best wishes

[Hidden in reply to Gordella]

Gordella,

Good advice from clutter above re meds.

The goal of Levothyroxine is to restore the patient to euthyroid status and for most people that means TSH just above or below 1.0.

Symptoms can lag behind good biochemistry by 6-8 weeks.

It is important to take your pill on an empty stomach with a glass of water, 1 hour before food, 2 hours before supplements and 4 hours before calcium, iron or vit D supplements.

People with thyroid issues often have vitamin deficiencies and it is recommended that you have tests for B12, Vit D, folate and ferritin as optimum levels are required to ensure thyroid meds are absorbed. Ask your doctor as low thyroid hormone will compromise nutrient & iron levels & post results complete with ranges for members to comment..

Flower

This following link explains the importance of vitamins and where they may be obtained. This forum is supported by the charity ThyroidUK. You do not have to join the charity to benefit from this forum but by doing so you will be supporting the charity and also entitled to various discounts when buying supplements, as detailed in the link below.

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

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Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

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[Gordella in reply to Hidden]

Hi there thanks again for your quick reply

I've been looking at the last few results and the previous set show tsh 3.3 and T4 of 15

Would that indicate the 100mg of levo is doing what its supposed to given the most recent results in my last post?

I exercise daily with my dig walking (fast pace) then I exercise 3x per week doing aerobic exercises. Keen to get back on track asap but don't want to start an unrealistic regime that I'd struggle to maintain long term

Thanks again

[Hidden in reply to Gordella]

Yes TSH is going down and T4 is going up as you would hope for.

Exercise is a fine balance Gordella,

Low impact exercise won't stress your adrenals which may be low due to coping with previous low thyroid hormone.

Supplementing selenium will help with T4- T3 conversion.

It is the T3 that will increase the BMR in nearly every body cell and especially the muscles.

It does so by causing the fat cells to release free fatty acids into the bloodstream where they are taken up by the tissues and burned by the mitochondria to make the ATP that drives muscle contractions.

Do not restrict calories as this can cause the body to lower its BMR to conserve energy (and so decrease thyroid hormone production) and don't exercise too intensely as you can use up too much T3.

Stamina will grow and you will know when you can do more.

Gentle exercise will lower cholesterol and triglyceride levels and make you feel happy.

I am happy now I can exercise (gently) again. .. lol.

Flower

Selenium and thyroid hormone conversion

ncbi.nlm.nih.gov/pubmed/161...

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Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

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