Dose increase

Hi there, just a quick question. My GP increased my dose by 25mcg every other day. It's been 3 weeks and I feel that it has had all the effect it is going to. However I still have to wait another 4 weeks for my blood tests.  I know the GP won't text before then but for my own knowledge would the tablets have done what ever they were going to? (Still feeling unwell) and would a private Endo test in advance of the 6 week point or make me wait. 

Thanks in advance

13 Replies

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  • CBann,

    It takes 7-10 days to absorb the increased dose before it starts to work and it will take up to six weeks to feel the full impact of the dose increase.  It takes 6-8 weeks after increasing dose to see how thyroid levels respond.

  • Every other day? So - having looked at your last post - 50mcg one day and 75mcg the next? I think that was a very cautious move - I can't say I'm surprised that an increase of 12.5mcg hasn't made a lot of difference...

    62.5mcg is a fairly small dose still. But to answer your question, in about another week you'll have got all the benefit. Most say 4-6 weeks.

    If you see a private endo, you'll probably have to pay for the blood tests as well.  Think I'd go back to my GP at the 6 week mark and ask to be retested.

  • Thanks both. Since my last blood test they have increased my dose twice each time an extra 25 every other day. So I am now on 75 mcg daily. I suppose the reason for my impatience is that my hair is falling out. Not loads but enough to worry about. I've not got thick hair anyway.  I have a blood test booked with the GP for 6th may but because I panicked and I have the insurance I booked in with he Endo on 28th April. I've seen people on here say that going on T3 helped them with their hair but my GP will not test it. 

  • Hi CBann, I know it is really awful when you start losing hair, I was so upset, but mine has stopped now. I started on 50mcg Levo and gradually moved up and in time my hair stopped falling out. I do have other symptoms still so not quite there yet but sometimes you really do have to have a bit of patience even though it seems to take forever and really drags. I was trying alsorts for hair loss and then just suddenly realized it had stopped (touch wood ). I have realized that it is significantly worse with stress though as are all my symptoms. I'm not saying this will happen for you but it may do given time. It is really important though to try to keep stress levels to a minimum IMO. Also have you had Iron levels checked because that also can have an impact on hair loss. Good luck, hope you start to feel better soon 

  • Thank you, I have had my iron levels checked and I have been told they are ok. I thought my stress levels were quite good till last week. That's when I started worrying about my hair, realised that my hands looked so old and my skin and nails were peeling. It's prob just the time in the month and a shift in my hormones. I am getting chronic back ache that actually woke me up last night and period pains from hell.  I feel worse than before I went on the tablets, but hopefully it's just that things get worse before they get better. 

  • Being 'told' they are 'ok', isn't good enough. You need to see the numbers.

    Always, always ask for a print-out of your blood test results - it is your legal right to have them. Don't just take your doctors word for anything. Because if he's anything like the majority of doctors, he knows nothing about hormones and nothing about nutrition. He will say that it's 'ok' if the result is just 'in-range'. But 'in-range' isn't always optimal.

    You need to know exactly what was tested and the exact results. :)  

  • I did think someone might say that :) I should hopefully get the numbers as part of referral if not I will ask them to be added. I got tested for iron at the same time as my thyroid when I got diagnosed back in October last year - is it likely that my levels will have changed since starting the Levo? Also what supplement can I take without testing. I am currently taking D and folic acid. I was actually thinking about seeing a nutritionist - does anyone know if that's worthwhile? I would be researching to find one that was knowledgeable in thyroid problems. Sorry I am full of questions. Thanks 

  • If you Don't ask questions, you never learn! :)

    Personnally, I would say no, not Worth seeing a nutritionist. I think you'll learn more on here than you can from an NHS nutritionist. Others might disagree, but that's my take on it.

    What are they going to tell you that you a) Don't already know or b) can find out with a bit of research?

    It's perfectly possible that your levels of iron have changed since October. But whether for worse or for better, there's not knowing.

    Is it vit D3 you're taking? How much? What was your level on testing? I would advise taking some vit K2 with it because vit D3 increases the absorption of calcium from food. So you need the K2 to direct the calcium into the bones and teeth, and not the tissues.

    I would not recommend taking folic acid. It is synthetic and not well absorbed, and has certain other disadvantages. Did you have folate tested before starting to supplement?

    You really, really need a base line before starting to supplement. You need vit D, vit B12, folate and ferritin tested. supplement any deficiencies, and then build up from there.

    It's quite possible that you are deficient in B12. Hypos often are. But you need to know your level so you know by how much to supplement. Optimal for B12 is 1000, no matter what the ranges say.

    And, if you are supplementing with B12, it's best to take a B complex, because the Bs all work together, and  need to be balanced. Get one with methylfolate, and that will bring your folate level up if it's low.    

    Vit D3 works with magnesium and zinc. I Don't think it's strictly necessary to test them because most people are deficient in them, anyway. You can just start taking some at low doses, and increase slightly. But not both at once. Always leave about a two week gap between starting different suppléments.    

    If you need to supplement with iron, it's best to take about 1000 mg vit C with it. This helps absorption and minimises constipation.

    Even if you Don't need iron, it's good to take vit C - but a good one, made from fruit, not just fizzy ascorbic acid from the supermarket. It would appear that it's best taken at bed time, and build up your dose to gut tolerence - from 3000 to 5000 mg.

    And may be you could take some selenium without the need for a test. Selenium helps with conversion, and has a beneficial effect on antibodies, if you have antibodies.

    You always have to ask for results. It's very rare that doctors just hand them to you on a plate. They either think you wouldn't understand (Don't bother your pretty little head with things like that, dear) or they just plain Don't want you to know! So, Don't forget to ask every time you have a blood test! :) 

  • That's great, thank you so much for all the info. I have had most of these things tested I believe. So will hopefully beable to post these on here once I have them (call with the doc scheduled for Friday). I take 2000iu of vit D3.  I can't remember what my level was but it was in the insufficient range rather than deficient. How much k2 should I take. I decide to start taking folic acid as I really want to start a family (I was diagnosed with unexplained fertility just before I was diagnosed - I am really hoping that getting my levels sorted will be the answer). Should I stop the folic acid? With the magnesium and zinc, selenium how much would you recommend of these? 

  • If I were you, yes, I would stop the folic acid. Then wait and see what your B12 level is to decide what to replace it with.

    I would say :

    100 mcg vit K2

    15 mg zinc

    400 mcg magnesium.

    Selenium, I'm not too sure. I think the usual dose is about 55 mcg a day. People talk about taking Brazil nuts to get selenium, but that's rather a hapazard way of doing it. There's no guarantee how much selenium there is in a Brazil nut. It can vary greatly.

  • My pmt is quite bad. I can't remember how bad it was before the Levothyroxine but I know it's worse now. Don't know if it's the hypo, the meds or my age ( 46, so could well be menopausal ) or a combination of the three but it's awful, I get so down and tired. I was never told that my iron levels were low but when I got all my test results on line it showed that they have been low for years. My ferritin is very low at the moment at 14.5 but my doctor doesn't think so because it is 'in range'. In range is not good enough for us sick people we need optimum levels for the thyroid meds to work. My low iron levels are no surprise to me. You have to ask for your exact levels and supplement yourself because unfortunately GP's know j..k s..t about it so don't take their 'it's okays' and 'normals' and take your health in your own hands otherwise you will never feel better. They can't be trusted simple as. Also wrinkly hands, dry nails are quite a common sign of hypo and may well get better with the meds, hope you feel better soon

  • Do you have thyroid antibodies? If so then you should expect to need an increasing amount of Levothyroxine as the months and years go by. The thyroid antibodies (which 90% of hypothyroid people have) gradually destroy your thyroid so it produces less and less hormone and you have to take more replacement. Doctors don't tend to tell you this. Eventually your thyroid will stop producing anything at all and you will end up on a full replacement dose of Levothyroxine, but you aren't anywhere near that yet.

  • I don't think they ever tested for antibodies. They came up with an excuse as why they didn't need to. I can't remember what it was 

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