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Thyroid UK
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Hi I'm Lisa. Just been diagnosed with hypothyroidism

My levels are tsh 4.54 and t4 11.7

Dr has started me on 25mg of thyroxine every other day.

I feel really shakey have palpatations cannot sleep and have lost my appetite completely.

Any tips on how I can get a good night's sleep or at least when I will start to feel better again.

14 Replies

It's going to take a few months to get you up to the optimal dose on thyroid meds especially if your doctor has asked for repeat bloods to be done again maybe 6weeks or so from now. It takes a while for the thyroid meds to stabilise in your system and hopefully bring your TSH down and increase your T4. The symptoms you describe are typical of hypothyroidism and will get easier as your dosage increases.

Also you could try a natural sleep remedy such as nytol as a short term solution.

I hope you fell better soon.


Thanks for responding. I know so many people just like me who are being given palmed off with depression. I asked the Dr to check my thyroid just to rule it out. I never thought it would come back as being under.

I though I had anxiety due to the loss of a loved one.

Fingers crossed I will pick up soon.

Another thing I've got recently is an itchy scalp? Arghhhhh!!


Hi Lisa

Yep I had same problem about 5years ago. Symptoms like being hit with a truck! Oh and my scalp was very sore and itchy that went away after got correct dosage.

You should see a difference when Doc starts upping your dose. Really glad you asked the doc to check your thyroid...pity they don't think of it themselves.

If you want to get ahead read up as much as you can about hypothyroidism and ask any questions on here just to get you through these next few months even!


Did the doctor give any reason for starting you on such a rediculously low dose of levo? Unless you are very fragile, very old, or with a heart condition, the starting dose should be 50 mcg a day. 12.5 mcg a day is likely to make you feel worse, rather than better. When did he say to go back for your next test?


I thought that. I have felt so much worse this passed week since being diagnosed. All the horrible stories I've read about this illness has shot my anxiety through the roof.

De said my thyroid was working a tiny bit harder than it should do therfore I only require a low dose.

Levels for tsh ar upto 4.5 and mine are 4.54.

T4 was 9 -19 mine is 11.7.

All new to me but I think I need to go back tomorrow. She wasn't very helpful and printed me off a leaflet to read .


She obviously doesn't know very much about thyroid - not many doctors do. You do not judge the starting dose by the level of the TSH. Hypo is hypo, and the starting dose is 50 mcg whatever the TSH. Then, you should get tested six weeks later, and increase by 25 mcg, and continue like that for as long as it takes to get rid of all the symptoms.

What time of day did you have that test? And had you eaten before it? TSH is highest first thing in the morning, and drops through the day. It also drops after eating. So, we always recommend an early morning test - before 9, anyway - and fasting over-night. Also, when you go for your next test, don't take your dose before the test. Leave a 24 hours gap between your last dose and the test. That way, you'll get the highest possible TSH, which is what you want because doctors really only look at the TSH.


I had the blood tests in the afternoon about 3.30. I had consumed lunch and a few cups of coffee at this point. Shall I ask for a re test first thing?


Well, you probably wouldn't get one at this stage. Wait a couple of weeks, at least, and then ask. Labs refuse to do tests if they consider they're too close together.

But, certainly, next time, make sure it's early morning - as early as you can - fasting, and don't take your levo before the test. I'm sure your TSH will be quite a bit higher. :)



Your GP has prescribed a ridiculously low dose unless you have serious heart disease. 25mcg is a low enough dose and it's debatable how helpful that would be.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org.uk if you would like a copy of the Pulse article to show your GP.

For maximum absorption Levothyroxine should be taken with water 1 hour before or 2 hours after food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.



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

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I have to go back in 6 weeks for another blood test to check my levels.



Make sure its an early morning and fasting test and take Levothyroxine after the blood test.

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I will do. What other tests are important for me to ask for or can I get them done privately?



See if your GP will do thyroid peroxidase antibodies, ferritin, vitamin D, B12 and folate. They can all be done privately if necessary.

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I will ask I'm going g back tomorrow as my scalp is driving me crazy, why don't they do these tests in the beginning? It just don't make sense to me!!


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