New here...Levothyroxine dosage issues

[kcrowell]

Hi there. So I finally got my doctor to treat my subclinical hypothyroidism (TSH 8.41, T4 normal) and was prescribed 50 mcg of levothyroxine. Made me feel AWFUl, super super tired although I didn't previously have that symptom and over all just in a funk. Had some heart palpitations so the doctor lowered me to 25 mcg. Now I don't feel any effect. Seeing doctor on Tuesday and hoping she will up my dose as I think that's what I need. Has anyone had similar circumstances with the dosage? I think I need more meds not less but we'll see what bloodwork shows. So sick of feeling this way.

[Dahlia17]

25mcg is the usual starting dose, 50 was too high. It's supposed to go up in increments, with blood tests to check after 6/8 weeks. You can actually post your results on here with the ranges in the brackets as well and someone will be able to advise you on them.

[kcrowell in reply to Dahlia17]

Thank you! I figured that was probably what is was. Hopefully I wont feel as terrible this time if she increases me again to 50 mcg

[Hidden]

I'm sorry I cannot be of much help as I have not experienced this myself, but have you been tested for thyroid antibodies (anti-TPO) and anti-thyroglobuline? Years ago, when being diagnosed with Hashimoto's disease, I was told by an endocrinologist that, when the thyroid gland is starting to fail (due to the autoimmune attack), the first thing that happens is that the TSH starts to rise (and the TSH should ideally not be above 2, preferably even closer to 1 in euthyroid people (=without thyroid disease), and that can happen a long time (even years) before the free Ts (FT4 and FT3) end up below range. So, an out-of-range TSH is often the first sign something is wrong with the thyroid, and follow-up is necessary.

You don't specify your FT4 levels; were they at the top of range, midrange, or bottom of range? That latter could also point to a failing thyroid gland.

When are you scheduled to have new labs?

[kcrowell in reply to Hidden]

I have had my thryoid antibodies and anti-thyroglobuline tested and they were normal although I have always felt that it might be Hashimoto's since I've had symptoms on both hyper and hypo spectrums. My FT4 was 1.4 on a scale of .9-1.7. Bloodtests in two days!

[Angel_of_the_North]

A TSH of 8.41 isn't subclinical! Youcan't use the levo properly unless your cofactors - vitamins and minerals are optimal. You need to get ferritin, B12, folate and D3 tested. Ferritin need to be at least 70, B12 over 500 (1000 preferred), folate half way rhough range and D3 around 90-120.

25 is a really low dose (generally given only to the elderly and fragile) and properly not enough to do anything except make you feel worse. Palpitaions are casued by underdosing as well as overdosing, but you won't get better without optimising vitamins and minerals.

The aim is to get Free t3 and free T4 to the top quarters of their ranges and this usually means TSH below 1 or even suppressed so that hypo symptoms go away.

It takes about 6 weeks for levo to take effect, so every 6 weeks you shoudl get new bloods done - fasting, first thing in the morning - and generally you'll get a dose increase of 25 each time until you feel better. Many GPs are not very clued up on the thyroid - many people here know more than your GP will.

[kcrowell]

Somehow my TSH came back at 1.05 with just the 25 mcg so looks like that will be my dosage for the next two months until I see the endocrinologist. Crazy that such a low dose would have had any effect at all! But I will be grateful if that means I begin feeling better.