Tight Chest:just started Levo

Hello there. I'm new to all this, but I find myself already in need of advice. I was going to ask advice about my test results, as I am one of those with border-line results, but with pretty bad symptoms.... I have a more urgent question. I took my first dose of 25mcg last night, about 7pm on an empty stomach. But about 4/5 hours later I started with a tight chest.... but not palpitations as is the common side-effect. It woke me up through the night, and I slept sat up for a while. I'm sure it was worse due to me freaking out!

Tight chest symptoms are not new to me, as I have a mild heart problem (the rhythm is fine - but my heart just runs fast) I am on Ivabradine, which has settled my heart symptoms down a lot since changing from beta-blockers a couple of years ago. I also do get costochondritis occasionally - so, the tight chest could be down to either of these things. I am getting advice from a private GP, who I am trying to get hold of today to ask what to do.

Did anybody have this tight chest symptom when starting on Levo? If I can't get hold of my doctor, I was thinking of taking half a tablet earlier in the day?? I realise my case is complicated by other conditions, but just wondered what other people's experiences were starting out on levo? Thanking you!!! :O)

34 Replies

  • Welcome to the forum, Cuileann-6.

    Members do sometimes have adverse effects when they first start taking Levothyroxine and they usually improve within 7-14 days. You could halve the dose for a week or two to see whether the tightness improves and then increase to 25mcg.

    You could take a look at the patient information leaflet to check whether you have a known allergy to any of the ingredients. Some members are intolerant to the acacia powder in Mercury Pharma and Teva Levothyroxine.

  • Thanks so much for replying so promptly. That has eased my mind a lot. I'll take half a tablet for a week and reassess. Thanks again :O)

  • It will take time for your body to adjust to the stimulant. It should settle down. My side effects were joint pain. I had to switch to Armour.

  • Thank you! Yes, of course, I hadn't thought of it as a stimulant - that explains the particular tightness, as when I think back, this is what happens when I eat dark chocolate. I am failry intolerant of any stimulant - I live a decaf life.... but I do allow myself a little dark chocolate every day - I'll perhaps need to pull back on that for a while! I'm taking SANOFI levothyroxine from Germany. Do people often find they tolerate different makes better than others. I'll need to keep that in mind too! Thanks again :O)

  • Different brands have different fillers etc and there have been many pists from folk who cannot tolerate specific brands.

  • Ok, that's good to keep in mind, thank you xxx

  • Look at the patient information leaflets for any medications you have already been taking and see if they are not recommended for people on levo or with thyroid problems.

    If you can't find the patient information leaflets you can search for them online here :


    Nutrient deficiencies can cause chest pain and heart problems and fast heart rate.

    In my own case my heart improved slowly but surely when I started increasing my iron levels. My iron was in my boots and I didn't absorb it well, so it took nearly two years of supplementing at prescription levels to get my iron and ferritin levels to optimal.

  • Thanks for the link, that's really helpful.... I'm sorry to hear it took so long for your iron levels to improve! You're right, I am deficient in vit D, ferritin, and folate. No improvement in those despite 3 months treatment. I'm hoping thyroxine will have a beneficial knock on effect.

    I've had to take matters into my own hands, as my gp will not investigate my thyroid function further. I am now suffering from muscle weakness too, after my legs collapsed on a family walk two weeks ago.

    Would it be OK if I asked you about my test results? I am getting advice from a retired gp, but would welcome your input.

    Thank you so much for taking the time to reply! Xxx

  • Vit D 38

    Serum free T4 = 14

    TSH = 3.1

    I understand these are within normal NHS ranges, apart from vit D which they are recognising as abnormal. But, on the advice of my private gp, I have just had antibodies plus t3 checked privately. Results next week. My symptoms of fatigue, migraines, dizziness, plus many more, started after my daughter was born 9 years ago and have gradually worsened, exponentially speeding up over past year.... Now i can hardly work and struggle to look after my daughter. I can no longer walk any distance.... Can get round the house and short distance outside, but no more. intense tiredness, needing 10hours sleep or more.

    So distressing to read of so many people being mis or under diagnosed... And having to fight so hard to get treatment! Obviously the ranges are too broad.

    Hope you have had a good day health wise. Thanks again :0)

  • Just a tip, when putting up your test results always put the ranges too, as labs around the country differ. Your TSH is too high. Your FT4 looks like it may be too low and it's a good idea if your GP would test FT3.

    You say you've had no improvement in the 3 months of supplementing. Are you on a high enough dose of supplements? Have you had your Vit B12 checked?

  • Thanks for the tip Silver Fairy... I'll do that in future :0) My previous tests supplied ranges but these last ones didn't for some reason? Is so helpful to have you confirm that my levels, whilst not wildly out of whack, something is wrong because of the terrible symptoms.

    Thanks again! Xxx

  • I've been having the same symptoms as well,i don't suffer from heart condition from what my cardiologist has told me but it sure feels like I'm having something.I also have pins and needles in the left chest area.But the worst is the chest tightness and the breathlessness as if the air isn;t enough.Actually I am gasping for air but not all of the time which is weird.I was started on liquid levo 13 days ago and symptoms started showing from day 6.On day 12 I was told to stop medication.

    Hope you will feel better soon.

  • Oh dear! That sounds terrible for you! Now you've had to come off thyroxine, what will be done about your thyroid problem? I hope that you feel better soon too. Thanks for taking the time to reply xxx

  • Vit D 38

    Serum free T4 = 14

    TSH = 3.1

    Your TSH is too high, suggesting you are under-medicated. TSH ranges are usually round about 0.3 - 4.5 or 0.5 - 5.0. There isn't a massive amount of variation in the UK ranges for TSH from lab to lab.

    Reference ranges do differ a lot for Free T4 though, from lab to lab. Lower limits I've seen in recent months have varied from about 7 up to about 12. Obviously a result of 14 is quite different when the lower limit is 7 compared to a lower limit of 12.

    When the lower limit is 7 then a result of 14 is actually quite good.

    When the lower limit is 12 then a result of 14 is not that great and is very likely to be well down in the lower half of the reference range.

    Vitamin D 38. This is very low. You should take 5000 iU - 6000 iU of vitamin D3 supplements per day. It is best absorbed with the fattiest meal of the day. You should be aiming for a result of about 100nmol/L. Some people feel best with a slighter higher result, some with slightly lower.

    There are some people who don't tolerate vitamin D supplements at all. The only option then is to increase the daylight/sunlight you get, or buy yourself a vitamin D lamp. (I don't know anything about vitamin D lamps, you'll have to research the options.)

    Vitamin D3 supplements will increase absorption of the calcium in your diet. To enable this extra calcium to be absorbed by bones and teeth rather than getting deposited in soft tissues it is essential to take Vitamin K2 and magnesium as co-factors in metabolising the vitamin D.

    For advice on magnesium supplements - there are lots of different kinds - see these links :




    All the supplements I've mentioned can be bought online quite easily from shopping sites and supplement sites. Shop around. :)

  • Sorry, I made a lot of typos on that post and had to edit it several times. :O

  • Omg humanbean.... Thank you SO much for replying so fully. You can't possibly know how much your help has meant to me...... to us as a family! I have felt so alone and overwhelmed.... as I'm sure we all do from time to time. I was wondering about vit K.... your reply explains everything. Really, thanks so much for taking time to go over that with me..... and for the trouble I put you to having to correct typos! Lol you've done such a good thing there. Thanks again from me, my partner and children xxx

  • You're welcome.

    Be sure to get vitamin K2, not vitamin K1. :)

  • I will. Thanks again. Sending love. X x x

  • Just ordered Solgar Vit K2 100mcg. Presumably, it is one per day (alongside my Vit D and Magnesium)?

    No more questions for today, I promise :o)

  • For vitamin K2 I just take the dose it says on the bottle. Easy peasy. :)

  • For magnesium the maximum you should be taking is whatever you need to get roughly 300mg - 350mg magnesium per day.

    High doses of magnesium can give people the runs, so cut back if that happens.

    Another thing about magnesium is that it makes some people sleepy, so taking it in the evening is best.

  • Great advice from you today. Am going to sleep a much happier person! Cannot thank you enough! Xxx

  • Night night. :)

  • Sleep well :o)

  • I should also mention, if vitamin D gets too high it can become toxic.

    Your levels should be tested to make sure you don't go overboard. Test in about 3 - 4 months. You can order a finger-prick test online - no doctors involved, and it's all done by post :


    Alternatively, you could ask your doctor to test, but don't be surprised if he refuses.

  • My gp has already made it clear that the labs will not agree to re-read vit D for a year! I will do as you suggest. It feels good to be in control. Thank you for worrying about me! Xxx

  • Maybe not the same given your history with beta blockers but after starting levo I had angina type symptoms but down the wrong arm plus a tight chest.An early book by a GP on the thyroid said this was faily common and treated with beta blockers which has in the main helped me.

  • Sorry you had these side-effects.... anything to do with the heart is a bit scary isn't it. Cutting down to half a tablet seems to have helped a lot. I'll just go steady with them! Thanks again Treepie! :o)

  • I think the thyroid hormones speed up your metabolism which leads to blockages ,or in my case irregular arteries ,whatever they are, showing up. The GP was Dr Joan Gomez ,I think, and the only book that I have read that refers to it as a consequence of taking levothyroxine.

  • It's good to know these things. I might write directly to my cardiologist and get his advice. I am finding it a little scary, as my heart wasn't behaving too well just before I started. Just sheer tiredness I think. Thanks so much for helping me :o)

  • Noticed you have just started levo on a very low dose which is just as well given the effects. It is not uncommon for such problems on starting levo .Over 50's start on a low dose for a similar reason.The body has to get used to the hormone. As you have already seen there are many knowledgeable folk on this site willing to give the benefit of their experience.I am still learning.

    There are a number of good books on the subject . I found a good informative book in the library " Thyroid for Dummies" .Its somewhat out of date now but good on the basics. Those who need to add T3 or be solely on T 3 will think it cops out on the issue .

  • Aye, my Body didn't like going straight onto 25mcg. But halving it seems to be working. Thanks for recommending the book. I have yet to fully grasp t3 and Rt3.... but I'll get there! Yes, people have been incredibly kind, including your good self! Just feel amazing after discovering this forum. I feel like a huge burden has been lifted. ;o)

  • I think a working Thyroid produces mainly T4 about 10% T3 and apparently T2 ,T1 and calcitonin.What the last three do seems not important to medics or perhaps not known . That we are mostly given just T4 which converts to T3 in the body( although some are poor converters) many on this site think our treatment is insufficient. Bear in mind most on this site have had unsatisfactory treatment.The vast majority are not on the site and doing OK on T4.

    rt3 I have read about but forgot .Perhaps not the most important thing to bother about at this stage!

  • It's taken me a while to read up on it all. Having this forum is a life line , as I've had to 'go rogue' lol. I need guidance and appreciate it so much ! Thank you. Hope you've had a good day xxx

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