hypo after RAI

[wendypartridge]

Three months after RAI my thyroid has died, I have a TSH of 47 ( 01-5) and a t4 of 3 (10-24) he has told me to start on 100grms of levo as it oly took 2 weeks for my tsh to go from 7 to 47, Is this does to high to start with can someone help please

[shaws Administrator]

I am not medically qualified but my TSH was 100 (didn't have RAI) and was given 50mcg to begin. That's the usual starting dose with 25mcg increments about every six weeks. You take it with one full glass of water on an empty stomach, usually first thing when we get up and wait about an hour before eating. Food interferes with the uptake of hormones. Some prefer bedtime dosing.

When you have your next test, allow 24 hour gap between dose and test and take afterwards. If you take a bedtime dose, miss this dose and take after test and again at night.

[wendypartridge in reply to shaws]

thank you Shaws, you have put my mind at rest. I have read some pretty scary sides effects of the drug but I have no choice I have to take it, thank you once again

[shaws Administrator in reply to wendypartridge]

We get life-long medications for anything else we may develop due to the seriousness of hypothyroidism if untreated.

We have to read and learn unfortunately but you may be one of the lucky ones and levo suits you. Medications are hormone replacement (not drugs) , i.e. T4 (levothyroxine) is inactive and converts to T3 (Active hormone) and is the only one required in our receptor cells. It is the energy for our whole metabolism.

If we accidentally took too much, we might not feel too good so would mss the next dose and everything would settle down and you'd start at a lower dose.

p.s. (I'm not medically qualified but had undiagnosed hypo)

[Clutter]

WendyPartridge,

100mcg is at the higher end of starting doses but it is an appropriate starting dose when your TSH is 47 and your thyroid gland has been ablated.

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_...

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, magnesium 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. Symptoms may lag behind good biochemistry by several months.

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.

thyroiduk.org.uk/tuk/about_...

[wendypartridge in reply to Clutter]

Thank you, Clutter, thank you so much, I just started understanding hyper now i need to educate myself with hypo. Thank you for the tip on when to get tested again . Where would we be without you and Shaws

[Hidden]

I am very surprised it has taken 3 months for you to get levo after your thyroid ablation. I was put onto levo immediately afterwards.

As you may be aware it is likely that you will fail to recover your health even when your blood results may all be "within range".

Firstly this is because it is not acceptable to be merely within any range, you need to be at the optimum point within the range, which most doctors do not apparently understand. Read threads on this forum to discover the ins and outs of this fact.

Secondly, for some unfathomable reason both of the synthetic hormones (levothyroxine/T4 and liothyronine/T3) are manufactured deliberately to omit any "contaminants" which are contained within the natural product (Porcine Natural Desiccated Thyroid). Without a thyroid gland the human body is therefore deprived of all of them; if you take levothyroxine merely to supplement the low production of the natural product, you will still be getting some, perhaps all, of your needs for these extra hormones. I must emphasise here that the synthetic chemicals stated above are completely different in nature than the comparable elements within the natural product and they MUST consequently work in different ways within the human body, despite what ANYBODY may tell you, even the manufacturers of Armour NDT which states this LIE on their web site:

"Armour Thyroid Tablets, USP, contain the labeled amounts of levothyroxine (T4) and

liothyronine (T3)" armourthyroid.com/treatment...

My own endocrinologist has repeated this LIE to me even though he must surely be aware that it is a LIE!

No amount of arguing with your doctor is likely to result in you being given an NHS prescription for NDT and the cost to you of a private prescription would be extortionate, so recommend you start to educate yourself in this subject for if/when you still feel very ill with hypothyroid symptoms and the doctor gives you his opinion that there is nothing wrong with you and you need psychiatric help.

[wendypartridge in reply to Hidden]

i understand what you are saying as i had problems when i was hyper .I never got levo straight away as my tests were showing hyper for a while but now i am hypo and i must now educate my self for the battle ahead

[kimberlyR in reply to Hidden]

I'm having a crisis about whether to use a natural thyroid medicine (NatureThroid) or levo. I have a longer post about my dilemma. In summary, I am 6 weeks pregnant with TSH 30. I was on levo 100 during my first pregnancy but never felt great. Switched to NatureThroid 75 mcg 1 year ago and felt great but somehow my TSH rose to 30. Now GP insists that I use levo 100 since the NDT pills are inconsistent in dose? I just wish I could have increased the dose of NatureThroid and not gone back to levo, but I don't know enough to insist and my pregnancy leaves no room for me to guess or self medicate.

[helvella Administrator Thyroid UK in reply to kimberlyR]

It is a rare doctor who knows anything about desiccated thyroid.

If you go back enough years, you will indeed find evidence that some of the desiccated thyroid products were inconsistent. The standard testing was to check how much iodine they contained - which is wholly inadequate. At the time, Armour actually had an animal laboratory to test biological activity - which is quite possibly why that product became the best known.

For at least twenty years, technology has allowed far better assay techniques. There is little reason to suspect the major USA products vary significantly. Whilst patients have reported issues, the causes have not been fully identified (at least in public).

If he is asserting that the products are inconsistent, ask him for the evidence. Surely, if he is a signed-up member of the evidence-based medicine brigade, he will have the evidence at his finger tips?

[Hidden]

Your doctor is entirely WRONG about NDT being inconsistent. From what I've read there has been far more cases of levo being inconsistent than there ever has been about NDT. In my case any inconsistency that may allegedly exist with NDT is utter tripe, as in the real world, levo is incapable of EVER giving me good health and ONLY NDT will stop me remaining ill for the remainder of my life. Levo keeps me alive, NDT gives me my health back.

My doctor WANTED me to be ill!!!

I believe that Levo treatment for 8 years has permanently damaged my body, given me kidney cancer and completely ruined a great deal of my retirement years.

In your position, pregnant, TSH 30 and consequently feeling rotten, I would immediately reject the Levo and start on NDT as that is what seems to have given you satisfaction in the past. Not doing so could possibly be damaging to your baby's health. Ask your doc if he is fully prepared to accept blame for any consequent damage based upon his ridiculous belief of the inconsistency of a natural product that was the ONLY medication available for over 6 decades and, so far as I am aware, never did anybody any harm, except when ignorant doctors overprescibed it.

Be firm, be insistent and don't accept any nonsense such as the old "inconsistency" rubbish. Your baby is far more important than that.