Advice on Levothyroxine

Hello everyone. I am new. Having borderline raised Tsh of 5.80 and T4 is 12.7. Have recently started on 50mcg of Levothyroxine and feel not so good so far, it’s only a week in, taking it every other morning - early. I have CFS and although I can see some good benefit the fatigue and brain fog is bad. If I change to night time do you need to not eat/drink of any length of time before taking the Levothyroxine. Also thinking of taking Higher Nature Thyroid Support. I would appreciate your help dear friends. Thank you.

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14 Replies

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  • Hi Nonyn, welcome to the forum.

    I'm sorry to tell you this, but a week is just a blink of the eye, in thyroid terms. You cannot possibly hope to feel any benefit from 50 mcg levo in a week. You've only just started absorbing it after seven days, and it takes six weeks to fully synthesis it, to start to feel better.

    Also, 50 mcg is just a starter dose, you're going to need retesting after six weeks, and an increase of 25 mcg, and you should repeat that process until your dose is higher enough to get rid of all your symptoms.

    Thyroid hormone should always be taken on an empty stomach - meaning two to three hours after eating, or one hour before eating or drinking anything other than water; at least two hours away from other supplements or medication; four hours away from iron, calcium, vit D or estrogen; six hours away from magnesium.

    If I were you, I would stay well clear of anything that calls itself 'thyroid support' - for 'support' read 'stimulant' - they usually contain iodine which you should only ever take if you've tested deficient.

    Next time you have a test, make your appointment for early in the morning - before 9 am - and fast over-night. Leave 24 hours between your last dose of levo and the blood draw. :)

  • Thank you. I have further questions below. Would appreciate your advice.

  • If you are taking levo every other morning that means you are taking the equivalent of 25mcg per day. That dose is very small and reserved for those with heart problems or the elderly. You may need a few dose increases every 6 to 8 weeks after blood tests before you see an improvement.

  • Good point! I missed that bit.

    Nionyn, why are you only taking your 50 mcg every other day? That's going to slow down your recovery even more.

  • Yes you can take at bedtime, it needs to be 2 hours after a main meal, an hour after anything except water. (3 hours after a large meal)

    Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

    You may find it more convenient and possibly more effective taken at bedtime

    verywell.com/should-i-take-...

    Why are you only taking alternate dates? Is this on GP advice. 25mcg is tiny dose and can actually make feel worse.

    Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12. If they are too low they stop Thyroid hormones working. Have these been tested, if not ask that they are at your 6 week retest

    Always get actual results and ranges on all blood tests

  • Thank you all for your very helpful replies. I am so new to this and it’s understanding. My GP suggested 100mcg every day but it is me thinking that I need to start small and low, perhaps incorrectly. I take many supplements, always have. I take a Biofil multi vit containing 150mcg of iodine which I understand is not advisable if taking Levothyroxine? I also take a small amount of coarse sea salt, hand harvested, am hoping this is ok to still take too. Would be interested for your views on this, also take Magnesium Malate. I shall take note of the time delays before supplementing. I have had a standard blood test which said my B12 was 861, not tested for vit d, I shall mention this to my GP. I supplement with a B12 spray which I find very helpful. Is there any multi vit that you may suggest?

    My GP advised that as I am borderline on raised TSH that he trial me on the Levothyroxine for 3 months and check my bloods and to see if I feel better, if no improvement in symptoms, he says that there is no need to continue taking it and if that is the case just monitor my blood levels every 3 years. If I feel better then he said that I can continue taking it indefinitely.

    Would taking the Levothyroxine at night help with brain fog morning after? Hope so as I find it hard to focus in work

    Sorry to trouble you dear friends but thank you for your guidance. Best wishes.

  • That’s interesting because 100mcg is a very large starter dose and quite high for a TSH that not greatly above the limits either. I’d have thought 50mcg a day and be tested in 6 weeks.

  • Thank you. Sorry to ask but is it worth trying it to see if I feel better, was unsure but I have found some benefit already. So new to this.

  • Both you and your doctor were right - and you were both wrong! lol I00 mcg a day to start is too high, and 25 mcg a day (or 50 every other day) is too low. Happy medium : 50 mcg a day. With hormones - which is what levo is - you always have to start low and build up slowly.

    But 3 months is much too slowly. You should go back for a retest six weeks after going up to 50 mcg. You should then have an increase of 25 mcg, taking you up to 75, and repeat the process until your symptoms have gone. So, 25 mcg increases every six weeks.

    Taking iodine is unadvisable when you are hypo, unless you have tested deficient. And, even then, it's not just as simple as taking a tablet. You need to be under the surveyance of a doctor who knows what he's doing - it's a whole different protocol.

    So, no more iodine - and no more multivits! They are very; very bad things, for a whole host of reasons, and you are totally wasting your money on them. What you need to do is get tested for vit D, vit B12, folate and ferritin, and build up a protocol around the results, taking just what you need, in the right quantities and at the right time - you can't just take everything together if you want to absorb it all.

    So, you've had your vit B tested and it was 861? That was good! It doesn't need raising any further, just maintaining. However, if you are using a vit B12 spray, you should also be taking a B complex, because the Bs all work together, and need to be kept balanced. You don't want your B12 way higher than the other Bs.

    It's good to take magnesium, too, but six hours away from levo. You could also add in some vit C. Doesn't matter when you take that, because it helps absorb most things.

    This will come as news to your doctor, but a TSH of 5.8 would not be called border-line, anywhere else in the world. Just the UK. You are hypo when you hit 3. But for some reason - financial, probably - in the UK they like to wait until it hits 10. So, you are going to need that levo for life, and never mind this 3 months trial nonsense. If you don't feel on top of the world after three months, it's because you've been on a starter dose for too long, and need an increase, which is why I say, go back after 6 weeks and ask for an increase. 50 mcg is just a starter dose. If he doesn't understand that, you're going to have to learn up on it, and explain it to him. Or, just lie through your teeth and say 'yes, doc, I feel better, but not quite there yet, feel I need and increase in dose'!

    Whilst it's perfectly possible to take your levo at night, or any other time of day as long as you respect the food etc. timings, there's no knowing if it will help with the brain fog in the morning. It could be that it won't, simply because you're not on a high enough dose, yet. But, then again, it might. Impossible to say because we're all so different. But, it's certainly worth a try!

    Don't worry about how many questions you ask - that's what we're here for! If you don't ask, you don't learn - and that's what you're here for. :D

  • Thank you for helping. I think I have been poorly for a long time really. My friend told me that during levels of stress this can affect your thyroid and it can right itself when things get easier. I am hopeful for this, unsure whether this is accurate. I was tested in June and my TSH was 5.44 and T4 was 13. My most recent test was TSH 5.80 and T4 is 12.7. Sometimes I feel I look into things too deeply and not sure if taking the Levothyroxine is the right thing to do, or whether in the future I will have to take it anyway. I also have CFS and have been poorly for years. I value your advice about everything and also the. Vitamin advice. I feel weary with everything and just want to feel better again. I don’t really understand what TSH and T4 mean. Thank you dear friend for your help and I shall keep going with the Levothyroxine for now. I am hopeful that the side effects will decrease with the correct dosage.

    Best wishes and thanks.

  • I don't think your friend is 100% right. I think by the time your TSH gets to 5.8 for two tests, it's not just stress, you are hypo, your thyroid is mal-functioning, and there is little hope it will right itself after all this time.

    TSH - Thyroid Stimulating Hormone - is a pituitary hormone. When the pituitary senses that there isn't enough thyroid hormone in the blood, it produces TSH to stimulate the thyroid to make more. If, for some reason, your thyroid can't respond, it carries on getting higher.

    T4 is thyroxine, a thyroid hormone. It is a storage hormone which has to be converted into the active hormone, T3. T4 is what you are taking when you take levo.

  • Thank you again. Just worried for the future. And worried about being able to be normal in work. But I shall be patient. I think it is all new. But in some ways relieved that I now know what the problem is. Have always thought it might be thyroid. Thank you for your knowledge and reply.

  • You're welcome. :)

  • I have been reading the too's and fro's of this information and realise how much I didn't know and how well its been explained here it also unfortunately also made me realise that I should not just believe everything my doctor says and learn to question him.

    Many thanks really grateful

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