Thyroid UK
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1 week in

Ok so all you loverly people have been so helpful when replying and reading previous posts. I have only been diagnosed for 1 week, and im on 25 mcg of levothyroxine, which doesn't seem a lot compaired to everyone else. My main symptoms have been tiredness, weight gain, and forgetfulness. I know you all need blood results to help me so i made an appointment and went to see my doctor on tues evening on the intention on getting them and completly forgot to get them. I had a long list of questions, which was mainly made up of the info on here whicg he answered all of them. I must add he is a very very good doctor and who specialises is diabetics. He said i am on the right dose for now and will see when i get my bloods done in 5 weeks time if i have to go higher but did say if my symptoms persist i can go back and go up to 50. The thing that worries me is since on the tablets i have felt worse so would going up to 50 make me feel even worse still?. Im thinking i should really trust my doctor when he says im on the right dose as i will be under his care for a long time to come and i do trust him. But all you guys have so much knowledge and experience i still feel confused. I know no one can help me until you see my results but im starting to feel a bit of a pain going to the doctors at the minute so will leave it a couple of weeks and pop them on here when i get them. 😀

20 Replies
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Hi I am new too - I am on 50mg when I questioned it my GP showed me the bible as she called it ;) GP was a registrar so refers to the good book ;)

She showed me that to start someone if they are under 50 yrs old to start on 50mg and if over start on 25mg

Wishing you all the best :)

I personally am having less light headed moments but still having them, I am starting to sleep a bit better too (now this could be down to now knowing what is wrong and not worrying about what it could be ;) )

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Thank you for your reply. I am only 49 but im thinking he started me on 25 as my levels wasnt that bad. I had a blood test just over 6 weeks ago and the tsh was 7.5 and said they normally medicate at 10 so maybe its just 10 i dont know but i have little choice but to trust the 2 doctors now that have said im on the right dose. Glad your feeling a little better and hope it continues 😀

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7.5 is very high! But some doctors follow the policy of starting medication only at 10. For many of us, even a raised TSH of 3 can mean we feel dreadful, even though we are 'in range' and apparently 'normal'. You will soon become very leery of the 'normal' word. I was diagnosed with a TSH of 4.95 and could barely keep awake most days.

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I am 48 ;)

My TSH 9.03 (0.4-4.0) I am not sure how it works

Wishing you all the best ;) and hope you start to feel better real soon :)

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Thank you cracker10 the same goes to yoy too. I think i have just overloaded myself with info and have got confused with it all from diet to how to take the tablets etc. I need to just feel well first digest the diagnosis then find out more about whats best and what isn't. I guess everyone is so differant.

Thank you

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Usually a starting dose is 50mcg unless you are very frail with a heart disease. Lots of doctors haven't a clue about hypothyroidism and its effect on our body or clinical symptoms.

Tick off your symptoms and as dose is increased you should begin to feel better.

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

All blood tests have to be at the very earliest possible, fasting (you can drink water) and allow a gap of 24 hours between last dose and test and take it afterwards. Also ask for B12, Vit d, iron, ferritin and folate to be tested as well. Everything has to be optimal.

You can read quite a few things in Thyroiduk's website. We have to read, learn and ask questions if we want to recover our health.

Also take levo first thing with one full glass of water as food interferes with the uptake of the hormones.

Always get a print-out of your results with the rangs for your own records.

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Thank you for the reply. I have asked 2 doctors now if I'm on the right dose and both have said yes so I have to trust the doctor as he is the one in control of my treatment. He said all the other test were" normal " but didn't test for vit D but I already take them anyway as I thought it was why I was feeling so tired etc.. I have learnt so much from this site already and my next test I will certainly be asking for. Print out and pop them on. Thank you 😊

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The 'right' dose is when we feel well and symptom-free.

Some doctors think if the TSH is somewhere in range we're on sufficient. Most feel well when TSH reaches 1 or below with FT4 and FT3 in the upper part of the range. :)

The dose has to be gradually increased every six weeks and I hope you feel well soon.

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Thank you I'm sure I will as soon as I get used to them. Thank you

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The normal starting dose can be 25 mcg or 50 mcg, but your doctor is right, you need to wait 5-6 weeks to have a blood test and see how your blood values are. At that point, if you still have symptoms (likely) then he will increase again, in your case most likely to 50 mcg. unfortunately hypothyroid treatment requires much patience and slow increases of medication. Also, in the meantime you need to find out your Vit D, folate, ferritin and Vit B12 values, they are extremely important as if you are not optimal in those values (not just 'in range') then you will not utilise your thyroid hormone properly.

Hope that helps! :)

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Thank you jadzhia i have heard its a slow process and will be paitent the main and important thing is i have found out the reason i have been feeling unwell. I did ask him about all those other results they were on my list 😀 he said they were all normal but they didnt check my vit d as he said it was tested in april and was normal but will test it in 5 weeks. I do take vit d anyway so i will continue until i get me next bloods done.

Thank you

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'Normal' simply means in the lab range but often the lower end of that range isn't optimal for health. You really need the exact values with their ranges. You can ask the receptionist for a print out of your results, you're legally entitled to have them. Then you can post them here and people will comment. :)

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Thank you i will do that.

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Hi Jennymiddle,

I too felt worse when I first started taking the levo... dizzy and sick and foggy. It then levelled out a bit as my body got used to it... it's also very new to me!

It then got worse again (another story - I think I'm struggling to convert T4 to T3... I'm working on a personal referral... my GP is refusing some of the tests I think I need...)

But the point was to reassure you that some people do feel worse to start with! There's not much written about feeling worse when you start levo on the internet and my doctor didn't warn me that it could happen... I just got a phone call telling me they'd found I was hypo, take the tablets, it'll all be fine, but it wasn't my experience!

I'm glad you've got a supportive doctor at the moment - hopefully that means you'll have a smooth ride!

Lotika.

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You will have a blood test every six weeks with an increase of 25mcg until you are symptom-free although and a TSH of 1.

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25mcg often makes people feel worse. It's enough for your own thyroid to have a "holiday" and stop working so hard. But it's not enough to give you much.

You might try taking it at bedtime. Lots on here find it helps and can be equivalent to a slight dose increase

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

Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

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

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.

academic.oup.com/jcem/artic...

All thyroid tests should be done as early as possible in morning and fasting and if taking Levo don't take it in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

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Thank you for your advice, so if I decided to take it on an evening how long would I have to leave it between having my dinner please as you said on an empty stomach.

Thank you

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Normal meal about 2 hours.

If you have a feast then 3 hours.

If eating out late then you can just take in middle of night

Quite a few do that as standard (assuming you get up off the loo in middle of night)

I find it much better taking at bedtime. Originally was on my endo's advice.

Also stops evening nibbling or fridge raid before bed!

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Thank you, that might work out better for me as I'm struggling in the morning to take it as I like a cup of tea before I go to the gym at 5.45 so take it with me and have it half way through. So if I switched to evening would I just not take the morning one the day I switch. Sorry for all the questions 😀

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As you have not yet had another blood test since starting your levothyroxine, there is absolutely no way that your two GPs can know at this point, that "you are on the right dose". As 25mcg is a small dose, below what you might have been safely prescribed (given that you aren't elderly and/or with a heart condition), it's just a number plucked out of the air, and odds are that you will find your optimum dose to be higher than that. That your GP specialises in diabetes is sadly not likely to be a good/helpful thing for your thyroid condition and it's really important that you always obtain copies of all your blood tests results, including lab reference ranges, so that you can accurately interpret them whenever your GP tells you "they're all normal" - because you need them to be optimal for you.

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