Hi
I take 25mcg levo once a week and have symptoms of moodiness, tiredness, headaches. Shouldn't I be feeling better after doing this for 3 months. Diagnosed hypo 2016. Thank you
TSH 6.8 (0.2 - 4.2)
FT4 13.9 (12 - 22)
FT3 3.2 (3.1 - 6.8)
TPO antibody 276 (<34)
TG antibody 195 (<115)
Should be every day, not once per week. Have you checked with the GP ?
The standard starter dose is 50mcgs once a DAY
Your results show you are very under medicated.
Make an appointment to discuss with GP. You should be taking 25mcg or more likely 50mcg daily, retesting in 6 weeks.
Ask for vitamin D, folate, ferritin and B12 to be tested. Very likely too low because you are on far too small dose of Levothyroxine
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.
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne: tukadmin@thyroiduk.org
What does the label on your Levo box say? The one that the pharmacy put on with instructions on how to take your meds. If it says once a week then your GP is a total idiot, see a different one, and the pharmacist should have queried it if the GP wrote once a week on the prescription.
Once a week
I'm amazed the pharmacist didn't query it. You should make an appointment with a different GP and point out that you should be started on at least 25mcg DAILY (most people are started on 50mcg unless elderly, a child or have a heart problems).
Why are you only taking 25mcg dose and why only once a week?
What reason did your doctor give for this?
Have you got any other medical conditions?
Did your doctor do any test to check Adrenals first before you took any Levothyroxine?
Usual start dose is 50mcg every day.
Have you read the Patient Information leaflet with your Levothyroxine?
Once a week because of the following
I have sweats, tremor, weight loss, palpitations, fast heart rate, family history of heart disease, chest pain, possible osteoporosis
Adrenals haven't been checked how are they checked usually?
Patient information leaflet says once a week
Those symptoms are due to the Hashi's (confirmed by your high antibodies). SlowDragon has information and links about Hashi's and I'm sure she will be along to help there.
My patient information leaflet says
"The usual starting dose is 50-100mcg every day,......"
Yes sorry it does say once a day but GP said once a week
Like I said, GP is an idiot and appears to know nothing about treating Hypothyroidism. See a different GP.
Have you had your chest pain investigated?
Have you had your weight loss investigated?
Why do you think you have Osteoporoisis? Are you waiting for a DXA scan? Have you been told you have Osteopenia? Ask your GP for blood tests to check your Vitamin D level and Calcium. You may have Vit D deficiency and need prescribed supplements.
Also ask for blood tests to check:
B12 & Folate; & Ferritin .
Quote from Levothyroxine leaflet :
" Patients over 50 years of age :
The usual starting dose will be no more than 50 micrograms every day. The dose may then be increased by 50 micrograms every 3-4 weeks until your thyroxine levels are correct. Your final daily dose will be between 50- 200 micrograms daily.
Patients over 50 years with heart problems:
The starting dose will be 25 micrograms every day or 50 micrograms every other day. The dose maybe increased by 25 micrograms every 4 weeks until your thyroxine levels are correct. Your final daily dose will usually be between 50-200 micrograms daily."
Serafana -
You were diagnosed in 2016 (with Hashimoto's Autoimmune Thyroiditis and Hypothyroidism? ) -
You have been taking just 25mcg Levothyroxine ONCE a week for the past 3 months. - Is that right?
What dose were you taking prior to 3 months the ago?
Did something happen back then?
You are more likely to have heart problems if you don't take your Levothyroxine.
ps
Also ask for testing for Coeliac Disease. Ask for urgent referal to Gastroenterologist re weight loss & quey Coeliac Disease.
Ask for referal to Endocrinologist.
What other conditions have you actually had diagnosed?
Are you on any other medication or supplements?
All I know about Adrenals test is that it seemed important to my Endocrinologist to have them checked first, before starting my Levothyroxine. Mine were OK .
Don't know if this applies to everyone.
I had chest pain investigated with chest x ray but not told of result. Weight loss not investigated. I haven't had DEXA scan but I take vit D 9000iu and my vit D has dropped and I have a bone injury that hasn't healed since I injured it 12 years ago.
Have been on 25mcg once a week for 3 months. Wasn't taking any levo at all before then
Has your calcium level been tested, with low vitd and bone problems you must check your calcium is not out of range either way.
Only vit D which is 60.7 (50 - 75 suboptimal) I take 9000iu since March 2015 and that result taken Dec 2017. Calcium usually tested with vit D but not this time. When it has been checked it is low. That is even when I take vit D. I will ask GP next time I see her if she will check my calcium. Thanks
I thought you were diagnosed in 2016? Who diagnosed you in 2016 your GP or an Endocrinologist? Why didn't they start Levothyroxine then?
Why do you think your old bone injury hasn't healed? Was there a delay in having the operation following the break?
I don't understand what's happening with your Vitamin D.
Do you have any blood tests results you can add - with dates of tests?
When was your chest xray, have you phoned to see if results are in?
If you want a DXA scan to see if you have Osteoprosis, have you thought of asking GP to arrange one. There's a long wait here so best to ask asap.
No.
25 mcg once a DAY wouldn't be enough to make you feel better as it is a starter dose for an frail elderly person. You need at least 50 mcg a day with blood tests every 6 weeks and a 25mcg increase each time until your TSH is under 1 and free T4 and free t3 in the top quarter of their ranges, not right at the bottom like yours are.
See a different GP, explain the mix up and ask for dose to be increased to 50mcg daily
vitamin D, folate, ferritin and B12 to be tested as well as blood test for coeliac disease
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ask GP for coeliac blood test first
thyroidpharmacist.com/artic...
thyroidpharmacist.com/artic...
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
With your levels, such a low dose and once a week is a big professional mistake, definitely, and to put it mildly. What they have also not taken into consideration is the fact that you have Hashimoto's which can aggravate your symptoms and further confuse things for you.
On 25mcg Levo 
Can I take supliments once a week?
Dose increase from 25mcg levo - 50mcg levo - stopped levo 8 weeks ago due to sweating which my endo said was a thyrotoxic symptomIs 25mcg of Levo enough to lower a TSH of 3.11 at a quicker pace? Or would it be better to take a higher dose?
4th day on 25mcg levo, feeling awful
