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Thyroid UK
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Need serious advice about Levothyroxine

Hi all,

So basically I️ was diagnosed with Hashimotos last July. Since I’ve been on different doses of Levo, and right now my dose is 50mcg.

During the past 2-3 months however, I’ve been taking Levothyroxine many of the days with an Iron supplement, which I️ just found out INHIBITS absorption. Does this explain my accelerated hair loss during the past few months? I️ barely have hair now...I’m a male 20 yo so this sucks.

I️ just started taking Levo at night, 4 hours after my last meal so I️ can maximize absorption.

I’m awake typing this at 4am, I️ slept at 11:30. Is this normal? Is taking Levo at night considered to make you wake up early? However I️ don’t feel groggy right now, full of energy actually but I️ don’t know if this is bad or good, because I️ may not be getting enough sleep?

1. How bad was taking Iron at the same time as Levo, and is that causing my hair loss? How bad was taking Iron with Levo, and will taking it at night 4 hours after my last meal help absorption, how long will it take to see results from switching to taking Levo by itself without inhibiting agents, and will my hair grow back? I’ve lost a good chunk.

2. Is taking Levo at night known to cause early waking up, because maybe it’s starting to get to work while we’re sleeping? Maybe it starts working too early for me?

Would very much appreciate your help :)

20 Replies

By the way my hair loss got worse than it was before, it didn’t just start balding.

But for some reason when I️ was on around 100mcg my hair was a lot better than it is now but then again I️ used to take it without the iron supplement, when my doc changed me to 50mcg in October, that’s when I️ started taking it with Iron (I’m stupid for this) and also coincidentally or not I’ve been losing hair so much faster lately.

Is it the dose or the Iron?


the first thing people will ask is if you have your blood test results...with ranges...if you have, add them to the opening post. why did your doctor reduce your meds by such a big drop? iron does reduce absorption of t4 so should be taken at least 4 hours away from your t4.

Hair loss can be caused by many things, without your results its difficult to advise further


Thanks for the reply.

I️ guess she saw my levels were coming back to normal so she reduced from 100 to 75 to now 50. But after 50 I️ started taking Iron with the Levo, so I️ guess I’m trying to find the culprit here.

Also after taking it isolated at night I’ve been feeling better, less hair shedding, symptoms a lot better, only thing is it’s waking me up super early


Doubtful it's the levo waking you up. T4 is practically inert, it's a storage hormone. And it doesn't convert instantly to T3.

Low iron can cause hair loss, as can low T3, low testosterone and many other things - including levo itself. But, impossible to say anything more without seeing your results. :)

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So it’s not the Levo waking me up?

Hmmmmm this is weird


I shouldn't think so, no. It's not a stimulant.


Personally I found I slept a bit better for taking my levo at night, but no idea if that was down to the levo, could have been coincidence. What has really helped my sleep was starting to address my high cortisol and adrenal function. Also, it might be worth thinking about your liver and whether it needs any support, as that can be a cause of waking at 3am+

So many things to think about and sort on this thyroid journey!!

Best of luck and I hope you get to the bottom of the hair loss.

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"I guess she saw my levels were coming back to normal so she reduced from 100 to 75 to now 50"

Symptoms aside, levels approaching normal would seem to indicate you're at, or approaching the dose you need; not that it's time to pull the plug on your Levo. Have you had new blood results since your reduction in dose, to post here?

Low levels of zinc can also cause hair loss.

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Blood test I’ll be getting done in 6 weeks


Do you have Hashimotos ?



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OK so post your latest results with ranges ....


My last test was done in October so a lot probably has changed.


But I️m getting a new test done in 6 weeks


Do you have the results of the tests done in October - at least members can see what was done and what will need doing next time :-)


Ya should I️ make a new post with it?

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if you have them to hand you can post them now !


Highly unlikely that 50mcgs is high enough

Post your results and ranges from when you were on 100mcg too

Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise

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








For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available


Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

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:

Prof Toft - article just published now saying T3 is likely essential for many


But with Hashimoto's especially we must get vitamins optimal first and Levo increase enough to bring TSH down to around one and FT4 towards top of range and FT3 at least half way in range

Strictly gluten free diet likely to help or be essential

If after all these steps FT3 remains low then, like many with Hashimoto's you may need addition of small dose of T3

Email Thyroid UK for list of recommended thyroid specialists some are T3 friendly

please email Dionne:


Are you taking any vitamins and supplements. If so which? And are you gluten free?

I know this isn’t addressing your original hair loss question but important you’re taking adequate vits to complement your T4. Can you add your last two blood test results?


50mcg is a starter dose ...what arevyour results for









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