Correct way of taking Levothyroxine

[Lou2018]

Hi I'm new. Is the correct way of taking Levothyroxine on an empty stomach with just water and leaving at least an hour before food and 4 hours before supplements. Endo is querying why my results are not that good on 50mcg Levo and why I am not improving. Diagnosed 2010 with hypothyroid. Thankyou

[Clutter]

Welcome to the forum, Lou2018.

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.

If your thyroid levels are not improving on 50mcg your endo should increase dose to 75mcg.

[Lou2018 in reply to Clutter]

Hi well they are TSH 6.7 FT4 13.9 FT3 3.1

Endo said they should be better than that

Previously taking 150mcg

[Clutter in reply to Lou2018]

Lou2018,

You are undermedicated and need more than 50mcg. I expect levels were better than that on 150mcg. Why was dose reduced?

[Lou2018 in reply to Clutter]

Not sure why dose was reduced.

TSH 0.89 (0.2 - 4.2)

FT4 20.8 (12 - 22)

FT3 3.5 (3.1 - 6.8)

[Clutter in reply to Lou2018]

Lou2018,

I can't see any reason whatsoever for reducing dose. All the results were within range so you weren't overmedicated on 150mcg. No wonder you are under medicated on 50mcg.

[Lou2018 in reply to Clutter]

Goitre, feeling cold, constipation, tiredness, weight gain, dark and puffy eyes, heavy periods. Endo says not thyroid related

[Clutter in reply to Lou2018]

Lou2018,

Endo is wrong.

[SeasideSusie Remembering in reply to Lou2018]

Endo should be in a different job particularly if he doesn't realise a goitre is thyroid related.

My guess is you have positive thyroid antibodies confirming autoimmune thyroid disease aka Hashimoto's and your endo doesn't recognise that either.

Another guess is that your endo is a diabetes specialist, as most of them are, and doesn't know much at all about thyroid disease.

[Lou2018 in reply to SeasideSusie]

Yes positive for both TPO and TG antibody

[BadHare in reply to Lou2018]

Endo qualification from a lucky bag?

[Lou2018 in reply to BadHare]

Probably

[SeasideSusie Remembering in reply to Lou2018]

As you are positive for Hashi's then it's very likely your nutrient levels are low or deficient, especially as you've had your dose lowered. Were you ever on T3?

Post any other results you have, with reference ranges.

TSH 0.89 (0.2 - 4.2)

FT4 20.8 (12 - 22)

FT3 3.5 (3.1 - 6.8)

There was no need to reduce your dose as none of your results are out of range. They actually show you need T3 added to your Levo. Like I said, endo should be in a different job, he is making you ill.

[Lou2018 in reply to SeasideSusie]

Briefly on T3 yes. Would like to restart it but endo has said he does not want me on it anymore. Was identified as having clinical need for it in August 2015.

Sep 2017 (175mcg Levo)

TSH 5.3 (0.2 - 4.2)

FT4 13.8 (12 - 22)

FT3 3.2 (3.1 - 6.8)

Jan 2017 (175mcg Levo)

TSH 1.76 (0.2 - 4.2)

FT4 15.9 (12 - 22)

FT3 3.4 (3.1 - 6.8)

Nov 2016 (175mcg Levo)

TSH 3.80 (0.2 - 4.2)

FT4 17.2 (12 - 22)

FT3 4.1 (3.1 - 6.8)

Jan 2016 (175mcg Levo and 10mcg T3)

TSH 0.08 (0.2 - 4.2)

FT4 21.1 (12 - 22)

FT3 4.8 (3.1 - 6.8)

Nov 2015 (175mcg Levo and 10mcg T3)

TSH <0.02 (0.2 - 4.2)

FT4 20.3 (12 - 22)

FT3 5.3 (3.1 - 6.8)

Sep 2015 (175mcg Levo and 10mcg T3)

TSH <0.02 (0.2 - 4.2)

FT4 20.6 (12 - 22)

FT3 5.4 (3.1 - 6.8)

[Nanaedake in reply to Lou2018]

When. or with which results did you feel the best?

[Lou2018 in reply to Nanaedake]

To be fair none of them.

[SeasideSusie Remembering in reply to Lou2018]

Vit D

B12

Folate

Ferritin

Iron panel

Full blood count

Have these been tested?

[Lou2018 in reply to SeasideSusie]

Yes

Dec 2017

Total vitamin D 55.9 (50 - 75)

Folate 2.3 (2.5 - 19.5)

Vitamin B12 227 (190 - 900)

Ferritin 21 (15 - 150)

MCV 82.9 (83 - 98)

MCHC 356 (310 - 350)

MCH 28.1 (28 - 32)

RBC 4.41 (3.80 - 5.80)

WBC 4.10 (4.00 - 11.00)

Haemoglobin 125 (115 - 150)

Platelets 241 (140 - 500)

Iron 7 (6 - 26)

Transferrin 13 (12 - 45)

Do I need iron again?

Receiving B12 injection tomorrow

Taking 1000iu Better You oral spray

[Mary-intussuception in reply to Lou2018]

You are receiving B12 injections, have you also been prescribed Folic Acid 5mg tablets?

When did you last have iron?

[Lou2018 in reply to Mary-intussuception]

GP says I can be given folate after B12 injections are started. Last had iron May 2016 before iron infusion

[SeasideSusie Remembering in reply to Lou2018]

MCV/MCHC suggest iron deficiency anaemia. Needs treatment so speak to your GP. Eating liver regularly will help increase ferritin level.

Folate deficiency - point out to GP, need folic acid/folate supplement after starting B12 injections.

Vit D needs to be 100-150nmol/L - needs around 5000iu D3 daily rather than 1000iu plus important cofactors K2-MK7 and magnesium. BetterYou D3 oral spray for best absorption.

Please see healthunlocked.com/thyroidu...

SlowDragon has links and information about Hashi's and gut/absorption problems and hopefully she will be along soon.

[Lou2018 in reply to SeasideSusie]

GP says I can start folate after B12 injection. So I just take the 1000iu 5 times?

Thanks

[SeasideSusie Remembering in reply to Lou2018]

Yes, but you need the cofactors as well - see post I linked to

Hashi's has trashed your nutrient levels, you need to be strictly gluten free and supplement with selenium L-selenomethionine 200mcg daily to help reduce antibodies.

Optimal nutrient levels important for thyroid hormone to work.

Read through this post for information and links by SlowDragon healthunlocked.com/thyroidu...

[Mary-intussuception]

When you go for B12 injection tomorrow, could you enquire if GP will give you increase of Levothyroxine? Also query iron?

[Lou2018 in reply to Mary-intussuception]

Yes will do this

[Mary-intussuception in reply to Lou2018]

Also ask GP to reinstate your T3?

Take all your results in with you?