When is the right time to change treatment?

[MrWellness94]

Hello all,

As the title says, when is the right time to discuss other treatments with my doctor? I was diagnosed with Hashimotos about 2 weeks ago and was put on levothyroxine 50mcg, so far the only symptom that improved was the cold intolerance and insomnia. However, I am still struggling with everyday life. I have a complete lack of motivation (I’ve never felt like this before), and depression as well as a reduced concentration which is hurting my college studies. Perhaps I should be more patient since I have only taken levothyroxine for a little over 2 weeks, but I feel a little worse. Is this normal? I’ve never felt this depressed or detached from life. I also have this “ I don’t care about anything” attitude just been in bed for days. I’m certain I may need an increase of levo but wondering if I should just add T3 since people feel significantly better on that. I was also considering switching to NDT.

[SeasideSusie Remembering]

It can take many months for us to feel well on Levo. It takes about 6 weeks to be fully absorbed so you won't be feeling much benefit yet. Some people do feel worse to start with. Patience is needed I'm afraid. There's no point in even contemplating any other thyroid medication until you know if Levo is helping, and you will need a few increases in dose (after retesting) to get you there. The aim of a treated hypo patient generally is for TSH to be 1 or below and FT4 and FT3 in the upper part of their respective reference ranges.

Are you scheduled to have repeat tests in 6-8 weeks time? Repeat retesting/increases every 6-8 weeks until your levels are where they need to be for you to feel well.

As you have Hashimoto's, you need to adopt a strict gluten free diet which has helped many members here. Gluten contains gliadin which is a protein thought to trigger antibody attacks. You don't need to be Coeliac for a gluten free diet to help with reducing antibodies. Supplementing with selenium L-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

[MrWellness94 in reply to SeasideSusie]

Hello SeasideSusie,

I suppose it was premature to even contemplate changing medication as it unfortunately takes time. Right now the symptoms feel overwhelming, hence the inability to be patient. In that case I guess I’ll just have to wait it out then. Yes, my doctor has requested testing on the 6th week mark. I am taking zinc, selenium, vitamin D+k2. I have yet to check my vitamin levels so perhaps that may also contribute to feeling like this. I have been having a difficult time adapting to a gluten free diet, however if I want to feel better, I must do that then. Thanks for the help!

[Heather77]

I have been on levothyroxine for many years and the dose can be increased or decreased depending on your TSH levels. As has been suggested, you need to be on levothyroxine medication for quite a while before you find a difference. It took me about three months before I felt reasonably well again.

My symptoms before diagnosis were hallmark ones, very cold, very tired, low mood and could not focus on things properly. I had been having some of these symptoms recently so knew my levels were a problem. They have increased my dose from 100 mcgs to 125mcs, as my TSH level was up to 3.26 from 1.6. At my surgery they like it to be at 2 or below.

My experience is that if I am 1 or below on my TSH level I feel good. It is an inexact science though as if you go to 0.33 or below then you can become hyperthyroid.

I am not sure about the gluten free diet for hypothyroidism, but probably need to read up on this. What I have read recently is that unless you have coeliac disease, gluten free diets are not so good, but would need to investigate this further.

Try not to despair though because they will be checking you often until you get the correct dose to enable you to feel much better.

In the winter your TSH level can increase more as obviously it takes more T4 to keep the body metabolism regulated particularly keeping your body warm, so people often need an increase in their dose in the winter months.

It is also the case that your cholesterol level can increase when you have hypothyroidism when your dose is too low. As soon as levo is increased, you cholesterol level will come down, at least that has been my experience over the years.

Take care and I hope you feel much better within a few months.

Heather

[MrWellness94 in reply to Heather77]

Hello Heather77,

Thank you for responding, it is comforting to know that even though it takes a while, one can feel better. Before medication and diagnosis my TSH was 10 which is very high, therefore it seems like it’s going to take some time for anything to change. Also, we are having very very cold weather here which makes sense that I would feel this way as well. I notice that during cold months I feel at my worst. Anyway thanks for your encouragement it really means a lot as right now I feel a bit overwhelmed with the symptoms.

[Heather77 in reply to MrWellness94]

I have been at 12 during my time being hypothyroid and they increased my dose immediately and a couple of months later, my TSH level was back to range again and I felt much better. All will be well in time....