I feel so unwell despite dose increase - Thyroid UK

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I feel so unwell despite dose increase

Dee8686 profile image
18 Replies

Upped my dose from 25mg levo to 50 about 10 days ago but I feel so so unwell. Worse in fact. Awaiting blood results on Monday but I thought I might feel a little better with the dose increase. Headaches, groggy on waking, no energy.. so tired and even pottering now seems like I overdo it.

Why am I feeling worse?

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Dee8686 profile image
Dee8686
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18 Replies
SlowDragon profile image
SlowDragonAdministrator

When dose is increased we often can feel worse, before we feel better. It takes 6 weeks for a dose increase to have full effect

What was most recent Thyroid test results?

Have you had vitamin D, folate, ferritin and B12 tested. Add results if you have them

Also do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies?

What supplements are you taking? And are you on gluten free diet?

Dee8686 profile image
Dee8686 in reply to SlowDragon

Thank you for replying. I will have blood test results on Tuesday and post then for feedback. All I know from my gp is that I have adrenal insufficiency (246) and awaiting further tests and my tsh was 4.1 in January and t4 17. That’s all the info I have now. Journey details in my profile. I just feel so awful. I’m just having to rest all the time because I feel so poorly and exhausted. It’s hard to comprehend that a slightly raised tsh can make you feel so unwell and doesn’t help when doctors tell you it can’t be thyroid causing problems. x

Dee8686 profile image
Dee8686 in reply to Dee8686

Currently supplementing a Viridian multi vitamin in high doses, 4 caps a day. Magnesium, adrenal support, vitamin c. I am gluten free and have been for years too but don’t know if I have hasinotos SlowDragon

SeasideSusie profile image
SeasideSusieRemembering in reply to Dee8686

Dee

Does you multivitamin contain iron? If so then you will get no benefit from anything else that it contains as iron must be taken 2 hours away from other supplements. Also, as you take 4 caps a day, is this in divided doses and are you leaving 4 hours between Levo and your multivitamin as iron must be taken 4 hours away from Levo.

You would be better testing vitamins and minerals and supplement with appropriate doses where levels are low, multis really aren't the answer.

Dee8686 profile image
Dee8686 in reply to SeasideSusie

I take the multi 4 hours away from the levo and I take 2 caps in the morning with food and 2 tabs at lunch time. This is the supplement viridian-nutrition.com/Shop... SeasideSusie x

SeasideSusie profile image
SeasideSusieRemembering in reply to Dee8686

It contains iron, calcium and Iodine. We shouldn't take Iodine or calcium unless tested and found to be deficient. Iodine is anti-thyroid and used to be used to treat overactive thyroid.

Personally I would ditch that supplement and do the tests that SlowDragon has mentioned then see exactly what needs supplementing.

Dee8686 profile image
Dee8686 in reply to SeasideSusie

Thank you- I will post results Tuesday and hopefully will be able to see where I need to target supplementation!

SlowDragon profile image
SlowDragonAdministrator in reply to Dee8686

Essential to know if you have Hashimoto's too (diagnosed by high thyroid antibodies)

If you do, especially, but even if you don't appear to, going strictly gluten free diet helps very very many.

Vitamin C is a good daily supplement to take to help support your adrenals. You don't need to test for that

All the others, we need to test first and supplement specifically for any that are low.

Suggest you get full Thyroid testing 6-8 weeks after this dose increase - TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT4 and FT3 plus vitamins

Private tests are available, NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

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 ideally 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. (Patient to patient tip, GP will be unaware)

Dee8686 profile image
Dee8686 in reply to SlowDragon

Thank you. Yes I will post all these results Tuesday then hopefully we can see the bigger picture as to what’s going on @slowdragon

shaws profile image
shawsAdministrator in reply to Dee8686

Your blood test has to be at the very earliest appointment, fasting (you can drink water). If it is later, change your appointment due to the fact that the TSH is earlier a.m. and drops throughout the day and may mean the difference between getting an increase or not.

Always make your blood test appointment weeks before yours is due as it is sometimes difficult to get an appointment at the time you want.

shaws profile image
shawsAdministrator

Unless you are very frail with a heart disease, the starting dose is 50mcg with an increase of 25mcg of levo every six weeks until we are symptom-free and TSH 1 or lower. Many doctors think 'somewhere' in the range is fine. It definitely isn't.

Dee8686 profile image
Dee8686 in reply to shaws

Thanks you. Will post results when I get them. Just looked over old results from 2016 and my ferritin was 24 with range 4-204mol ...

I know it’s an out of date reading but that’s low and should have been addressed! shaws

shaws profile image
shawsAdministrator in reply to Dee8686

How much do hypothyroid need to read and learn in order to get well? It really shouldn't be necessary but one doctor (deceased) told the Endocrinologists that patients are in a 'parlous situation' due to not being diagnosed/treated optimally and not being offered alternatives. This doctor has now died and he wouldn't believe that T3 was withdrawn now as well as NDT.

samaja profile image
samaja

If you read the levo leaflet it clearly says there that your adrenals should be sorted out first because levo might give you some nasty side effects so it is another possibility that your increase has caused this negative reaction. Was it recommended by your doctor?

Dee8686 profile image
Dee8686 in reply to samaja

I asked for the increase without knowing my cortisol result at the time. I’m not sure what to do now 😕

samaja profile image
samaja in reply to Dee8686

Obviously you need to talk to the doctor asap and investigate further. Try to see them on Monday or at least press for a telephone consultation. Unfortunately dose increases are not always the answer as I know from personal experience. Never got beyond 50 mcg and actually even 25 is only ok after sorting out a lot of other deficiencies. Hang on there for a couple of days longer, just take it easy and rest!

Dee8686 profile image
Dee8686 in reply to samaja

I will- I have benenden insurance so will call a doctor tmw and ask..what is your experience please?

samaja profile image
samaja

You know the beginning of the story from my first post (and the 50 I took then for a couple of months was the biggest dose ever for me) and what followed afterwards was a year without any levo but working on my health by changing the diet to organic - and gluten free, addressing deficiencies, having the right supplements, felling better and going downhill after becoming postmenopausal which led to BHRT and after stabilising the sex hormones restarting levo again (my decision on having hypothyroid symptoms) with 12.5 and now 25 mcg and now working mainly on stress response and stress resilience and mental aspects of my condition. I have not tested for the faulty DIOI gene but my recent test showed very high rT3 which might confirm my suspicion that I am a poor converter and will probably never do great on levo alone. I also learnt that symptoms come and go and the better I know my body and work with it rather than against it (mindset is the key for me!) the better results I am getting. It is definitely a very educational journey but apart from all the bad stuff it can be also exciting and good for you in the long run. All the best to you! Take care Dee 8-)

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