Nausea and underactive thyroid.

[melon_one]

Hello!

I am just wondering if it is normal to get nausea after starting Levothyroxine?

9th Feb my GP tested TSH only and Vit D levels.

TSH 7.6 (range 0.27-4.2)

Vit D 118 (range >51)

I was started on 50mg Levothyroxine end of Feb but had a few adverse reactions (which my specialist nurse says is nothing to do with brand 😳)

I tried again starting on 25mg for a week and then increased to 50mg. It’s now been 22days on Thyroxine (8days at 50mg) and the nausea is getting worse it is like a hangover from hell including weakness, headaches and not being able to stand up. It feels like my body cannot support itself.

I am having bloods done W/B 9th April and seeing Endo Team 20th April.

I have been getting 3 monthly B12 injections for awhile but haven’t had levels done for 2years (getting this checked in April).

Vit B (range 211-911)

Feb 2013 - 221

Oct 2014 - 673

Jan 2015 - 354

April 2016 - 492

I was previously overactive and in 2013 was treated with radio iodine. I only have TSH data from GP but TSH and T4 were constantly monitored at the hospital (I don’t have that data at the moment) and I ‘surprisingly’ stayed normal until now!

I plan on getting copies of all previous data as I know from reading all the comments posted it’s really important to understand my results.

My specialist nurse says this is a blip and doesn’t think I need T4. I’m not sure I agree. But don’t know what to think at the minute. 🤔

Vitamin D (range >51)

Jan 2015 - <31

April 2015 - 65

Aug 2015 - 86

Aug 2016 - 43

Jan 2017 - 90

Feb 2018 - 118

I was taking 3200iu Vit D and was told to reduce to 800iu on 14th Feb.

TSH (range 0.55 - 4.78)

Aug 2015 - 2.6

Nov 2015 - 2.9

April 2016 - 2.7

Nov 2016 - 1.1

Jan 2017 - 1.1

July 2017 - 1.7

Feb 2018 - 7.6 (range 0.27 - 4.2)

My blood test in April will test TFT (TSH & T4), T3, Vit D, B12, Ferritin and Folate as well as FBC U&E and Bone profile.

Am I wrong in thinking I am under medicated? (as that’s what it feels like)

I know I won’t be sure till my blood test in April and I need to ride this out. I just want to know if the nausea and generally feeling worse with exhaustion and everything is part of the underactive thyroid?

If that is right, will it get better when I’m on the correct dose?

Please tell me it does! I need some light at the end of the tunnel. It is so debilitating and I’ve been off work for 5 weeks and hoping to go back to work after Easter holidays (I am a teacher).

Thank you so much for reading this and any advice you can give will be greatly appreciated!

😊

[crimple]

Which brand of levo are you taking and have you had any tests for antibodies?

[melon_one in reply to crimple]

First attempt tried Mercury Pharma (but found reaction was due to penicillin)

Second attempt Actavis and had hangover reaction.

Then went back to Mercury Pharma as I didn’t think the reaction was due to Levothyroxine and started lower on 25mg and increased up to 50mg as advised by Endo Nurse.

I think I might have had TPO antibodies tested (but not 100% sure as my memory is rubbish at the minute) at the hospital that would have been done 2013 I think. I will check when I see Endo Team next.

I was diagnosed with Addison’s secondary adrenal failure in 2014.

[crimple in reply to melon_one]

I don't really know anything about adrenals. Hopefully someone who does will come along with suggestions!

[melon_one in reply to crimple]

Thank you. My adrenals are well controlled finally!

Now just the thyroid to deal with.

I am starting to wonder if...

a) I’m having adverse reactions to Pharma mercury brand

b) under medicated or not converting T4 to T3

[crimple]

Very difficult to say without T4 and T3 results. Medichecks do thyroid offers on Thursdays.

[melon_one in reply to crimple]

I will phone the hosiptal in the morning and post the results if I can get them.

[SlowDragon Administrator in reply to melon_one]

Starting Levothyroxine may affect adrenals. Your adrenal medication may need adjusting. You should be seen by endocrinologist really because adrenals and thyroid are so interconnected. This is beyond a GP

When patients are first started on Levothyroxine it can reveal adrenal insufficiency.

healthunlocked.com/thyroidu...

endocrine-abstracts.org/ea/...

hashimotoshealing.com/hashi...

Presumably you had Graves' disease before RAI

You might want to consider reading up about gluten free diet

[melon_one in reply to SlowDragon]

My GP contacted Endo Team as he felt with my symptoms and TSH elevated to 7.6 (not at 10 as needed for Levo) would need Levo.

Endo agreed and said to start 50mg Levo. I’ve spoken with my specialist nurse twice but I’m only seeing consultant on 20th April.

Nothing was said about adrenals and needing to increase Hydrocortisone. I was diagnosed in 2014 with secondary adrenal failure due to medication (asthmatic and Pulmonary aspergillosis).

My maintenance dose is 27.5mg Hydrocortisone (15mg/7.5mg/5mg) I also take 100mg Fludrocortisone.

Graves’ disease was never mentioned. I actually have no idea what caused overactive thyroid (diagnosed in 2013)

I just had a large goitre before bloods diagnosed OAT and treated with radio iodine. I will ask about that.

After doing a lot of reading and the comments on these forums I have gone gluten free since mid February approximately 4weeks now (I never had a lot of gluten anyway as I have a yeast intolerance)

Slowdragon thank you that’s been interesting reading!

Surely the hospital would have told me to adjust my Hydrocortisone when starting Levo?

Not sure what I’m suppose to do as when I’ve spoken to my specialist nurse she thinking my elevated TSH level is a blip and don’t need Thyroxine!

I don’t feel like my symptoms are hyper showing over medicated (although I could be wrong)

But are my symptoms as the first article highlighted adrenal or conversion??

[SlowDragon Administrator in reply to melon_one]

It can be very difficult to work out which problem is causing which symptom.

You need careful monitoring. Definitely need FT3 and FT4 tested regularly. Not just TSH

Good vitamin levels are essential too.

Ask GP to test vitamin D, folate, ferritin and B12 plus thyroid antibodies

Private tests are available if GP is unhelpful or unable to get FT3 and 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)

[melon_one in reply to SlowDragon]

I’m having a blood test w/b 9th April

[Eastgate2016]

I had awful acid reflux and nausea with levo. It reminded me of morning sickness. I don’t think I could absorb it properly.

[melon_one in reply to Eastgate2016]

Did the nausea go away? What did you do?

[Eastgate2016 in reply to melon_one]

I have been taking a probiotic and apple cider vinegar, but my biggest change has been switching to NDT. I think being more natural, I am able to absorb it easier.

[Eastgate2016 in reply to Eastgate2016]

This has only been for 6 weeks though, so not counting my chickens just yet. 😊

[melon_one in reply to Eastgate2016]

Thanks. I hope it continues to work for you!

[silverfox7]

It's not unusual to experience a reaction to the fillers but agree it can be difficult to work out what is causing the problem. Take an anti histamine one hour before your thyroid meds and see if that stops the problem.

[melon_one in reply to silverfox7]

According to my specialist nurse ‘it’s nothing to do with brands and fillers’ and shouldn’t get adverse reactions.

I take 180mg Fexofenadine antihistamines eveyday. I have also been taking liquid piriton.