Do i need to up my dosage ???????

[Cassie101]

Free thyroxine (T4) level,

Serum

13.1 pmol/L

(Norm:

10.5-

24.5)

TSH level, Serum 2.32 0.27-4.2 mU/L

FSH level, Serum 7.4 U/L

ONLY TAKING 25 LEVO EVERY OTHER NIGHT really need some advice thank you x

[Cassie101]

So how should i take my meds coz im currently on 25 every other night should i be on it every nite i do hv bad side effects 2 the tablets any ideas ???

[Cassie101]

Wockhardt so do u think i need to up my dose and how i take them ?

[greygoose]

Considering you are on such a stupid dose, your levels aren't bad. Why aren't you taking more?

[Cassie101 in reply to greygoose]

Hi i seem 2 hv really bad side effects to the meds.. so been taking every other night how should i take my meds ? And should i up the dose? Coz the endo seem to think my tests are ok but i dont feel ok... thanks for replying

[greygoose in reply to Cassie101]

Not surprising you don't feel good, because your TSH is too high for someone on thyroid hormone replacement, meaning that your Frees are too low for you. Or, it could be that you don't convert the levo to T3 very well. Normally, the TSH should be one or under. So, that would suggest that you do need to increase your dose - or, at least try an increase - say 25 mcg every day - for six weeks and see if you feel any better.

Do you have your labs from when you were diagnosed? Do you have high antibodies?

[Jlangley in reply to greygoose]

Why is it a stupid dose (genuine question)? Isn’t it good to be on lowest possible dose that eliminates symptoms? Surely better that docs increase slowly and find the balance that way? Not being combative, genuinely curious!

[greygoose in reply to Jlangley]

Because such a low dose is not likely to help anything. And, the proof is that the OP doesn't feel well, her symptoms aren't eliminated. Even with 25 mcg every day, it can make people worse rather than better. And, the reason for that is that 25 mcg is enough to stop all thyroid production, but not enough to replace it, so the patient has the equivalent of a reduction in dose, and their TSH rises.

The OP's TSH is surprisingly low considering her dose, and makes me thing we don't have the complete picture. Which is why I asked for levels at the time of diagnosis. And, if she has antibodies, which can change everything. 25 mcg every other day is really not worth taking, and I wonder how the OP would feel if she stopped taking it altogether - not that I'm suggesting she does, but that's the way my mind works.

[Cassie101 in reply to greygoose]

I do have high antibodies and a goitre i will post them up 2mora when i get a copy from gp.. so i hv tryed stopping alltogether bt my kneck becomes mre swollen dont no what to do..

[greygoose in reply to Cassie101]

Interesting. But, of course, if you have antibodies, then your levels are going to swing around, so don't mean very much. But I am surprised that 25 mcg every other day actually does anything.

Your endo is wrong about your results being ok, but then endos usually are wrong about everything. You could very well be having a reaction to the fillers in the tablets. Which brand are you taking? Have you ever tried a different brand?

[Cassie101 in reply to greygoose]

Wockhardt thats the 1 im taking atm i hv tryed teva and mucury but they make me worse.. so should i try taken it every night? Would that make a difference jst dont want tje side effects of them☹

[greygoose in reply to Cassie101]

No-one can predict how you are going to react. The only way is to try it.

People often do well on Wockhardt, but there are always exceptions. Not sure if there's another brand you can try…

But, have you considered getting your own NDT and trying that?

[Cassie101 in reply to greygoose]

They wont give me the ndt i have asked

[greygoose in reply to Cassie101]

I know. I said buy your own.

[SlowDragon Ambassador]

Essential to test vitamin D, folate, ferritin and B12

Ask GP to test if not been done, plus both TPO and TG thyroid antibodies

Low vitamins often mean it's difficult to tolerate Levothyroxine

When hypothyroid low vitamins are extremely common

What brand of Levo are you taking?

Standard starter dose of Levothyroxine is 50mcg. Taking too small a dose can often cause problems

NHS guidelines saying standard starter dose is 50mcgs

beta.nhs.uk/medicines/levot...

[Jlangley]

Hi reallyfedup,

Would love to hear more about why citrate should be avoided but not finding much online. Do you have any info on this please? Thanks so much

[Jlangley]

Fair enough! Are ya allowed give me the headlines? No worries if not just curious as I’ve been taking it and had no probs but want to make sure none brewing!

[helvella Administrator]

What is wrong with black mold?

That it is black? That it is mold (or mould)? That it sounds unpleasant?

We are being told everyday how important the various things that grow in our guts. I suspect an awful lot of them would be seriously off-putting if identified and investigated individually.

Are you saying that ALL forms of citrate should be avoided? Lemons? As an anti-coagulant in blood products?

It is a very drastic curtailment.

[helvella Administrator]

Do you have any idea of the scale of what you are telling people to do?

There are around 1,300 items on the EMC site which contain citrate or citric acid, including Teva and Mercury Pharma levothyroxine tablets and all liquid levothyroxine products. Are you really saying that everyone should only take Actavis and Wockhardt levothyroxine tablets? (Of the UK levothyroxine products, of course.)

(Citric acid appears to be a step on the way between original fermentation and production of whichever citrate is required.)

Citrates and citric acid are also used in very large numbers of foods, drinks, hygiene products, etc.

The scale of change required to avoid all forms of citrate is staggering. It demands not just one paper, but a raft of papers and multiple independent confirmation.

I couldn't find anything that matched in PubMed - this was my initial search:

ncbi.nlm.nih.gov/pubmed/?te...

[helvella Administrator]

I don't think there is any deceit whatsoever about the source of citrates. It is a technique that has been in use for about a century.

What I meant about scale was the enormous changes you are pushing individuals to make. Wholesale change of medicines. Is the negative of citrate so great it is worth suffering through changing makes? Even stopping certain medicines entirely?

In my book, you need to provide an awful lot more than "Citrate is made from black mold ....and should be avoided ..inc magnesium citrate" as a reason to make those potentially very significant changes.

Indeed, whilst aspergillus appears still to be the dominant process, other techniques do exist but I have not managed to track down how much is made by each technique. It would be pretty annoying to have stopped something good on the basis of the use of aspergillus use and later find that product did not use citrate from that source.

[helvella Administrator]

No I am not.

I am questioning the evidence you have to support what you are saying about citrate. Even if there is general evidence, which you will eventually post, we need the specific evidence that this particular form of citrate is used in each product.

Further, I think you are underestimating the impact on individuals of suddenly switching products - such as from Mercury Pharma to Wockhardt levothyroxine. Aside from the almost certain impossibility of the supply chains being able to cope.