LEVOTHYROXINE

[Wayne39]

I'm currently on 150mg of Levothyroxine and feel worse then when I was on 100g. Would it be ok to reduce to 100mg straight away. As although my TSH has reduced I feel worse.

[jimh111]

A quick glance at your previous post suggests you would be OK on 100 mcg (mcg not mg, not important just to clarify). It would seem that you should do better on the 150 mcg but things don't always work out that way. Also, whilst the thyroid is in the process of failing its output can vary.

To answer your question you could reduce back to 100 mcg straight away. If you have been on 150 mcg for less than a week I would personally give it more time, if it's been more than a week then I think you have had long enough to judge. Although most patients might do best when their TSH comes down to 1 or 2 many require a much lower TSH and some a higher TSH, so a target TSH only applies to some patients.

[Wayne39 in reply to jimh111]

Hi Jim

Yes sorry I stand correct your right I meant mcg very important as you say.

I have been on 150mcg for 4 weeks but I think when I have my blood test in 2 weeks I'm going to ask the doctor if he will let me reduce to 100mcg. I didn't feel great on that but a lot better then I do now.

I will ask if he can test FT3/FT4 because I just don't no the dose to be on. Funny thing is I was on 100mcg from 2012 up until around 3 months ago. The n something seem to change and I felt rubbish.

Yes I saw that most go on about a TSH under one as the benchmark then you feel better. But I do feel the lower I've got mine the worse I have felt.

I've had this pain underneath my right foot only and just felt sluggish.

Really appreciate your advice

[jimh111 in reply to Wayne39]

Yes you may as well stay on 150 mcg until your blood test so that you get steady state results. I'm sure your doctor will be happy to reduce your dose. It's very difficult for a GP to get fT3 assayed as the hospital biochemist tends to override them (absolute nonsense). However, if your doctor were to mention you have abnormal response to levothyroxine or 'discordant' results or whatever they might be able to insist on TSH, fT3, fT4. They will need to state firmly that TSH, fT3, fT4 needs to be done. They could write on the form requesting the lab contacts them if they are unable to do all three. This might do the trick as they will be too lazy to call the doctor!

[Wayne39 in reply to jimh111]

Hi Jim

Again thank you so much for your help on this.

I will ask the DR if he can do it if not I will get the private results. Problem I have is that if I go back to my DR with the FT3/FT4 results he's not going to act on them is he. As they only g oby TSH results!

[Hennerton in reply to Wayne39]

You could try 125? No need to make such a drastic reduction.

[Wayne39 in reply to Hennerton]

Hi Hennerton

I was on 125mcg before and felt just as bad I've gone up in 25mcg divisions to 150mcg and still feel no different.

I felt better on 100mcg

[Hennerton in reply to Wayne39]

I think you need to get full thyroid blood tests. We are all guessing until we know your free T4/3 results and see whether you are converting well. If you are not, the increased dose will make you feel most unwell. Can you ask your GP to help or use one of the companies recommended by Thyroid UK? Also check vitamins and minerals like Vit D, B12, folate, iron and ferritin. Low levels of these, particularly as you are a runner, will affect how you feel.

[Mollie2 in reply to Wayne39]

Hi wayne, Are you taking a generic meds? They change frequently, ie put in different fillers and tell no one. Also they can be 10% either side of the theraputic dose, look it up. And the chinese generics are a no no now, going by reports about generic chinese levothyroxine! Said to be contaminated.

[Portia1974]

The suggestion to try 125mcg instead seems sensible to me since, as I understand it , doses are increased in 25mcg increments. So if you jumped from 100mcg to 150mcg that might explain the wobble.

Also, have you checked that the pharmacy have consistently dispensed the same brand over the course of your increase? If for instance you had 100mcg of Actavis Levo and felt well, then when you increased instead of giving you additional 50mcg tabs of Actavis, they're mixing and giving you 50mcg of Teva tabs...or indeed changing your brand entirely...this could be a factor in feeling crappy.

Teva did NOT agree with me at all. Mercury Pharma has been a bit better but still have headaches and nausea. So now trying Actavis.

Just a thought.

[helvella Administrator Thyroid UK in reply to Portia1974]

It is possible to make very fine adjustments to levothyroxine doses. No need to always go for exact multiples of 25 micrograms!

dropbox.com/s/sllu21khbeyth...

[Portia1974 in reply to helvella]

Very true.

[Wayne39 in reply to helvella]

Very interesting information

Thank you

[Wayne39 in reply to Portia1974]

Hi Portia

I was on 100mcg then I went up in 25mcg divisions to 150mcg but still feel rubbish. Felt better on 100mcg tbh.

The bit about the brand is very interesting and helpful I will defiantly look into that!

Thank you for your help and you have provided me with some valuable information