Hot flush or hyper?

[JAmanda]

Hi,

I’ve recently started taking levo - 10 weeks or so - and am 52. I sometimes get this rising hot feeling and my pulse races - am I acclimatising to the t4 or over medicating or having a menopausal episode?!

Thanks.

[Gr8Nica]

When I started treatment with T4 I was getting horrible hot flushes mixed with extreme freezing feeling episodes. Over time they got much better (only on rare occasions). Others might have had different experiences though. Since I added T3 I don't get those anymore.

The only time when my pulse was racing it was when they increased my dose too high to fast.

Did you have any change in a dose recently? What dose are you on now?

[SlowDragon Administrator]

Racing pulse can be due to under medication

How much Levothyroxine are you currently taking. Were you started on 50mcg

You should have had bloods retested after 6-8 weeks on starter dose

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

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. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

[JAmanda in reply to SlowDragon]

Many thanks for info but I guess I’ll need to wait fir Endo appt as am not much wiser - could be under or over medicated or a menopausal thing. I’m so much better than I was 3 months ago that I’m not too worried.

I was started on 25 for a lark I think (sub clinical but lots of symptoms) I upped it to 50 and told doc who agreed to continue. My tsh is now 2.5 so I suspect I could take a bit more. Seeing Gp tues (not that I expect much).

Thanks anyway.

[SlowDragon Administrator in reply to JAmanda]

Most patients need TSH around or just under one. Most important is to test FT3 and FT4

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

NHS guidelines saying standard starter dose is 50mcgs. Most people eventually need somewhere between 100mcg and 200mcg Levothyroxine. Dose only increased in 25mcg steps. Retesting each time

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