I was diagnosed with hypothyroidism by a doctor and was given 100 mg of levothyroxine (Ethyroid), but the side effects were dry eye, floater, sensitivity to reduced light, hot eyes, painful eyes, etc.
I want to ask how long this side effect will end?
Thank you to anyone who can enlighten me.
God bless you
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TanHokLie
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Starting on 100mcg dose is quite high. Normally it's at 50mcg and retesting bloods after 6-8 weeks with slow increase in Levothyroxine by 25mcg steps upward as body adjusts over several months
Do you have results and ranges from before starting on Levothyroxine
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
NHS guidelines saying standard starter dose is 50mcgs
I got Total Thyroidectomy Surgery on July 26, 2018 due to hyperthyroidism.
After the surgery, the lab results on August 2, 2018, show:
Hb = 12.2 (standard 13.1-17.2) = below
Ft4 = 27 (standard 10.6-19.4) = upper
T3 = 0.75 (standard 0.92-2.33) = below
Tshs = 2.38 (standard 0.25-5)
Sodium = 129 duplo (135-148) below
Potassium = 4.5 (3.5 - 5.3)
Calcium ion = 4.2 (4.6-5.2) below
The doctor gave a dose of Eutyrox = 100 mg, but after 7 days, I felt palpitations, rapid breathing, restlessness, lack of concentration, slightly sore eyes, then the doctor changed to 50 mg.
After 3.5 weeks, I felt pounding, absent-minded, nervous, sleepless, weak, the lab results on August 27, 2018 showed:
Hb = 12.1 (standard 13.1-17.2) = below
Ft4 = 16.73 (standard 10.6-19.4)
T3 = not check-in
Tshs = 12.76 (standard 0.25-5) = upper
Sodium = not check-in
Potassium = not check-in
Calcium ion = not check-in
Then the doctor converts Eutyrox = to 100 mg. After 3.5 weeks, I felt pounding = another pounding, anxiety, lack of concentration, shortness of breath, hot eyes, pain, a floater in my eyes, lack of appetite etc. The lab results on 19 September 2018, show that
Hb = 11.8 (standard 13.1-17.2) = below
Ft4 = 25.8 (standard 10.6-19.4) = upper
T3 = not check-in
Tshs = 3.33 (standard 0.25-5)
Sodium = not check-in
Potassium = not check-in
Calcium ion = 4.4 (4.6-5.2) = below
Vitamin d = 18.5 (<= 20) = deficiency
the doctor changed the dose of Eutyrox = 75 mg, and I just tried 3 days, hopefully there will be a change.
Your vitamin D is presumably measured in ng/ml (UK units are nmol)
Your level is extremely low and must be improved by supplementing. Has Doctor prescribed loading dose?
Calcium levels will rise naturally as vitamin D improves
Thyroid hormones need good vitamin levels
Presumably you had Graves' disease
Like Hashimoto's, Graves is autoimmune, they both affect the gut and can lead to low vitamin levels so important to test folate, ferritin and B12 as well
Links about Graves, Hashimoto's and gluten connection
The aim of Levothyroxine is to bring TSH down to around one and FT4 towards top of range and FT3 at least half way in range
This can take fine tuning, dose needs increasing slowly, 25mcg at a time and then waiting 6-8 weeks before retesting
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)
Getting vitamins optimal is essential too
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.
Other medication at least 2 hours away, some like iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription
As others have said, after thyroidectomy you may find you need addition of small dose of T3, but getting vitamins optimal and Levo dose correct plus gluten free, are first steps
Levothyroxine is T4 and must be converted into T3 before we can use it. Some people need a small amount of T3 as well
The body is meant to convert t4 to t3 by itself. But in some people, like you, it doesn’t happen as much as it should, which results in low t3. T3 is the active hormone, which gives you energy. T4 is a storage hormone, and it’s role is to be converted into t3. But having extremely high levels of t4 above range isn’t good for you and could be giving you side effects. And since your body isn’t converting it into t3 it’s not very useful for you either. You need more t3 and less t4.
So the conclusion is how to convert T4 to T3. But the problem is hypothyroid drugs in Indonesia (I live in Indonesia,,,,) there is only one type drug for hipothyroid that is levotiroxine.
Getting your vitamin levels to optimum can help your body to convert t4 to t3 but some people will never be able to make enough t3, and these people often take t3 medicine to supplement t4 or even just take t3 only. There are a set of genes which mean some people would never be able to make enough of it.
Even if you cannot get t3 in Indonesia you can buy it abroad and get it delivered by post. It is possible to get it from some countries without a prescription, such as Greece. Many people on here end up doing this if they cannot get it from their doctor. You could do a thread asking people for reliable suppliers.
Levothyroxine is one of the very few things dispensed by a pharmacy which has no listed side effects and the problems with your eyes are probably not side effects. Some however report issues with the fillers used in forming the tablets.
When taking levo to treat hypothyrodism the body detects it and the control mechanism can cause the thyroid gland to make less thyroid hormones. The net result is that taking these amounts of levo does not help and in some cases can make things worse. About 125 mcg levo is regarded as a full replacement dose - this provides all the body needs and the thyroid gland does not have to make any. You may have to increase your levo.
Hypothyroidism causes weak eye muscles and loose ligaments leading to poor focusing. Healthy eyes are bright, clear, and shiny. Hypothyroidism can lead to red, irritated, dry eyes. Floaters, visual disturbances and night vision problems are frequent. People with hypothyroidism have reduced ability to convert beta-carotene into vitamin A, which is necessary for vision, especially at night.
It is, of course, a matter for discussion and investigation to determine which of these listed side effects are due to excessive doses, or excipients, or any other factor.
Given the issues around doctors being over reliant on blood test results to determine dosage of thyroid medication it is likely that a number of patients are not on the correct dosage and will have symptoms of over or under medication. The fact that BNF have not identified some of their side effects as "usually at excessive dosage" does not mean that they could be due to this or even insufficient dosage.
I think I got the idea that thyroid hormones had no side effects from sources such as the patient information for Liothyronine Sodium (T3). medicines.org.uk/emc/produc...
4.8 Undesirable effects (information for doctors)
The following effects are indicative of excessive dosage and usually disappear on reduction of dosage or withdrawal of treatment for a day or two. Anginal pain, cardiac arrhythmias, palpitations, muscle cramps, tachycardia, diarrhoea, restlessness, excitability, headache, flushing, sweating, excessive loss of weight and muscular weakness, vomiting, tremor, insomnia, fever, heat intolerance, transient hair loss in children, hypersensitivity reactions including rash, pruritus and oedema also reported.
The patient tab lists the side effects with the proviso: "These effects normally mean the dose of the medicine needs changing. You should consult your doctor if they occur. The effects usually go away when the dose has been changed."
Unfortunately my symptoms became worse whilst taking 100mcg levothyroxine only and I was terribly ill as the T4 wasnt converting to T3 it took 7 years of begging my gp to help me by prescribing the T3 i so obviously needed but he refused even after agreeing i wasnt converting so i made the decision to stop taking the levo as I was desperately ill and had gained 4st in weight and I ordered "armour" a combination of T4 and T3 and from a pharmaceutical company in America (im in the UK) and iv never felt better . My energy levels have increased my muscle cramps and pain in my joints have all but vanished and I dont go back to bed in the day time for a 4 hour sleep . Iv almost got my life back . Im also gluten free and dairy free and have banished sugar and processesd food from my life i feel so much better im not fixed but im better now than when I was on just taking levothyroxine. It's NOT the case for everyone but for me taking just levo didnt help me it almost killed me I ended up in A&E twice and also suffered a stroke and it was linked to my hypothyroidism and hashimotos disease. I hope you find the right medication for you . This is definitely the right place to seek help the members here are very helpful and full of knowledge iv learned a lot from them . Good luck 😁
Are you sure this is as a result of levothyroxine? Just because it developed at same time does mean it is so .... For example these symptoms are very much the same as what I have had for years which is now diagnosed as Sjorgens Syndrome, but only this year I developed signs of hypothyroidism and turns out I have Hashimotos also... The current thought is possibly slow progression lupus is the underlying cause.. Those symptoms are so reminiscent of Sjorgens that perhaps you should be looking at a full auto immune panel to be sure
The blood tests you need to rule out systemic auto immune disease is not hb, liver and kidney function.... You need full auto immune antibodies panel which will include tests for ANA , Anti LA and RO antibodies and some others I am not sure of... If Ana was positive it us very indicative of Sjorgens and or Lupus, but unless you get Malar rash and a few other symptoms it is not as likely, but as you have symptoms seen in Sjorgens (you don't have to have it affecting eyes and saliva /mouth - mine has only mildly started affecting dry mouth and I am 6 years in) then with ANA and then a reduced tear breakup test /shirmer test on eyes will confirm Sjorgens. I am ANA negative still but I am RO positive which indicates Sjorgens, Lupus or lymphoma.. I have been diagnosed with Sjorgens but am being checked for lupus as we think slow progression and ANA will become positive in the future... If your hypothyroidism is Hashimotos then it is worth noting that it is often seen in Sjorgens and Lupus patients and those with Sjorgens can often have or develop lupus.
The best drops I have found in uk for day time use is Hylo forte.... Only ones to offer any kind of temporary relief, and also 'simple eye ointment' for night which is a really thick greasy gel.... There is no cure for Sjorgens, you treat symptoms with eye drops and any pains with anti inflammatories and pain killers, and immune suppressants which are designed to just dampen the immune system so it is not in overdrive... It won't necessarily stop a flair up
It looks like your t4 keeps going quite over range but your t3 is rock bottom. A bit too much t4 gave me pain and tension behind the eyes, but i still had way too little t3. It’s almost like having symptoms of both! If you don’t convert well, taking more t4 to up your t3 isn’t going to work. You convert really badly.
The aim is generally to get your t4 at least half way through range, but not overrange or you may get side effects. And importantly, you need to get your t3 about three quarters of way through range.
Just keeping giving you t4 isn’t going to help, and the combination t3&4 medications generally have a low percentage t3, as do NDT (animal thyroid as opposed to synthetic).
You might need less t4, and more t3....because you convert so badly. Some people on here take t3 only, because they don’t convert well or t4 gives them side effects.
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