Subclinical Hypothyroidism and side effects of ... - Thyroid UK

Thyroid UK

137,610 members161,357 posts

Subclinical Hypothyroidism and side effects of levothyroxine

Flowerflower profile image
9 Replies

Hello!

I've been diagnosed with subclinical hypothyroidism, have done two blood tests (when I wasn't on medication yet), here are the results:

- first test: TSH 10.10 (elevated) and Free T4 13.2 (normal)

- second test: TSH 5.5 (elevated, Free T4 12.4 (normal) and auto antibodies elevated

I've never had any bad effects of hypothyroidism before being diagnosed (besides occasional low energy levels and bloating) but I've been trying to conceive for a year and after doing the blood tests, the doctor gave me levothyroxine 50mg to start with as he said that might be the reason why I'm not getting pregnant.

The problem is that as soon as I took the first tablet, I felt worse. I had heart palpitations throughout the day, felt anxious and nervous. I called the doctor and he said I should try taking 25mg. I've done that the second day but the symptoms were the same. It looks like I can't take levo and have really bad side effects.

Is there anybody else that has such bad side effects after taking such a small dose of levothyroxine? Also, has anybody tried any other tables for hypothyroidism that helped with managing side effects?

Any thoughts would be much appreciated!

Thank you!

Written by
Flowerflower profile image
Flowerflower
To view profiles and participate in discussions please or .
Read more about...
9 Replies
Marz profile image
Marz

I am wondering if you have the following tested - B12 - Folate - Ferritin - VitD. They need to be good in range for your thyroid hormones to work well - yours and the ones you take. B12 is good above 500 - Folate and Ferritin are good mid-range and VitD around 100.

25mcg is a very small dose and usually 50mcg is a starter dose. This can sometimes have a negative effect and make you feel worse. It did me back in 2005 - before I joined this forum :-) Are you due to be re-tested within 6 weeks ? You will need a dose increase. Your TSH needs to be around 2 for conception ... I have just read an article for a friend so will link it below.

verywellhealth.com/infertil...

Sounds as if you have Hashimotos - so read the article above as it does mention Hashi's ...

Hope all goes well for you and that you soon feel better.

Flowerflower profile image
Flowerflower in reply to Marz

Thank you Marz, much appreciated! My Vitamin D levels were normal but they didn't check the levels of Folate, Ferritin or B12 (I will ask them to do that). Unfortunately, they confirmed I have Hashimoto.

They first prescribed me 50mcg of TEVA but, as mentioned above, I had a really bad reaction (heart palpitations, shortness of breath...). I went back to my endocrinologist and he gave me a different prescription (the old one, with lactose) and I feel much better but still have shortness of breath. Do you have any other suggestions in terms of brand of tables? I've heard of Activis, Armour and Vegeance but I'm not sure which one to try first.

The problem is that I discovered I have Thyroid issues because I went to a fertility clinic to check why I'm not able to get pregnant and besides being bloated and feeling cold old the time, I didn't have any major health issues. I feel like now that I've started taking the drugs, I'm feeling much worse, which shouldn't be the case...

Marz profile image
Marz in reply to Flowerflower

So often levels of B12 - Folate - Ferritin and VitD need to be optimal for you to feel well and for your thyroid hormones to work well in the body. Hard to believe I know but .... 😊 Also low ferririn/iron could be the cause of your breathlessness. Iron transports oxygen around the body - in the red blood cells. When oxygen is low the heart beats faster in order to produce more. Sometimes causing palpitations. My simplistic explanation. 😊

Flowerflower profile image
Flowerflower in reply to Marz

Many thanks, this is very helpful!!

SlowDragon profile image
SlowDragonAdministrator

TSH needs to be under 2.5 when TTC

thyroiduk.org.uk/tuk/about_...

gp-update.co.uk/files/docs/...

With a TSH of over ten you were not sub clinical but hypothyroid

As Marz says, you need vitamin D, folate, ferritin and B12 tested

Low vitamins are extremely common when hypothyroid

You also need thyroid antibodies tested to see if cause is autoimmune thyroid disease also called Hashimoto's

So 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 .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

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.

verywell.com/should-i-take-...

Other medication at least 2 hours away, some like HRT, 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.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

I think you meant 25mcg (not 25mg)

NHS guidelines saying standard starter dose is 50mcgs

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

Flowerflower profile image
Flowerflower in reply to SlowDragon

Many thanks, SlowDragon! I definitely had really a bad reaction to TEVA - thank you for highlighting that. I've tried the old formula (with lactose) and I felt much better, but still not 100%. My search continues as I need to find medication that will make me feel myself again.

SlowDragon profile image
SlowDragonAdministrator in reply to Flowerflower

With Hashimoto's we often need TSH under one, FT4 towards top of range and FT3 at least half way in range

Dose is increased in 25mcg steps retesting 6-8 weeks later each time

Typically most patients need somewhere between 100mcg and 200mcg Levothyroxine.

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)

ALWAYS get actual results and ranges on all blood tests, You are legally entitled to printed copies of your blood test results and ranges.

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need enhanced access to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up. They can no longer charge for printing out, rules changed after May 25th 2018

Vitamins need to be OPTIMAL, not just somewhere within range. Members can advise when you get the results

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's gut connection is very poorly understood

Flowerflower profile image
Flowerflower in reply to SlowDragon

Thank you, SlowDragon, really appreciate all the information!

SlowDragon profile image
SlowDragonAdministrator in reply to Flowerflower

List of Levothyroxine brands available in U.K.

Wockhart, Activis or Mercury Pharma are probably most common/popular

thyroiduk.org.uk/tuk/treatm...

You may also like...

Hypothyroid and fertility-side effects from Levothyroxine

the dose to 25mg which sorted my TSH to 2.5 but gave me the same side horrible side effects which...

Did anyone experience side effects with Levothyroxine for hypothyroidism in the first 3 months?

am newly diagnosed with hypothyroidism and have type 2 diabetes. Started taking Levothyroxine (25...

Subclinical hypothyroidism

finally been diagnosed with subclinical hypothyroidism. Both my antibodies are positive and my TSH...

Levothyroxine side effects

the test. The problem: I'm 8 days OFF any Levo and I'm still stiff and tired == the side effects are

Levothyroxine Side Effects

I was diagnosed last week with hypothyroidism and put on 25mg levothyroxine. First tablet first...