After a six-year battle to be taken seriously, I have finally been prescribed medication for my thyroid. It's been a tough journey because I've always been considered subclinical, but I finally saw a private doctor last week who said he would like me to try Levothyroxine. He's starting me out on 75mg.
I just wondered if there's anything I should be doing to ensure I get the most out of this medication that I can. I know not to take it with dairy (to be honest, I have mostly cut dairy out of my diet alongside gluten) or caffeine, or close to any iron supplements. Is it best to take at night or in the morning? And I'm aware that low ferritin adversely affect conversion of T4 to T3; are there any other deficiencies I should watch out for that could potentially reduce the efficacy of this medication?
Thank you all for your advice.
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Unless lactose intolerant it's likely best to avoid Teva brand of Levothyroxine. But if you are actually lactose intolerant then you need to try this brand as is only lactose free one
Though it's a bit like Marmite, some love it, others hate it
Widely available brands are Activis, Wockhart and Mercury Pharma
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.
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.
Again some like morning, others prefer evening dosing
Most important thing is to take it everyday, get a weekly pill dispenser. If you forget one dose, take it as soon as you remember. It's a storage hormone, in theory you can take a weeks dose all at once. But not suggesting you try it!
Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine
Important to test vitamin D, folate and B12 too
Thyroid levels need retesting 6-8 weeks after each dose increase
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)
Do you have high thyroid antibodies? If so this is autoimmune thyroid disease also called Hashimoto's
Thanks very much. The first time I had my antibodies tested they were at 130 (this was about five years ago). I then went on a gluten free diet and when they were checked subsequently - maybe around six months after quitting gluten - the antibodies had dropped to 30.
However they haven't been tested in a while. My GP doesn't keep tabs because she doesn't actually believe I have a thyroid problem worth medicating. She even told me today that while the private doctor had recommended I have my T3 checked when I get my next lot of bloods done, she isn't sure I will get it because "we don't check T3".
NHS almost never test FT3......as they don't want to prescribe T3, they don't want to test it
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
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.
If antibodies were high in past, even if under range now, then you have Hashimoto's
Antibodies very, very often drop once strictly gluten free
I’d start on 25mcg if I were you and raise by 25mcg each time. 75mcg is probably too ambitious a starting dose, may cause you problems (eg chest pain). Many would suggest you leave six weeks between increases but I would suggest you follow your instinct. But there is no point in having a test at all until dose has been stable for six weeks.
Some research suggests taking at night is best. I would suggest you take it well away from all supplements and food and take with water. Stick with the same brand (though if you don’t think it’s doing anything, and if it’s Teva, you might like to try a different brand).
I believe that dieting is unhelpful to thyroid balance (in me anyway, short bursts only are best).
Thanks! I've actually been given two brands - I've got two packs of 50mcg which are Almus,and two packs of 25mcg which are Mercury Pharma. Hoping there won't be an issue with mixing them...
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