Thyroxine doses

[quietoneme]

Can you tell me what dose everyone is at please i am on 275mg but feel this needs to increase again i feel crap all the time and am missing out on my grandkids

[SlowDragon Administrator]

That's higher than average, but not as high as a few

It suggest poor gut absorption

How do you take your Levothyroxine?

Is it always the same brand at each prescription

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

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

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Can you add your most recent blood test results and ranges for a TSH, FT3 and FT4 plus have you had both TPO and TG thyroid antibodies tested

Essential to test vitamin D, folate, ferritin and B12 too. These are often too low, especially if you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies

Ask GP to test vitamins, antibodies and to do coeliac blood test too if antibodies are raised

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

[quietoneme in reply to SlowDragon]

I take my thyroxine same time each morning

[SlowDragon Administrator in reply to quietoneme]

Is it always the same brand?

Do you wait an hour before having anything other than water?

No other medication at same time?

Any gut symptoms? Coeliac? IBS?

do you have any actual blood test results? if not will need to get hold of copies. 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

[MissGrace]

Great advice as always from SlowDragon. Have you had your FT3 tested? I wonder if you are downing that dose, but your body isn’t able to do much with it? Maybe are one of those who needs T3 and constantly increasing T4 isn’t going to help. Good luck. 🤸🏿‍♀️

[shaws Administrator]

Your dose is high but not much good if you cannot convert levothyroxine (T4) to sufficient liothyronine (T3).

It is T3 which runs our whole metabolism from head to toe so the doctor should test your Free T3 and Free T4. I shall give a link which explains why and if he/she will not test them you can get a private test from one of our private labs for these. If you decide to do this the blood draw should be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose and test and take it afterwards. This helps keep the TSH at its highest as that seems to be all the doctors look at.

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/testin...

Levothyroxine (T4) is an inactive hormone and has to convert to T3. T3 is the Active thyroid hormone and it is required in our millions of T3 receptor cells in order for our body to function as normal. Brain and heart contain the most T3 receptor cells.

thyroiduk.org.uk/tuk/testin...

[MaisieGray]

There isn't really any value to knowing what dose others are taking, it is an individual thing. They are very rare, but there are some incidences where people have needed 800mcg for instance! Ensuring that you are taking your meds and organising your blood tests "properly", and having regular & comprehensive testing of thyroid function, vitamins and minerals, and autoimmunity (the latter doesn't need repeat testing once you've had a positive result) as SlowDragon explains, are the important first steps to resolving your issues.

[silverfox7]

We are all individuals so there isn't a single answer but it's the dose that make one feel well again.

The usual problems people have is either not on enough medication or not converting properly but there is something else. There are suggestions on what to do and not what to do and any of these could cause a variation if not taken correctly.

I'll just talk through one example. It is suggested we take our medication on an empty stomach and don't eat for an hour. The reason being that food inhibits absorption so if you don't eat for that hour then you stomach can digest the medication. But sometimes someone will say I don't bother doing that and I'm fit and well. But the argument would be to this person that they are probably on a much higher dose than they could be because they are having to overcome the effects of eating the food! So they are taking more medication than most to still function well so an artificially high amount.