Dizziness/headaches : Hi I’m new in here I’ve... - Thyroid UK

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Dizziness/headaches

Dukemaster profile image
38 Replies

Hi I’m new in here I’ve been feeling unwell dizziness headaches joint pain insomniac I’ve been taking Levothyroxine but been changed brand to anhydrous Levothyroxine sodium 50mcg my latest blood results are if anyone can give me advice would appreciate thank you

TSH 3.04 mU/L

Free T4 15.2 pmol/L

Vit B12 137ng/L

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Dukemaster
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38 Replies
MaisieGray profile image
MaisieGray

Anhydrous levothyroxine sodium isn't a brand, it's the active ingredient of your Levo tablets (anhydrous simply means without water) that is compounded with the inactive excipients to form the tablet shape.

Dukemaster profile image
Dukemaster in reply to MaisieGray

Thank you !

vocalEK profile image
vocalEK in reply to MaisieGray

Some people are sensitive to the inactive excipients, so you might need a change of brands.

greygoose profile image
greygoose

I'm afraid we need the ranges to comment on the FT4 and the B12, but your TSH is too high, you need an increase in dose. :)

Dukemaster profile image
Dukemaster in reply to greygoose

Thank you for your reply

greygoose profile image
greygoose in reply to Dukemaster

You're welcome. :)

SlowDragon profile image
SlowDragonAdministrator

Can you add the ranges on FT4 and B12

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps, retesting 6-8 weeks after each dose increase. This continues until TSH is around one (certainly under 2) and FT4 in top third of range

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

You also need vitamin D, folate, ferritin and both TPO and TG thyroid antibodies tested

See GP for dose increase in Levothyroxine and other tests

Recommended on here that 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)

Dukemaster profile image
Dukemaster in reply to SlowDragon

Thank you for your reply

TSH 3.04 mU/L (0.3-5.0)

Free T4 15.2 pmol/L (7.9-16.0)

VitB12 137ng/L (120-900)

SlowDragon profile image
SlowDragonAdministrator in reply to Dukemaster

Your B12 is extremely low

You need folate testing too

Folate and B12 work together. Both likely to be low

Request full testing for Pernicious Anaemia before starting on either B12 injections via GP, or if they refuse to do so self supplementing sublingual B12.

Do you have B12 deficiency symptoms?

Dizziness is a symptom

b12deficiency.info/signs-an...

Plus vitamin D and ferritin need testing

Vitamin levels drop as direct result of being under treated for hypothyroidism.

50mcg is only a starter dose. Most patients need around 100mcg, sometimes more

Request 25mcg dose increase in Levothyroxine and bloods retested 6-8 weeks later

Recommended on here that 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)

Jazzw profile image
Jazzw

Won’t know for sure until you post the ranges but that B12 looks incredibly low - as in, you probably need Vit B12 shots low.

And 50mcg of Levo - whatever brand - clearly isn’t enough. You’re undermedicated.

Dukemaster profile image
Dukemaster in reply to Jazzw

Thank you for your reply I was having 3 monthly b12 injections but then stopped as they said my iron stores were adequate for 2 years

TSH 3.04 mU/L. (0.3-5.0)

Free T4 15.2 pmol/L (7.9-16)

SlowDragon profile image
SlowDragonAdministrator in reply to Dukemaster

Iron stores are nothing to do with B12

Your B12 level is extremely low and needs urgent improvement. Probably as direct result of being hypothyroid because you are not on high enough dose of Levothyroxine

See GP to discuss restarting B12 injections

You also need vitamin D, folate and ferritin retested

Levothyroxine dose should be increased slowly in 25mcg steps, retesting 6-8 weeks after each dose increase

NICE guidelines (see initiation and titration how to initiate and increase.)

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

cks.nice.org.uk/hypothyroid...

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...

Dukemaster profile image
Dukemaster in reply to SlowDragon

Thank you for your help I’m seeing GP Thursday as I’m feeling really unwell hoping that they will get it sorted out for me I’ve had all the bloods suggested on here taken today so the latest results will be with GP Thursday

Dukemaster profile image
Dukemaster in reply to SlowDragon

The GP have never really taken much notice of my thyroid meds they started me on Levo 50mcg and I’ve been on that dose only for a long time but I will take all this info with me Thursday I’m very thankful for this help.

lesel profile image
lesel

If you have changed brands I wonder if your new brand is manufactured by Teva, I am unable to take this brand as it makes me quite ill.

Dukemaster profile image
Dukemaster in reply to lesel

I’m not sure of the brand will find out and thank you

KittyAO profile image
KittyAO

Like @lesel mentioned, if you have Teva levothyroxine, this gave me terrible headaches and a sore neck - and I yellow carded them so that the NHS are aware. Hope you start to feel better soon.

Dukemaster profile image
Dukemaster in reply to KittyAO

Hi thank you I will find out the brand and thank you for your reply

vocalEK profile image
vocalEK in reply to Dukemaster

It's probably a "generic", but do find out which company manufactured your pills.

Dukemaster profile image
Dukemaster in reply to vocalEK

Thank you for your help

Salsero profile image
Salsero

As mentioned above, you need your Vit D, folates and ferritin tested, which if low will bring the dizziness

Dukemaster profile image
Dukemaster in reply to Salsero

Thank you

JonesTheAverage profile image
JonesTheAverage

Not sure if I can help with my input (newbie too), but I have similar symptoms (75mcg) and asked GP for a slight increase. He was not happy with the way I was feeling and asked for further blood tests. Turns out I’m low in sodium (and vit d), and he has repeated the tests to be on a safe side. Still awaiting the results, but it would be worth asking yours for kidney function tests (unless done already and they are fine). Looking at the symptoms of low blood sodium, they are freaking the same as hypo, and there are number of causes inc underactive thyroid, adrenal function....Good luck x

in reply to JonesTheAverage

It's good that you have a GP who seems willing to listen and do the tests you need

Dukemaster profile image
Dukemaster in reply to JonesTheAverage

Thank you

Salsero profile image
Salsero in reply to Dukemaster

Just to let you know I use Medichecks in the UK for my tests, as my GP won't do them. They have a Thyroid UltraVit test that covers thyroid levels and the essential vitamins. I used them twice: once to find out my Vit D levels were low and then again 4 months later to check the supplements had lifted them back to normal. It was a very fast and efficient service.

Good luck Dukemaster.

Dukemaster profile image
Dukemaster in reply to Salsero

Thank you for your help

Miserable1970 profile image
Miserable1970

Are you male or female? What age?

Dukemaster profile image
Dukemaster in reply to Miserable1970

Female age 60

Miserable1970 profile image
Miserable1970 in reply to Dukemaster

Sorry only getting back 😣 my menopause gives me those symptoms plus many more, im on hrt and feeling much better. Are your symptoms any better? X

PoDundee profile image
PoDundee

Try cutting out sugar. Works for me. Worth a try.

Dukemaster profile image
Dukemaster in reply to PoDundee

Thank you I will try anything

Hashela profile image
Hashela

Honestly that ft4 is top of range - you aren’t converting at all. You must feel terrible. Can you get your hands on some t3 or ndt until you get your vitamins in range?

Dukemaster profile image
Dukemaster in reply to Hashela

Hi I’m going GP Thursday so hoping that they will get it sorted out yes I’m feeling pretty rubbish 😒thank you for your help

tinkerbell22 profile image
tinkerbell22 in reply to Hashela

I was thinking the same as Hashela. I am in a similar situation where my T4 is high but I'm still hypothyroid. My vit B (and other vitamins) is very low... I also have a heavy metal toxicity. So I think my symptoms may be coming a lot from vitamin deficiencies and my heavy metal toxicity. Yes I agree your levothyroxine is very low dose But maybe your focus needs to be on vitamins initially? I focused on my thyroid meds increases rather than vitamins (as I wasn't tolerating supplements) but now my thyroid levels are good but I still feel terrible so have switched my focus to my vitamins. I don't regret the path I took as it was all I could do. But if you tolerate supplements then I would say to try the vitamins path first.

My GP was useless re my vitamins, I have to take charge of this myself too. If you are "in range" then apparently you're totally fine, which isn't true at all! Doctors ignore what the "Optimal range" is... So I'd be surprised if they'd give you B12 shots. You can still try though! Some are better than others.

Also it would be very useful to see what your T3 level is... You may need to do a home blood test for this privately, eg thru Blue Horizon.

I also had terrible side effects off all the UK levothyroxine... I had migraines every day and enormous anxiety, and boils(!) as soon as I started taking it. I switched to Synthroid which is a brand name (therefore properly regulated) and these side effects instantly vanished!!

Some people find a different Uk generic works for them, which is ideal as I have to pay a fortune for my synthroid as I buy it from abroad... So do try other generics locally. Talk to your pharmacist and ask them for a different one to usual. Show them your current box of meds and say "not this one again!". If you find one that you want to try for a while then ask the pharmacist to put a note on your file to say to always make sure you have that version. If they aren't helpful then go elsewhere to another pharmacist.

Hope this helps

Dukemaster profile image
Dukemaster in reply to tinkerbell22

Thank you so much for all your help and advice

Hashela profile image
Hashela

Thoughts on sublingual vitamins to absorb buccally rather than ingested? I do my b12 this way.

Do you have antibodies? If so, an eye has to be kept on any triggers if you know them... I’ve got antitpo so no gluten for me.

Dukemaster profile image
Dukemaster in reply to Hashela

Thank you for your advice no antibodies as far as I am aware

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