Newbie here looking for advice on Levo dosage

[loopy2902]

Hi there I am new to the group 👋I have been on 300mg of Levo thyroxine for approx 17 years and my levels are up and down never stable , I have asked docs to see a specialist but they seem to fob me off , is this a normal dose as I've been told it's high.I suffer with terrible reflux and oesophagus pain is this linked? Many Thanks in advance Xx

[SlowDragon Administrator]

It's common, but with more careful management and testing you can very likely get symptoms much improved

Acid reflux is common hypothyroid symptom

Do you have any recent blood test results and ranges you can add?

What vitamin supplements do you currently take, if any?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

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

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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?

Ask GP to test vitamins and antibodies if not been done

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all 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

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 BOTH 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_...

[greygoose]

Apart from the reflux, how do you feel?

300 mcg is quite high, and if you still feel hypo on that dose there are two possibilities: a) you're not absorbing it well b) you're not converting it well.

To know which - if either - we would need to see some blood test results and ranges. But, the first question I always ask is: how do you take your levo? Do you take it on an empty stomach waiting at least an hour before eating or drinking anything other than water; and at least two hours before taking any other medications or supplements?

Then we need to ask: do you always do your tests early morning, fasting, leaving a 24 hour gap between the last dose of levo and the blood draw? If not, you can't compare them.

However, do you know if you have Hashi's? If so, that would account for your levels going up and down.

I wouldn't worry about not getting to see a specialist. You probably wouldn't be able to find one, anyway. Most endos are diabetes specialists with some very weird ideas about thyroid. They have been know to really mess people up! So, I would never recommend seeing one unless you know he's good with thyroid. You'll get better advice and understanding on here.

[loopy2902 in reply to greygoose]

Thankyoufor your replies , beleive it or not , i have only been told by the doctor this week to take on empty stomach and an hour before food (after being on it 17 years !) I used to take it after my breakfast with a cup of tea so that's been wrong for so long. I will get my blood results from docs tomorrow and post them on here. I have to have another blood test in 6 weeks so hoping this new method works.

[greygoose in reply to loopy2902]

Oh, goodness! Well, you might want to reduce your dose a bit, then, because I doubt you've been absorbing much. But, we'll know more when you post your results and ranges.