Help with my meds please or advice

[Heavenly78]

Hi everyone I'm new on here I take a few medication I have underactive thyriods witch I take levothyroxine 75 micrograms ànd suffer with depresion witch I take 50mg of sertaline and low on ironwitch I take ferrous fumarate I take all my tablets at the same time once a day but by dinner time my eyes are rolling can any one help I hate feeling like this thanx in advance xx

[MaisieGray]

Heavenly78 There are few things about which we are advised "no, never do that", but taking other meds and supplements at the same time as our thyroid meds is perhaps the biggest definite no no! Certain things such as iron and calcium, although there are others, need to have a 4 hour separation, and others need to be taken 2 hours apart from Levo. Food/drink should be consumed not less than one hour after your Levo and not less than two hours before it. Additionally, some meds and supplements also need to be taken apart from each other too, irrespective of your Levo. So if you are taking those things all together, that may very well be at least partly responsible for how you are feeling. However, 75 mcg of Levo is not a large dose, and you may in any case, be under-medicated - for some, both depression and anxiety can be evidence of that. Can you post your most recent thyroid blood test results and their ranges, so that folks can comment more specifically. Also, for a number of reasons, we may be nutritionally deficient across the board, and not just with iron, which can impact on thyroid functioning and/or our general health. Do you have test results also, for calcium, iron, vit D, and Vit B12?

[Heavenly78 in reply to MaisieGray]

I don't have any results and I don't kno what the results are in never kno I just get told to take tablets and I do i take them all together otherwise I forget and ifor I forget I stress and stop taking all tablets then apparently I put myself at risk of heart failure I hate taking tablets

[MaisieGray in reply to Heavenly78]

I doubt that anyone, given the choice, would opt to take tablets if they didn't have to, but I take the view that thanks to the efforts of some clever people, I have the good fortune to live in a time when science has provided me with lots of opportunities, and being able to replace my missing endogeous thyroid hormones with manufactured ones, is a positive for me; and in the bigger picture, generally, taking tablets is a miniscule inconvenience. Before the mid 1890s, when the first thyroid treatment was conceived of, some people simply went mad, or slipped into a coma, and subsequently died. It's thought that many of the women in work houses and asylums could have had untreated hypothyroidism simple because there wasn't any treatment. Like many others, I have to take a number of prescribed tablets each day, ten in my case, plus other supplements, and sometimes it can seem like there aren't enough hours in the day, to keep them separate from each other, and from food and drink, but it's a minor inconvenience if they make me feel better, or even well. You say that you hate feeling as you do, and presumably came here for help, but unless we each take responsibility for our health and our treatment, things may be unlikely to change/improve for any of us; and logically, if you can remember to take one lot of tablets, you can remember to take others. Using a pill box, or setting alarms on your phone, for instance, can help. Regarding test results, under the 2018 Data Protection legislation, you are entitled to ask for a printout of all your test results, free of charge. Simply ask the receptionist for a copy, so that you can be better informed and guided to better health.

[Heavenly78 in reply to MaisieGray]

I will go to my gp and request a copy thanx MaisieGray

[SlowDragon Administrator]

Getting a weekly pill dispenser with 3 doses per day, morning, lunch and bedtime

amazon.co.uk/Organiser-Opre...

Levothyroxine needs to always be taken on its own on an empty stomach and then nothing apart from water for at least an hour after

Many take Levothyroxine 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

Suggest you explain to GP you had been taking your Levothyroxine at same time as iron supplements. That you realise this was making Levothyroxine ineffective.

Blood test should be redone after 6-8 weeks on new dosing regime to retest check thyroid and vitamin levels

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)

[Heavenly78 in reply to SlowDragon]

Ok so I went to docs and I got a print off 1and a half pages long but how do i paste it on here

[Theresa_18 in reply to Heavenly78]

Can you copy and paste them

[SlowDragon Administrator in reply to Heavenly78]

Put up a new post - but you can only add one image per post

We only need most recent results and ranges for TSH, FT3 and FT4, plus have you also had TPO and TG thyroid antibodies tested

Also vitamin D, folate, ferritin and B12 tested. Add results and ranges please

[Theresa_18 in reply to SlowDragon]

Hi slowdragon, this is my niece she as sent me her results she as 3 sheets

[SlowDragon Administrator in reply to Theresa_18]

Probably most are not relevant

Either do 3 posts - one image in each

Or type up relevant ones

[Theresa_18 in reply to SlowDragon]

Can't seem to get them on here, could you tell me which ones you would want to see that a relevant and I will type them up

[Theresa_18 in reply to SlowDragon]

This is what I see

Tsh 5.935 - 0 57-3.60

Serum free t4 9.3 7.90 14.00

Folate 6.1 4.00

Ferritin 17 11.00 - 307

B12 232 203

There are lots of other results on there

[SlowDragon Administrator in reply to Theresa_18]

So up until recently Heavenly78 was taking her Levothyroxine with other medication

What other medication? Some medication of supplements affect Levothyroxine more than others

How much Levothyroxine is she currently prescribed?

Low vitamins are direct result of being under medicated and/or because of taking Levothyroxine alongside other medication

Levothyroxine is an extremely fussy medication, it must be taken on empty stomach and then nothing apart from water for at least an hour after dose

Her ferritin is very low. Needs to be at least 70

She should have full iron panel done

That iron panel might be in some of the test results

Eating liver or liver pate once a week should help improve ferritin levels

B12 and folate look extremely low. GP should be testing for Pernicious Anaemia before starting B12 injections or daily sublingual B12. Folic acid supplements should not be started until 48 hours after first B12 injection

She needs vitamin D tested

[Theresa_18 in reply to SlowDragon]

75 micrograms a day

210mg of ferrous fumarate

And 50mg sertaline.

This is what she currently takes

[SlowDragon Administrator in reply to Theresa_18]

So she has been taking Levothyroxine at same time as ferrous fumerate?

This will block a large percentage of her Levothyroxine

Iron must be taken at least FOUR HOURS away from Levo

bnf.nice.org.uk/interaction...

drugs.com/drug-interactions...

Taking sertraline and iron in morning and Levothyroxine at bedtime is one option

Many take Levothyroxine early morning, on waking, but it may be more convenient and possibly more effective if Levothyroxine is 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

Strongly recommend getting a weekly pill dispenser and keeping by the bed so that doesn't forget to take Levothyroxine every day

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

See GP explain the mess up and get restarted on taking Levothyroxine correctly. Then bloods should be retested 6 weeks later

She probably still needs a dose increase, but hopefully TSH should drop quite significantly

The aim of Levothyroxine is to bring TSH down to under two and FT4 in top third of range

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...

[Theresa_18 in reply to SlowDragon]

Thank you so much for your help, hopefully we can get her back on track

[Theresa_18 in reply to SlowDragon]

Will look at the other results she as posted them I think she managed to do it

[Heavenly78 in reply to Theresa_18]

Thanx so much for ure help I have asked for a call off doc to ask about thyriod bloods and as of yet no call xx