Subclinical hypothyroidism

[Cade83]

So I’ve finally been diagnosed with subclinical hypothyroidism. Both my antibodies are positive and my TSH is up and down, when I got it checked by medichecks it was 8.3 and when I got it done by my GP surgery 2-3 weeks later it was 5.4. My free T4 was 10.3.

So my GP asked a endocrinologist what to do because I do have symptoms and I kept checking my patient access to see if anything had changed and I just checked and a new repeat prescription is on it for 75mg levothyroxine sodium. What I wanted to know was, isn’t that quite a high dose to start off on? I was expecting to start on 25mg and see how it went. I don’t want to be on a high dose if I end up with bad side effects. Any advice would be great.

[Heloise]

Hi Cade, you said a "repeat" prescription but is 75 mcgs of levo your first prescription? Were you advised how to take it? I agree if you have never taken any thyroid hormone before 75 mcgs. might be too much. Many seem to start at 50 mcgs. and take about six weeks to increase to 100 mcgs. It's best to take either in the morning or at bedtime on an empty stomach with water. Wait at least a half hour to eat. I hope it begins to help but going gluten and dairy free to reduce your antibodies would be an additional support.

[Cade83 in reply to Heloise]

Hi Heloise, thanks for your reply. Yeah sorry it’s my first prescription of levothyroxine, I have other meds so I meant she’s added levothyroxine to my repeat prescriptions. It says to take in the morning half hour before food. I may ask whether to start on 50 mcg because I really don’t want to have too much. I’m trying to cut gluten out but it’s not easy and dairy would be even harder. I was thinking of changing to paleo diet. Have you tried this?

[SlowDragon Administrator in reply to Cade83]

You mention already taking other medication. Make sure to always take Levothyroxine on its own

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

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

[BonnieT in reply to SlowDragon]

I had fluctuating results until I started taking my meds an hour before my usual rise and shine time with a full glass of water. I would go back to sleep before having my toast and coffee an hour later. Brought all my bloodwork into the normal range but could still not lose the weight I had gained. Need to try harder with that. Keeping the thyroid levels in the normal range is a key to everything else. I also know I need to take this medication for the rest of my life.

[SlowDragon Administrator in reply to BonnieT]

BonnieT

You might find trying taking Levothyroxine at bedtime is even more effective

Some try it and don't get on with it.

[BonnieT in reply to SlowDragon]

I have been on synthroid for 40 years. I’m afraid to change things now. Now it’s the pain that gets to me from the RA but I think it’s more than RA.

[SlowDragon Administrator in reply to BonnieT]

Presumably you have Hashimoto's as you also have RA

Are you on strictly gluten free diet?

glutenfreesociety.org/glute...

arthritis.org/living-with-a...

Low vitamin D, folate, ferritin and B12 are extremely common with Hashimoto's

[Heloise in reply to Cade83]

I see. Are you in the UK? I'm in the U.S. and just see a P.A. so if I've done everything and taken all sorts of thyroid hormone from Levo to straight T3 and diets. It is difficult to avoid certain foods but you may not have to do it forever. It's just that gluten opens the junctions in the stomach and allow it to leak. That's the real problem. I know Izabella Wentz recommends the autoimmune paleo diet. Switching to coconut milk is helpful. Give it a try even if you don't totally succeed, it will help.

It's been so long ago but I think I started at 25 mcgs of Synthroid. I don't think your doctor should give you a hard time.

[Hidden in reply to Heloise]

Victims

[Hidden in reply to Cade83]

Νo reason to cut gluten or somethink else if you don't hve really alergy to them. Only 20-30% have problem. I font have any problem with them

[SlowDragon Administrator]

Standard starter dose is 50mcg, but some research suggests it's actually better to start on higher dose if you can tolerate it

25mcg is too low and often makes people feel worse

The only brand in UK that is a single 75mcg tablet is Teva. Teva brand upsets many people, and best avoided unless lactose intolerant

So ask Pharmacy for 50mcg and 25mcg tablets. Ideally they should be same brand

thyroiduk.org.uk/tuk/treatm...

Perhaps start on 50mcg and see how you get on. You can add the 25mcg in after 2-3 weeks.

Bloods should be retested 6-8 weeks after being on constant dose

Ask GP to test vitamin D, folate, B12 and ferritin if not been tested. These are frequently too low with Hashimoto's and often need supplementing to improve

[Cade83 in reply to SlowDragon]

This is a strange one but has anyone ever felt like they weren’t breathing enough at times or felt like they were maybe over thinking it and felt like they were trying to consciously make themselves breath? Does hypothyroidism or Hashimoto’s cause ectopic heart beats? Also does the Levothyroxine make a huge difference to heart beat. Only I’m very conscious about heart rate because of past experience. Does fatigue get better quite quickly? I haven’t taken my first tablet yet so just curious.

[SlowDragon Administrator in reply to Cade83]

Yes, that feeling of lack of air is referred to as "air hunger" and hypothyroid symptom

Irregular heartbeat is common too

List of symptoms

thyroiduk.org.uk/tuk/about_...

It takes around 6-8 weeks for dose to have full effect. Then bloods retested. Dose increased slowly in 25mcg steps upwards, retested 6-8 weeks later each time

[Cade83 in reply to SlowDragon]

Thank you for the reply I feel better knowing it’s not just me and anxiety. I think I will try the 75mcg as that’s what the endocrinologist prescribed. See how it goes.

[SlowDragon Administrator in reply to Cade83]

Which brand is the Levothyroxine?

Is is a single 75mcg tablet?

If so this is likely to be Teva brand which doesn't suit many people

Better to start on one more likely to suit.

[Cade83 in reply to SlowDragon]

I’ve just picked them up and they are Teva. In what way do people not get on with them?

[SlowDragon Administrator in reply to Cade83]

As you have picked them up, you better try them

They may suit you, some people love Teva

But if you have a reaction it's likely the brand, not the Levothyroxine

Here's posts about it

healthunlocked.com/search/p...

[Angel_of_the_North]

The usual starting dose is 50mcg for an adult.

[Freddyy]

What is ur tsh level ?