Just started levothyroxine

[Julespaloma]

Hi all. Well after 3 years of feeling absolutely awful and having every blood test going, including repeated up and down TSH levels - mainly elevated at 3.59, 0.72, 2.50, 1.0, 2.7, 3.55, 3.7, 3.89, last one 4.44, but below normal T4 at 13, 12, 11, 10) my doc has prescribed Levo. Have to start in low dose because of bouts of AF. Drawing bloods next week for antibodies. Liver ALP also slightly up - I don’t drink alcohol at all but do have osteoarthritis and Fibromyalgia. Having read a lot on here I’m seriously wondering what is causing what at this point! Repeating that test next week. I’ve been started on 25 of levo Mercury Pharma brand. I’m 58 kilos weight. Aside from some anxiety about potential side effects on my heart condition, I really hope this starts to help... Yes, I have that desperate feeling of “please let this work!”

[SlowDragon Administrator]

Welcome to the forum

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

Ask GP to test vitamins now. They may need supplementing to improve to help thyroid hormones work better

25mcg is only half the standard starter dose, it can make you feel worse initially until dose is increased upwards after blood tests

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

Bloods should be retested 6-8 weeks after each dose increase

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)

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_...

List of hypothyroid symptoms

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

Fibromyalgia is often linked to low FT3. There's some research suggests AF may be too

ahajournals.org/doi/10.1161...

laboratoryequipment.com/new...

[Julespaloma in reply to SlowDragon]

Thank you SD for all the additional info - much appreciated!