Swollen ankles

[Skippy10]

Hi all, I hope someone can assist. I have recently been diagnosed with under active thyroid and am now taking levothyroxine 25mcg, I am also on HRT. I have been on holiday for 7 days and have suffered with swollen ankles since my arrival, a cold compression works for a short while but not for long, I have never suffered with this before and need advice on how best to reduce swelling long term. Thanks in advance.

[Marz]

Your starting dose is low - normally 50 mcg - unless you are old with a heart issue. I too suffered swollen ankles before diagnosis so it could me linked due to a sluggish circulation. They used to swell badly when flying - now mildly/rarely ... I travelled with elastic bandages which I kept in the fridge and bound my ankles up at night 😊

If you are on a phone - scroll down and down to Related Posts where there are 10 more similar posts to yours.

Are you booked in for a blood test sux weeks from starting Levo ? Do you have Hashimotos ? Were your vitamins and minerals tested ? - B12 -Folate - Ferritin - VitD ? It helps if they are all optimal. Apologies for the questions ...

Are you on any other medications ? Hope you enjoy your holiday ...

[Greekchick]

Hi Skippy,

If you are on HRT, please speak to your pharmacist or doctor. HRT interferes with the absorption of levothyroxine (it is a known interaction between the two drugs) and this may possibly be causing some of the problems you are having. Hope you feel better soon and good luck. Sending you positive thoughts.

[Aurealis]

Have you tried lying down with your ankles raised ? Could also try a fan blowing on your lower leg /feet.

[SlowDragon Administrator]

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

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)

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

Standard starter dose is 50mcg. Starting on very low dose of 25mcg, turns your own thyroid production down and doesn't yet offer a high enough replacement dose.

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range

Vitamin levels need to be optimal too. So getting these tested at next blood test, plus thyroid antibodies, if these haven't been done yet

NHS guidelines

including what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

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 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_...

[Skippy10]

Many thanks everyone, information provided has been very useful, I don't think I'm getting right support from GP at the moment so have booked another blood test and on receipt of results will go back to discuss with GP now I am armed with more information about what I need to be aware of from results.

[Hidden in reply to Skippy10]

I too had swollen ankles when first taking Levo, but after addition of some surgical knee length socks and a diuretic they aren’t too bad. Are you holidaying somewhere hot? Do try and put your feet up every time you sit down.

Di

[Skippy10 in reply to Hidden]

Hi, was in Thailand in 40 degree heat so very hot, I'm back in the UK now and pleased to say they have reduced.

[Hidden in reply to Skippy10]

So glad. Mine swell up in heat and blood vessels pop! Joys of getting old!