Headaches and levothyroxine

[Mum23girls]

Hi all I'm new here.

Recently had thyroid function tested. It was 5.1, upper limit 5, but because I'm symptomatic and my parents/brother are underactive I was prescribed 50mg levothyroxine.

I take propanalol and nortriptyline to control migraines, which were well controlled. Since starting new medication had headaches everyday. Not due back at drs for 3 weeks.

Is my medication all interacting or maybe I've gone overactive.

Any advice appreciated.

Thanks

[shaws Administrator]

Welcome to our forum and and you're fortunate your GP has prescribed levothyroxine when TSH is 5 (in UK) as the regulations state we shouldn't be prescribed until TSH reaches 10 and by then we could have a lot of symptoms.

50mcg of levothyroxine is a starting dose, which is increased by 25mcg every six weeks until you feel well and TSH is around 1 or lower. You wouldn't be overdosed on 50mcg of T4 (levothyroxine).

You may settle down as your dose is increased - which it should when you reach an optimum dose. Sometimes some people may be sensitive to some fillers/binders in the replacement hormone but you must let your body have a chance to absorb T4 (levothyroxine) which is an inactive hormone and its job is to convert to T3 (liothyronine) and it is T3 which is needed in our millions of T3 receptor cells in order for us to function as normal with no symptoms. Some hints:-

Usually levo is taken first thing on an empty stomach with one full glass of water and wait an hour before eating. Food/coffee interferes with the uptake of the hormones.

When having a blood test, always make the very earliest appointment (TSH is highest then) as it may prevent your dose being reduced. Many GPs think a low or very low TSH (whilst taking T4) means we've gone hyPERthyroid but that's not true.

Always get a print-out of your results and the ranges must be shown. Ranges are important for members to comment upon them as labs differ in their machines.

You should also allow a 24 hour gap between last dose of levo and the test and take afterwards.

It is a learning curve when first diagnosed. If your GP hasn't tested for thyroid antibodies, ask for this on the next test. If antibodies are present it would mean you have Hashimoto's another form of hypothyroidism and the commonest. This is due to your body having antibodies in blood which attack the thyroid gland until you're hypothyroid.

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

GP should also test B12, Vit D, iron, ferritin and folate. Everything has to be optimal.

[Mum23girls in reply to shaws]

Thankyou for your advice. I will take levothyroxine earlier and leave bigger gap before eating as you suggested. Also appreciate the information, puts my mind at rest and will take on board.

[greygoose]

Do you leave a two hour gap between your pain medication and your levo?

Levo should be taken entirely on its own, on an empty stomach to avoid interaction with other medications.

If you are hypO you cannot go hypER, it's a physical impossibility. You could be over-medicated, but on 50 mcg levo, that is most unlikely.

Have you had your antibodies tested, do you know?

[Mum23girls in reply to greygoose]

Thanks for that. Good to know. Yes I take my preventatives in evening and levothyroxine in morning.

[greygoose in reply to Mum23girls]

That should be ok, then.

The problem often is when starting on thyroid hormone replacement, that symptoms get worse for a while before they get better. And new symptoms can sometimes make an appearance. Presumably you will be retested in six weeks from the time you started the levo, and your dose will be increased. And, as your hormone levels rise, the symptoms should decrease.