Thyroid medication possible side effects

[Dr_Rob]

About 8 years ago I had the right node of my thyroid gland removed. I was subsequently off and on Levothyroxine. Then almost two years ago due to inconsistent TSH levels I was diagnosed with a benign tumor on my pituitary gland. I had it removed. About a year ago 25 mg. Euthyrox was prescribed. I have never had elevated blood pressure before. Now my blood pressure is rather high and I have been experiencing intermittent chest pains. Some research I performed pinpointed the thyroid medication as the culprit. I stopped taking the thyroid medication and my chest pains have disappeared while also having lower blood pressure numbers. I am hesitant to resume the medication. Anyone else experience similar circumstances?

[greygoose]

If you've been on 25 mcg for a year, then I'm not surprised you are experiencing extra symptoms. 25 mcg is just enough to stop any remaining production from your thyroid, but not enough to replace it. So, in effect, when taking 25 mcg levo, you end up with a reduction in thyroid hormone. A starter dose should be 50.

Stopping the levo and feeling better proves nothing, because it is a well-known phenomena and happens to just about everybody. Why it happens, we don't know. But, the good feelings don't last long, and the hypo symptoms sooner or later come creeping back. And high blood pressure can be a hypo symptom.

Do you have any blood test results to share with us? Is your doctor testing your FT4 and FT3? Because if you have a pituitary problem, just testing the TSH is of no use.

[SlowDragon Administrator]

As greygoose says, with pituitary issue it's absolutely no use just testing TSH (it's made by pituitary )

In your case it's absolutely essential to test FT3 and FT4 at every test.

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

How long since you stopped taking Levothyroxine?

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 or if very under treated

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Is this how you do your tests?

Standard starter dose is 50mcgs

25mcg frequently causes worse symptoms. it turns your own thyroid production down, yet is far too little replacement

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards from initial 50mcg until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NHS guidelines on Levothyroxine including that most patients need somewhere between 100mcg and 200mcg Levothyroxine. Also what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

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

Medichecks currently have an offer on until end of May - 20% off

thyroiduk.org.uk/index.html

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_...

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.