As you say, 25mcg is low starting dose. Common to feel worse on just 25mcg
Bloods will need retesting after 6 weeks, then dose can be increased to 50mcg
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).
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 and thyroid antibodies
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
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
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 .
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 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 eventually 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)
I doubt that they will do all of the above. The standard blood test is TSH and T4.
He should test for antibodies as that would mean you'd have an Autoimmune Thyroid Disease (the commonest one) also called Hashimoto's. Most doctors think that checking antibodies makes no difference as the treatment is the same for hypo or hashi's.
It makes a difference to us, the patient, because if we have hashi's we can help reduce the antibodies that attack the gland until we are hypothyroid.
Follow SlowDragon 's excellent advice. We have to read, learn and ask questions and keep in mind that millions seem to recover their health on levothyroxine only - when they get to an optimum dose. The aim is a TSH of 1 or lower but many doctors believe that if it reaches 'in range' even the top of the range that we're on sufficient but the aim is relief of all clinical symptoms and for that we need an optimum dose or the addition of some T3. The aim, eventually, is a TSH of 1 or lower with Free T4 and Free T3 in the upper part of the ranges.
No ..what’s happening to you is not unusual. 25mcg Levo is just a starter dose and serves only to damp down the body’s own thyroid production. So you feel worse. A more sensible starter dose (unless the patient is very frail/elderly) would be 50mcg..tested after 6 weeks and raised etc etc. So ´yes’ it’s disappointing but just the start of your thyroid health project. Good luck!
Try to be (should that be BEE) brave these 'Things', really DO Take Time. I have NO 'Quick Fix', or Panacea, for you BEE. A couple of Points, to remember, though..... YES we all can, and do, feel like erm….how can I put this....Politely.....that is.....Oh Hang it....like SHIT sometimes. Head Hurts, Tummy Hurts, Arms Hurt, Legs Hurt, Chest, 'Privates', Feet and even your Toes HURT! Not only that but you haven't 'Bin', in days (Weeks?) but, in spite of this, you are EXTREEMLY uncomfortable 'Down There'. You feel Worn Out, even though, you have done 'Nothing'- you even had a Take Away Meal, the Washing is still in a pile, You didn't Shower either, you Meant to Wash the sheets.....Need I go on? How do I know this? Because this is ME today- my Take Away, My Washing, My Sheets...…
So, you see, BEE (Heck that Rhymes) we ALL have 'Off' Days, we just have to Accept them, as best we can. There IS Light, at the end of the Tunnel....The Trouble is, that there are CORNERS- blocking the way, so you can't actually 'See' it. My advice, for what it's worth- Pick yourself 'Up', Brush yourself 'Down' and 'Trust' that the light IS ahead of you....It Is BEE, really it is. The Sun Will Come Out Tomorrow, You Can Bet Your Bottom Dollar....
I will pray, for you, BEE. Warmest Wishes, 'Hang In there'. Your Friend
Hi Bee 😊 you are not alone - I too started my ‘thyroid journey’ 9 weeks ago. Starting dose of 25 mcgs Levothyroxine. I think I was into my fourth week before I noticed a slight difference in my muscle pains as these were one of my worst symptoms in my arms, neck and shoulders. I had blood tests at 6 weeks (I followed the guidance from members on this forum on blood tests) and my GP increased my dose to 50 mcgs . I am now 3 weeks (today) into my increased dose. I still feel exhausted, all of my energy spent on getting through my working week with nothing left by a Friday. My muscle pains are improving (ever so slightly). I am trying to be patient which we all know is so hard especially when we do expect that the medication will work wonders immediately.
I did have some side effects when my dose increased and I can understand now why my GP was adamant that my starting dose should be 25mcgs (for those over 50).
Hang in there and hopefully you will start to see improvements soon. Sending positive thoughts xx
I started at 25 also and it didn’t do anything for me either. And I felt very low. But that may have been my scenario: I was feeling shit, then got a diagnosis - oh relief! There is A REASON I feel like this! And I have to take tablets - ok. Then a few weeks in, realising the tablets weren’t working and then feeling very disappointed. I felt myself mentally crashing out.
Anyway my Endo tests every 4 weeks, and quite quickly I was up to 100 and I’m feeling really really good. So please, hang in there, as another poster said, there is light at the end of the tunnel. Don’t get too despondent
I was started on 50mcg in January. I've been more tired since starting levo but found I was deficient in vitamin D. I'm now supplementing. I'm not as tired as I was - I was extremely tired and lacked energy for about a week - now I just get a bout of tiredness either in the afternoon or evening. Also my iron is a little low so going to restart taking iron. I hope your doctor will get you on the cirrectcdose and you get it sorted out.
have you thought of adding some real one to one support into your life? for instance joining co counselling, which is almost free way of having personal outlet for a good moan, a good support.we all need real people. not just websites.
BEE2019, unfortunately everything with thyroid goes super slow, and we need a lot of patience. As a super rough guide, it takes in the region of 6 months to get on a stable dose, and that is assuming you are lucky and have a smooth run with no extra complications.
Best practice is you will get retested at the 6 week point, and have your dose adjusted by 25mcg. Then another test 6 weeks after that, and so on. People will often feel worse until the dose is over 50mcg, and typical doses are between 75 and 200mcg. If you're at the higher end it takes a while to get there!
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So fed up, don't know what to do.
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