Levothyroxine and mild nausea?: I posted about a... - Thyroid UK

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Levothyroxine and mild nausea?

Bramble83 profile image
26 Replies

I posted about a week ago and got some great advice, having been put on Levothyroxine by my IVF clinic following a miscarriage and TSH level of 3.1

I started taking 50mg of Levothyroxine about a week ago and have noticed in the last few days, that I seem to have a mild but constant feeling of slight nausea- could it be the Levothyroxine causing this?

I am taking the tablets when I wake up in the middle of the night, as helpfully suggested by a few people on here, as I also have Addison’s disease and was keen to keep the thyroid meds away from my hydrocortisone.

I don’t seem to notice the nausea in the morning but more from around midday.

Any ideas??? Thank you 😀

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Bramble83
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26 Replies
Aurealis profile image
Aurealis

Hi Bramble83, yes it might be - what brand of Levo have you been given. Many people get problems with Teva brand.

Bramble83 profile image
Bramble83 in reply toAurealis

All it says on it is Mercury Pharma

Aurealis profile image
Aurealis in reply toBramble83

It’s not Teva then - did you have 25mcg dose first - if not it may be that starting on 50mcg is too much too soon

Bramble83 profile image
Bramble83 in reply toAurealis

They put it straight up to 50mg when I asked my endocrinologist- a few people on here suggested that 25mg may do more harm than good, in terms of my thyroid producing less as it would detect the low amount of the Levo.

Would having too much make me feel sick? I haven’t got any other symptoms at all- I Googled hyperthyroid just in case and none of that’s applicable! Heart rate is still in the mid 40’s and I don’t feel remotely warm, jittery etc

birkie profile image
birkie in reply toAurealis

Hi

I had total thiyroid removal on the 8th may this year as i was toxic and very overactive i started on levo one brand is actavis 100 mg the other is teva 25mg my surgeon recommend I take 125mg everyday..but I found this to be to high as a starter dose so I droped it to 100 mg but this to was to high with awfull symptoms I'm now on 50mg it's the 25 mg teva and I'm now starting to have nausea I find I cannot take my other Meds I take the levothroxine first thing 6.30 then wait a couple of hours before taking my other Meds which are duloexetine for fibro/arthritis and opmrezole for acid reflux..I have had bad experiences taking Meds. ...could not take anti thiyroid meds..antibiotics asprin..anti inflammatory Meds.amptitripline. HRT..I have thrombosis..does the nausea subside iv not been on them that long

Thanks

Ginny52 profile image
Ginny52

The speeding-up of your metabolism might mean you need an increase in your hc dose- endo should have addressed this. Maybe try a stress-dose and see if the nausea gets better?

Bramble83 profile image
Bramble83 in reply toGinny52

Thank you, hadn’t thought of that. The only thing that makes me a bit dubious of that is that my heart rate is still low and normally if my cortisol is low my heart rate rockets as my BP drops.

How quickly would the Levo work?

Ginny52 profile image
Ginny52 in reply toBramble83

Dr Vanderpump, who is a staunch defender of Levo monotherapy, says it can take up to a year, but I think this is because he wants to say that it isn’t helping them are just not giving it time!

My dosing history has been patchy in the extreme (disagreements between endos about treating me), but on one occasion when I had no treatment at all for months and then had my Levo treatment resumed, I felt so ill by the time I got the pills that the very first night I fell blissfully asleep!

I believe I lost two pregnancies from undiagnosed hypothyroidism. I was able to conceive, but it always failed. I’ve read that 6 weeks or so is about how long it should take to get up to speed- but you didn’t have symptoms apart from tsh and the miscarriage?

Best luck! X

Bramble83 profile image
Bramble83 in reply toGinny52

Goodness, sounds like you had a tough time 😞

It’s really difficult to say about the symptoms, as because I have Addison’s disease, I tend to put anything / everything down to that and just get on with things and have always just been super grateful it doesn’t make me more poorly and I can still lead a normal life 😀

If I look up hypo symptoms there are quite a few that are relevant but again, i’d never really thought anything of them; I am permanently freezing cold and my morning temp is around 36.2 (I measured consistently for quite a while when first trying to get pregnant), inability to lose weight, despite the fact I eat no more than 1200-1500 calories a day and run 5-10km, 3-4 times a week, tiredness, a lot of hair loss and bad muscle cramps.

I just put it down to a combination of Addisons and taking steroids 😀

Ginny52 profile image
Ginny52 in reply toBramble83

There’s so much crossover in symptoms! But I do hope it helps eventually xxx

silverfox7 profile image
silverfox7

Take an antihistamine one hour before your thyroid message d see if that stops it. If so it's an allergy and it's quite common to have an allergy to one of the fillers in the medication. Fillers are necessary as they bulk up the tablet and also keep it stable. The recommended thing is to try a different brand and see if that helps. Each brand has a mix of fillers so you may need to swap more than once to get one your body is happy with then best to get the GP to request that on your prescription so that's what you should be given. But always check you have been given the correct brand.BEFORE you leave the pharmacy. They will not replace it if you leave the pharmacy area.

Bramble83 profile image
Bramble83 in reply tosilverfox7

Thank you, that’s really helpful, I will try that and see if it helps.

Out of interest, if it was that, any ideas I would feel more sick the longer it is since I took the tablet? I tend to feel fine in the morning and nauseous the longer it gets since I took the last Levo tablet.

silverfox7 profile image
silverfox7

No sure either way but the actual allergy symptoms may persist longer until it's all out of the system.

SilverAvocado profile image
SilverAvocado

Bramble83, a dose of 50mcg is still low enough to make you feel worse before you feel better, so it's possible that this nausea is just part of that. Ideally have your blood tested again at 6 weeks and a dose adjustment. It's not a quick process to start feeling better with thyroid hormone, and will probably take several months before you are stable and much better.

I am still adjusting my dose, and nausea is something I experience quite often. I believe it is something to do with blood sugar levels, which in turn are probably adrenal issues. I don't have anything like as serious as Addisons, but have had a thyroidectomy and been very ill, and had a few thrills and spills with cortisol.

Raising thyroid hormone is generally considered to be demanding to the adrenals, because your metabolism will increase. This means all the rest of your body's systems will have to follow suit and do more to support your increase in energy, and the adrenal glands disproportionally take on that extra work.

It's definitely something to keep an eye on, and its possible you might need a dose adjustment. I've just seen you mention that you're quite active and dieting, it might be an idea to cut down on exercise, eat a few more calories,

and rest a bit more while you're in this early part of dose adjustment. Be as kind and gentle to yourself as you would be if you had the flu or a broken arm or something else more visible, because this is all a lot of strain on your body. I think the fact you have Addisons as well may mean it's a more difficult process, because the thyroid and the adrenals work so closely together.

Emyloulou might have some more advice for you.

Bramble83 profile image
Bramble83

Thank you, that’s so much helpful information!

It sounds like you’ve had a tough time- I hope things are looking up for you now 😀

I have just found the nausea odd, as it’s not something I’ve experienced before, even with my Addisons. I know it’s not low blood sugar, as that was one of the things I got before my Addisons diagnosis and I would repeatedly lose consciousness (it was uncontrollable) but never felt sick.

Believe it or not, i’m not actually dieting, just found it bizarre that i’m eating so few calories, doing so my exercise and for the first time in my life, losing weight just doesn’t seem to happen, i’m Just staying the same! I’ve always been slim and active and have always found it very easy to lose a few pounds before holiday etc if I wanted to, however in the last 6 months or so, it doesn’t seem to matter how little I eat or how much exercise I do, the scales just wouldn’t budge! I put it down to the steroids but it had never been a problem before whilst I was on them.

It’s quite a strange concept to me, as I was really quite unwell before my Addisons diagnosis and the minute I started HC, I was back to normal literally within days.

I guess this whole thyroid thing just feels like i’m a bit of a fraud- a TSH level of 3 barely seems significant (outside of the IVF and miscarriage) and I don’t feel any different, whereas I know quite a lot of people feel quite poorly with it.

It’s quite strange not knowing what affect the Levo is having on me, as you get so used to self management with Addison’s, as it’s so dangerous that you always have to know what’s going on; I feel bizarrely in the dark over the whole thyroid thing. I wish they could just test my levels now and know if I’m on the right dose or not! Guess it doesn’t quite work like that with thyroid though 😂

They are testing my levels again after 6 weeks, as my TSH needs to be below 2 and preferably closer to 1 before they’ll let us do our next IVF 😞

Thanks again for all the super helpful advice; I really appreciate the time you’ve taken to reply and try and help me

Clairewalker751 profile image
Clairewalker751

When I was first diagnosed with a TSH of 40 my GP put me straight on 100mg of Levo my symptoms improved significantly quite quickly but I had mild nausea for a good couple of weeks

Bramble83 profile image
Bramble83 in reply toClairewalker751

Wow, 40 is super high!

Will just stick it out and see if it improves. Thank you 😀

Could be, but my low cortisol always cause nausea. Are you sure you are on the right amount still for your Addisons as you've just been through a lot of stress and revving up your thyroid again is also stressful for the body.

Bramble83 profile image
Bramble83 in reply toAngel_of_the_North

If I’m honest, I have no idea! I’ve been on 20mg a day for the last year and it works pretty well for me. I started on 15mg and was still getting a few symptoms, so we upped to 20mg and I put on no weight etc, so we decided that was a good dose for me (i’m 5ft 8 and about 60kg)

I do quite a lot of exercise (run 3-4 times a week, around 5-10km each time) and have quite a demanding job, with a lot of international travel but rarely have to updose. It’s only if I push myself really hard on a morning run, that I tend to burn through my HC a bit quick and tend to need a bit extra, otherwise my BP tanks and heart rate shoots right up. BP is normally around 100/60 and resting heart rate about 40-45bpm.

I’m a pretty chilled person 😀 so didn’t really find the whole IVF thing too bad (I work in the medical industry, which helps a huge amount, as am very used to being around medical stuff, operating theatres etc)

The part I have no idea about is what affect revving up my thyroid has on my adrenals!!! Totally clueless!

It all feels a bit odd, as with a TSH of 3 it’s barely significant, so all seems like i’m a bit of a fraud on the whole thyroid thing.

I just really want to get the level right, as until my TSH is between 1 and 2 (they said preferably closer to 1) they won’t let us proceed with the next IVF.

I’m also a bit mindful of not wanting to mess up my general health by taking the Levo, as my Addisons is really well managed and I never really notice that i’m anything other than fine; I feel like since starting the Levo I just feel worse and it’s only been a week 😞

Angel_of_the_North profile image
Angel_of_the_North in reply toBramble83

Well, few healthy people have a TSH above 2.5 - the mode is around 1.2 (the curve is very skewed left), so 3 is unlikely to be a healthy level. I'd get your cortisol checked just to be on the safe side, or may be just see if a bit of salt helps in the short term. You'll probably see a heart rate rise up to "normal" levels, too.

Bramble83 profile image
Bramble83 in reply toAngel_of_the_North

Thank you, I didn’t realise that- I presumed that 3 was pretty standard and it was just the fertility clinic being very particular after the miscarriage and because we’re NHS funded at the moment.

I already drink quite a lot of sole water (salted water) and take electrolyte capsules daily, to keep my BP up 😀

Might drop my endocrinologist a note, as i’ve also noticed that since starting the Levo, I feel a lot more tired than usual, which is not what I was expecting either!

Thanks again for your help and advice, I really appreciate it.

Catsnkayaks profile image
Catsnkayaks

I've had blood sugar issues since thyroid issues were identified. Mornings are the worst with a sudden dip leading to very bad nausea. I'm also a veteran of IVF. I'd recommend dropping the exercise to a gentle level for a few weeks to let your body adjust and upping the calorie intake a little to include lots of protein portions. Good luck.

Fae1960 profile image
Fae1960

Hi Bramble83 I can’t take mercury pharma or teva as both brands make me feel really nauseous and unwell ! I prefer Actavis

Maybe give it a try ! Lloyd’s chemist supply under the name north star and boots chemist but I can’t remember the name sorry.

Fae1960 profile image
Fae1960

I think Mercury Pharma and Teva tablets contain acacia fillers ? which can cause stomach problems nausea, bloating etc. I was having difficulty getting my prescription and so agreed to try these brands but felt so rough on them. Hope you start to feel better soon.

Bramble83 profile image
Bramble83 in reply toFae1960

Thank you, that’s really good to know. I am picking up my repeat prescription job Friday, so will have a chat with the pharmacist 😀

Fae1960 profile image
Fae1960

It’s worth a try ! I was hoping that the Teva or Mercury Pharma tablets would suit me as I have slightly raised cholesterol levels and I am gaining weight ! Age related ! And research suggests the filler Acacia can help with these 2 issues ! Never mind ☺️ Will have to stop eating lol

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