Missed dosage

[Newgirl01]

Hi i missed 2 days of levo due to running out of my prescription. I have been feeling very weak ever since this. It was only 2 days but could it because i missed it? I am only on 25mcg and 22 weeks pregnant xx

[shaws Administrator]

If that happens next time I'd ask the pharmacist if he can give you some tablets until prescription is received.

Levothyroxine has a long half-life, therefore I don't think anything bad will happen but a starting dose is 50mcg - unless you are very frail with a heart disease with 25mcg increases every six weeks until TSH if around 1.

[shaws Administrator]

Excerpt from following link:-

As a result, the normal thyroid-stimulating hormone (TSH) level during pregnancy is lower than the normal nonpregnancy level. The new recommendations for TSH levels during pregnancy are the following: First trimester: less than 2.5 with a range of 0.1-2.5. Second trimester: 0.2-3.0.

medscape.com/viewarticle/75...

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

[Newgirl01 in reply to shaws]

Thankyou! Much appreciated

[SlowDragon Administrator]

Have you had thyroid levels retested since starting on 25mcg Levothyroxine 2 months ago?

You may need higher dose by now

Have you had vitamin D, folate, ferritin and B12 tested too?

Strongly recommend getting FULL Thyroid and vitamin testing privately if GP unhelpful

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

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).

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

[Newgirl01 in reply to SlowDragon]

Hi yes I got them checked in the hospital last week and they told me if there was any need they would contact me if i needed an increase and no word yet.

[SlowDragon Administrator in reply to Newgirl01]

You are legally entitled to printed copies of your blood test results and ranges

Ring up and request them by email

[Newgirl01 in reply to SlowDragon]

Yes i will definitely do that. Thankyou

[SlowDragon Administrator in reply to Newgirl01]

Frequently they only test TSH which is completely inadequate

Obviously good vitamin levels are important, but especially when pregnant

[humanbean]

Once you've got your prescription you could take 75mcg one day, or 50mcg one day and 50mcg the next to make up for what you missed, then return to taking your normal dose. Although it doesn't happen often and isn't recommended in the long term, people are sometimes prescribed Levo to take just once a week. For someone who has missed only 50mcg of Levo you might as well take it all in one go or perhaps add it to a couple of doses as I mention above.

I suspect you are probably under-medicated. 25mcg is a miserable and miserly dose, and if you've been on it for two months it is time for another blood test and an increase in dose.