I've been on 75mg levothyroxine since last September. It has helped in that my system runs faster, I've had more energy and symptoms like constipation all gone.
But I have thinning hair, am irritable and anxious, and my blood pressure is higher than it should be.
Doc considers me to have health anxiety which is fair enough since two awful family deaths in recent years.
Any advice? Am I a tired and busy working mum of two young kids? Is it the menopause? Is it the thyroxine?
Well 75mcg is only one step up from starter dose of 50mcg Levothyroxine
First thing is, do you have any actual blood test results? if not will need to get hold of copies.
You are legally entitled to printed copies of your blood test results and ranges.
UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
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
Anxiety is common hypothyroid symptom
Hair loss often low ferritin
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?
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
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 primary 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 significantly under one) and most important is that 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 (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.
Levothyroxine should always be taken on empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and more effective taken at bedtime
All medication at least two hours away from Levo. Some like HRT, PPI's, magnesium, iron or vitamin D, at least four hours away
Majority of us forced to test privately, certainly NHS very unlikely to test FT3. You need to test TSH, FT4 and FT3 together (and also both TPO and TG thyroid antibodies, if not been tested yet)
GP should test vitamins
Best to just ask receptionist for copies of your blood test results ......BEFORE you see GP ideally.....so you can ask members advice before seeing GP
New NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking Levo thyroxine
I would ignore the health anxiety idea because if you believe it then you won't pursue the physical symptoms and get to the bottom of it. Do what Slowdragon says and get test results, find out the facts, do any futher necessary tests and then decide course of action. In the meantime, if you think you might have some anxieties then get a hypnotherapy tape or do yoga for calm. The doctor's job is to rule out physical causes for your symptoms.
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Ask the receptionist for copy of your blood tests when you go. At my surgery they normally print them out on the spot, no questions.
Hi, if you are concerned about being in the menopause, your GP can order a simple blood test. It's not 100% accurate due to women having different hormone levels pre menopause. Most women do, however get a definitive answer. I think it' always better to know than to worry!
Knowing your most recent FT4 FT3 TSH would be very helpful . This Great Forum experts can chime in and help you . Please include reference ranges .
Nutrients are very important too .
Vitamin "D" /K2 , B-Complex , B12/folate, Iron if low can cause irritability/ hair loss /high BP, vitamin "C" , magnesium, Minerals .
Having Adrenal/Cortisol levels checked out via 24 hour saliva is very helpful . DHEA-S is via serum testing .
Gut/digestive health is *Extremely* important . Going gluten dairy sugar eggs soy coffee free is very helpful . It sounds like lot to sort out but with time you will see many benefits .
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