Taking 175mcg levo - still hypo

[reabook]

I'm on 175mcg of levothyroxine -was first diagnosed hypo in 2004 and have had Levo steadily increased since then. My bloods show that I'm underactive but my gp is reluctant to increase Levo to 200. I have raised inflammation markers. I feel so ill with joint pain ( I have difficulty with everyday tasks such as dressing) exhaustion, diarrhoea I'm not sure where to go from here.

Has anyone else had something similar and if so how did you get the help needed? What happens when you're on the maximum dose of levo and it's not helping? Id appreciate any advice.

[MaisieGray]

Well there is no maximum dose, you need what you need. But if you add your results and their reference ranges, folks can comment more accurately.

[pennyannie]

Hello Reabook

Totally agree with previous reply, there is no " top " limit of Levothyroxine. We need what we need for the relief of symptoms, and the dose should be increased by 25mcg every 6 weeks, with full blood tests taken showing your T3 and T4 levels, until such time as you feel better.

Levothyroxine is T4 and is a prohormone and your body needs to convert it into the active hormone T3, which is what your body runs on. Your conversion of T4 to T3 can be compromised if your vitamins and minerals are not well maintained and it would be wise to have your ferritin, folate, B12 and vitamin D optimal in their ranges.

You could ask your doctor to run a full thyroid panel for you, to include the above details.

If you don't find your doctor supportive you can get these tests done privately and the full details are on the Thyroid uk website. Once with the results you can start a new post on here where you will receive the necessary advice to regain your thyroid health.

[reabook in reply to pennyannie]

Thanks for your advice pennyannie I've got the details from Thyroid UK and have ordered the test. I shall post the results. Thanks again.

[McPammy]

Have you had your T3 checked. It could be that you still have hypo symptoms even if your T4 is at the top of the range. If your TSH still too high, you could be a poor converter to T3. Its essential that your T3 is also checked at the same time as T4 and TSH.

This is what happened to myself.

Also B12, ferritin, folate snd Vit D need to be optimal, not at the bottom of the ranges, to help converting T4 to T3.

[reabook in reply to McPammy]

Thanks McPammy. I shall get T3 levels checked. I take ferritin folate and D3 supplements (take folate at night to avoid taking at same time as levo) and have b12 every 12 weeks as I have pa. I'll post results when I get them. Thanks for your help.

[McPammy in reply to reabook]

Ok great. Yes do have your T3 checked too. I also have ferritin when required and B12 every 3 months. I’m a vegetarian and don’t eat enough of these vitamins in my diet. D is fine for me. I do find that when I take ferris fumerate for ferritin that my folate increases along side without any folate medication. Be careful with ferris fumerate/ferritin going too high as it can effect thyroid medication absorption. I’ve noticed that each time I’m on ferris fumerate, even though I take mine going to bed also, that I feel as though the thyroid medication is not working well. I only need small doses of T4 and T3 so maybe the doses of ferris fumerate need to be lower. Just a thought.

[Mrsbuns]

Hi Reabook

I'm no expert infact quite the opposite but from all the wonderful advice on this forum given by all these wonderful people I am improving. My first great improvement was going gluten free - helped the brain fog and made me feel ' better' in many areas. I increased my T4 to 150 and 175 alternative days as 175 daily seems to increase my dioreah. My T4 is way over range but my T3 is now high but in range. So I've learnt I'm not a great converter - still working on all my vits and minerals - improving slowly. I've learnt this is a marathon not a sprint and I've learnt to curb my frustration at not getting instant rezukts😬. Each of us is different and we have to learn what works for us. I'm giving an nhs endo one last try (October 7th) and if no support I'm going to source T3 myself and with the wonderful support from the forum start that journey. Sorry this is not an answer as such to your post just my opinion that ranges are not worth the paper they are written on and many of our doctors make us worse not better - but with time and research we can do it ourselves - good luck 😁

[reabook in reply to Mrsbuns]

Thanks Mrsbuns. I hadn't realised how complicated this can be - especially with dismissive gps. Hope you continue to feel more well.

[Mrsbuns in reply to reabook]

Yes it is complicated but doable with the help and support on here. Until 3 months ago I couldn't walk without sticks and the muscles and joint pain was unbelievable - now I'm not using sticks and can do a 30 minute walk and some tai chi every day - the pain has not gone but its much reduced and my energy level is much much better. I find magnesium oil the best for the muscle pain - better you brand - only a little at a time as too much makes my skin itch like hell! 😂

[HLAB35]

I have researched thyroid issues in a wide range of places and pieced together a supplement, diet and activity 'regime' that works most of the time. Cutting back on some activity when I start to get twinges in my back - it's an indicator that I have overdone it. I agree that topical Magnesium is a game changer for muscle pains. The lotion and gels are really good. Also, for good conversion you need selenium. I also think b vitamins like b3 and b6 get overlooked as does vitamin a (which is something that Hypos struggle to get enough of because we can't convert beta carotene to retinoids very well).

[Mrsbuns in reply to HLAB35]

Hi HLAB35 - thanks for the info. How / what/ how much selenium do you take? Not a supplement I'm taking and sounds like I should add to my list 👍

[HLAB35 in reply to Mrsbuns]

200mcg of Selenium daily... it seems to lower antibody attacks as well as improve conversion - definitely worth taking if you're a so-so converter like me

[LAHs]

Hi readbook, you are probably getting enough T4 but in addition to all of the vitamins and minerals mentioned above you will also need to supplement with Selenium (Se). Se is the catalyst for the T4 to T3 reaction, without Se conversion will not work. Get a baseline level of your Free T3 (FT3) if you haven't already got it from a recent blood test while you were on 175mcg Levo, then start taking Se, I am not sure of the dose in pill form because I take 2 Brazil nuts per day just because I don't like taking metals in pill form (iron excepted). After about a month go measure your FT3 again and see if it has increased. Also you should feel better after about a couple of weeks max.

PS from HLAB above it seems that 200mcg of Se seems to be an OK dose to take. If you go the pill route read up on all the side affects of Se overdose and monitor your overall health, if you start to suffer any overdose effects, lower your Se dose. Personally I just take 2 Brazil nuts per day then you don't have the overdose problem. Some people will say that you may not get the correct dose of Se from the Brazil nuts, your FT3 results will let you know this - and it's pretty unusual to get a "low dose" Brazil nut. If your FT3 level doesn't increase much then eat three nuts per day.