So my latest bloods still show underactive , I'm seeing thyroid specialist, latest results on levo 50mg twice weekly and other days 25mcg, in last week have started alternating days 25mcg then 50mcg been a week since starting this and now my heart rate up again today in 130,s, prior to this heart rate had been better , long story meds were stopped for 3 weeks hence the 11.97 reading then put on 25mcg for month and retested, then another month of 50mcg twice week with 25mcg other days, I'm wondering what else could be causing heart rate, I also feel like I'm on a boat when heart rate up, could it be the meds causing heart rate or something else, I had dramiticaly improved but now feeling wired again, my b12 is fine, any thoughts would be appreciated?
Latest Bloods : So my latest bloods still show... - Thyroid UK
Latest Bloods
What is your diagnosis (Hashimoto's etc)?
Why take 50 mcg of levo only two days a week and 25 mcg the other five days? Normally, people take the same dose every day or alternate doses every other day (for instance, 75/100 mcg to achieve the effect of 87.5 mcg daily) to achieve consistent hormone levels.
You daily dose does not even amount to 37.5 mcg daily which is a TINY dose. No wonder you are not feeling well.
As you say, you are still hypothyroid and need to raise levo.
When you say "Thyroid specialist", do you mean an endocrinologist? If sh/e is only testing your TSH and dosing by it, I'd say ditch him or her and find a doctor who knows what s/he's doing...if forced to dose by the TSH only, you are not likely to ever feel well.
You need FT4 and FT3 tested along with thyroid antibodies (anti-TPO) and anti-thyroglobuline.
Also, you need to have your nutrients tested: vitamins B12 and D, folate, ferritin, iron, TIBC, zinc, and selenium as they need to be optimal to ensure adequate T4 to T3 conversion.
Was taking 50mcg on Tues and sun and other days 25mcg, I have hashimotis and earlier this year had b12 injections, this is where all my problems started after injections became extremely unwell, have been on thyroid meds for 15 years with no problems until now, that's why I'm wondering whether something else is causing the heart rate, have had lots of tests in last year but nothing is explaining the heart rate?
I notice that happening to me when my iron and/or b12 levels are low.
Thyroid hormone replacement is not static and your hormone needs may have changed since you were first put on levo. Your TSH alone suggests you are hypo but you really need your free Ts tested as well.
Had t3 tested when was within range and was highet end, which grey goose suggested I needed increase, have just had iron tests done now so results tomorrow and had my b12 serum and active recently retested which was good along with folate, could I have become sensitive to the meds?? I don't know ?? Also had a positive ana test earlier this year but lupus etc was negative, I'm over it
I’m sorry I don’t understand the first sentence about your free T3 .
Had this tested before stopping meds when I was on 75mcg it was higher end
Well, FT3 levels are supposed to be in the upper third of range if optimally treated. That's the truly active thyroid hormone and if it's suboptimal you remain hypo regardless of your TSH.
When your FT3 levels are optimal you need to go by symptom-relief to decide whether you are at the right dose for you, because the TSH can be below range without it meaning that you are hyperthyroid.
Many people on T4 only don't convert T4 to T3 well enough, but you may be one of the people that do. However, if you used to be on 75 mcg of levo, I fail to see why your daily dose was cut by more than 50%? Usually, if labs show you're overmedicated and this is backed up by symptoms (suppressed TSH along with above range free T3 and possibly free T4 and hyper symptoms such as increased sweating or racing heart) , you decrease levo by 25 mcg every six weeks or so.
Was having hyper symptoms that's why we stopped thyroid as was at wits end with symptoms as was prepared to try anything to feel half alive again but beginning to think it's not my thyroid at all , slowly getting levels back within range now but still no answers on heart rate which started after b12 injections, just curious if anyone has any further things I can investigate
You should never stop thyroid meds without extensive testing. At most, you should decrease levo after being properly tested. Do you have labs showing your TSH, FT4, and FT3 to post here (labs from when you were having hyper symptoms before going off meds)?
They are on my page from previous post
Tsh was 1.86 range 0.40-4.00
Ft4 18.2 range 10-20
Ft3 5.1 range 3.5-6.5
Wasn't really showing overactive, this was on 75mcg which like I said started to take properly Aug last year as was never told to take in morning before anything else, I used to forget it a lot and take at random times, a lot of my symptoms have now passed but the heart rate continues off and on, I have seen cardiologist that did ct scan and several other tests, including adrenal ones, but all ok?? Have also had pre meno ruled out
Based on your previous labs I’d say you definitely did NOT need a decrease in meds, possibly even a slight increase. Not even an endocrinologist could have anything to say about those labs as they are all in range...!
Yes I see that now, that's why I'm thinking something else going on, guess I need to build back up now, just so frustrating trying to find an answer, I changed gp and all trying to get to the bottom of it, so I can always go back on the 75mcg and back to old doct?
Yes, but increase levo slowly, by adding 25 mcg and wait for approx six weeks before adding another 25 mcg. Or add 12,5 mcg if you get heart palps. You’ll get there eventually, no need to rush anything
So atm since week ago been having 25mcg then 50mcg the following day alternating do you think that ok or should I do 50mcg every second day?
So 2 days 25mcg then 50mcg and so on?
Why did you stop meds?
Because I had started to take my meds properly several months before so thought maybe I was absorbing more now, endo said it was only way of telling if my symptoms were thyroid related, was to stop all together for 3 weeks, then restart on small dose and gradually increase again, I was so unwell after b12 that lasted months I was prepared to try this, was reluctant though
Your endo does not seem very knowledgeable to say the least! You need labs to see if you were in fact overmedicated. And, I repeat, you should only decrease levo by 25 mcg at a time, and hold it there for a few weeks to see if you notice any change in symptoms.
Well, Hashimoto's causes gradual destruction of the thyroid gland, which is why most people need to raise their levo gradually as their thyroid function decreases. Your dose is considered a low starting dose and I'm surprised you've been doing well on little more than 25 mcg daily for 15 years if you have Hashimoto's.
I was on 50mcg for 10 years then last 4 years 75mcg, sorry haven't worded correctly
I still find it strange that your dose was not only decreased but also cut by over 50%, as people with Hashimoto's usually need more levo with time, not less. 75 mcg is still not that high a dose so I would have expected you to need to increase rather than decerase it.
50mcg Levothyroxine is only a starter dose
High heart rate can be due to under medication or low vitamins
Suggest you get FULL Thyroid and vitamin testing
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to regularly retest vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised.......or if had thyroid medication stopped
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water . 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
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
Bloods should be retested 6-8 weeks after each dose change
Do you always get same brand of Levothyroxine?
Many people find different brands are not interchangeable
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.
nhs.uk/medicines/levothyrox...
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
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