Advice

[mummytosix]

I’m on 75mg of levo, is it ok to take 5mg stemetil tablets. My doctor has said it’s ok to take 3 of these a day to help with my nausea and dizziness but I’m sure I read somewhere that you shouldn’t take them when your on levo.

[bantam12]

I've taken them for vertigo, no problems.

[SeasideSusie Remembering]

Levo should be taken on it's own, at least 2 hours away from any other medication and some need longer.

Have you Googled to see if there is any specific information about Stemetil and Levothyroxine?

Stemetil is listed on Thyroid UK's main website on their "Drugs and Chemicals That Can Cause Problems" page, it's bottom of the list of "Medicines that can strain your thyroid" so it would be worth reading that:

thyroiduk.org.uk/tuk/treatm...

Drugbank has it listed on page 86 of "Drug Interactions":

The metabolism of Levothyroxine can be decreased when combined with Prochlorperazine (Stemetil)

[humanbean in reply to SeasideSusie]

I've never heard of Drugbank before. Thanks for mentioning it.

[humanbean in reply to SeasideSusie]

Just in case it is of some interest the sites I have used in the past that I've found useful are

1) emc - Electronic Medicines Compendium -

medicines.org.uk/emc/

The emc lists drugs that are licensed in the UK. It contains a large searchable database of Patient Information Leaflets (PIL) and Summaries of Product Characteristics (SPC). Unfortunately the list is not complete - some pharma manufacturers keep their PILs and SPCs on their own websites.

2) Drugs.com - drugs.com/

This site lists extensive information on all sorts of attributes of medications licensed for use in the US (I think). It has a consumer/patient section and a professional section for doctors. It also has a useful drug interactions checker.

drugs.com/drug_interactions...

Hope this is useful for someone.

[crabapple in reply to SeasideSusie]

Thank you. I'd kinda given up worrying about why it was use with caution. Now I know why, I'm going back to not worrying.

[mummytosix]

Thankyou for that link 🙂 I’ve just had a read and it says that it can suppress thyroid activity which can reflect in my blood tests. Does that mean that it’s ok to take or its best to avoid it?

[mummytosix in reply to mummytosix]

Arggghhhh in the other drug link you’ve sent (medicines.org.uk/emc/ )it lists stemetil as a drug you shouldn’t take alongside Levothyroxine 😫

[humanbean in reply to mummytosix]

I think you should discuss the problem with the doctor who prescribed it for you.

If you look at this page from the British National Formulary :

bnf.nice.org.uk/drug/prochl...

it may lead you to alternatives that you could ask your doctor about.

Prochlorperazine is the official name for the active ingredient in stemetil (which I'm assuming is a brand name).

This page may lead to something useful too :

bnf.nice.org.uk/treatment-s...

[mummytosix in reply to humanbean]

I don’t know how much more discussing with my doctors I can take. I’m at the end of my tether. Because my tsh is within range now (3.25) they are dismissing the fact that all the issues I’ve got could be thyroid related. I’m being sent for an mri for my headaches and dizziness, an abdomen scan for my stomach pains and sickness, an internal scan for my abdomen pain and I even had to have a chlamydia test today despite me telling them I had one a year ago and I’ve not been sexually active since. I continually hurt everywhere like I have flu. I’m constantly freezing cold and my hands shake. The doctor sent my last load of bloods off requesting tsh, t3 and t4 but the labs sent it back with only tsh and noted that t3 and t4 weren’t necessary. I can’t afford private blood tests at the moment and seriously I’m just at my wits end 😓😓

[SlowDragon Administrator in reply to mummytosix]

If your TSH is 3.25 you are under medicated and hypothyroid

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

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)

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Ask GP to test vitamin D, folate, ferritin and B12

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[humanbean in reply to mummytosix]

A TSH of 3.25 is high enough in some countries for a diagnosis of overt hypothyroidism. You are under-medicated. I can't offer any advice on what you should do to get prescribed a higher dose of Levo other than, perhaps, change doctor?

...

This link may be of interest - it gives details of what is normal TSH in healthy people with no known thyroid disease. :

healthunlocked.com/thyroidu...

As you can see from the graph a TSH of 3.25 is substantially higher than what most healthy people have.

...

I know that there is a reference somewhere to the ideal TSH being kept under 2 when being treated for hypothyroidism, but I can't remember what it is.

SeasideSusie SlowDragon do either of you have the link stating TSH should be kept below 2?

[humanbean in reply to humanbean]

SeasideSusie has just posted the link I wanted, saying that TSH in a treated patient should be 0.2 - 2.0 :

pathology.leedsth.nhs.uk/pa...

Read her replies to this thread :

healthunlocked.com/thyroidu...

[vocalEK in reply to mummytosix]

Isn't it nice that lab personnel have so much more medical knowledge and experience than doctors?

[Wetsuiter]

I don’t know how much more discussing with my doctors I can take.

my sympathies! i think many of us could use that as our catch phrase

[SlowDragon Administrator]

Looking through your previous posts couldn't see any thyroid antibodies test results

Ask GP to test thyroid antibodies and for 25mcg increase in Levothyroxine

Print out guidelines from Leeds NHS I gave you in earlier reply

If they refuse to increase Levothyroxine dose, ask for referral to an endocrinologist

Email Dionne at Thyroid Uk for list of recommended thyroid specialists first so you know who you want to see

thyroiduk.org.uk/tuk/About_...

[mummytosix in reply to SlowDragon]

I’ve asked for a referral to an endo but apparently I can’t be referred until I’m a year into treatment.

I took a chart in with me that shows optimal levels (I copied it from a link on here) and both doctors that I’ve seen have said that my issues are nothing to do with my thyroid as my levels are “normal” and that I’m looking into things too much. They won’t increase my levo.

Their verdict is that my anxiety and depression are causing my fatigue, shaking, palpitations, sickness and they have referred me for counselling, and everything else they are sending me for scans and mri. I think that they think I’m just a moaning hypochondriac 😓

They say there is no need for an antibody test.

[humanbean in reply to mummytosix]

Their verdict is that my anxiety and depression are causing my fatigue, shaking, palpitations, sickness and they have referred me for counselling,

It looks as though you have been caught in the IAPT (Improving Access to Psychological Therapies) trap.

See this link :

england.nhs.uk/mental-healt...

A group of psychiatrists in the UK have , over the last thirty years or so, managed to persuade the government and the NHS that cause and effect can be switched for all sorts of illnesses. In other words they have convinced people with power that :

Being depressed and anxious causes all sorts of physical symptoms that are not caused by physical illness, so no treatment for their physical symptoms is required, they just need to get their heads shrunk and to take anti-depressants.

Whereas any sensible person will know that physical illness, particularly when badly treated or untreated, will cause depression and anxiety. If the physical illness is treated properly the depression and anxiety go away.

The effect of this has been to make many doctors callous in the extreme. They rarely cure or treat anything successfully these days, and they often don't even try to alleviate symptoms (because they are all in the patient's head). And women, whose health problems are so often disbelieved, have become the main casualties of this government and NHS approved cruelty.

The whole IAPT experiment has cost immense amounts of money, and has been almost a total failure in actually saving money (because it so rarely helps anyone who is genuinely ill). But the project is effectively too big to fail so patients have to continue suffering. In the meantime, effective physical treatment is being withdrawn from patients in preference for counselling and mental health treatment.

Sadly, it means that for people with an unsympathetic doctor and a poorly treated thyroid condition, we either have to pay for our own tests and treatment or we have to find a doctor who still has a heart and a brain and will treat us adequately.

[Marymary7]

Have you been tested for low B 12 or Pernicious Anemia?

[humanbean]

This thread may have some information you could give to your doctor.

healthunlocked.com/thyroidu...

The author, Portia1974 , has done a follow up post today :

healthunlocked.com/thyroidu...

[mummytosix]

I’ve managed to get a print off of all my blood test results today. The doctor couldn’t print them on Wednesday because his printer wouldn’t work. After being told my tsh is 3.25 I can’t find anywhere on my test results that say if it’s actually been checked. The lab refused to do my T3 but they checked my T4 and that’s 8.4pmol/L (range 9.0-19.0)

Isn’t my T4 supposed to be nearer the top end of the range? Am I still under medicated?

The doctor told me that everything was in range and refused to increase my levo 😕

[JaneChapple]

Mummytosix

Yes you are most definitely undertreated. You need a more sympathetic doctor who will refer you to a sympathetic endo. Show him the PIL leaflet and list of symptoms you still have. Its very frustrating I know from my own experiences that they wont or dont want to listen to thevpatient. My son's result was similar to yours and endo agreed to increase his levo to 125 to get result under 2 but GP result said normal, no further action required! Also levo may not work for you if youc ave trouble converting (D102 gene). You can get private test for this but again docs wont necessarily take any notice. Have you considered NDT (natural dessicated thyroid) or T3 - liothyronine?. You would probably have to self treat and buy your own meds/tests thought, but lots of help available here.

By the way most surgeries allow patients to see their own results on line these days, you just need to register free for this service with your GP.

You could see an endo privately if you can afford it. You can email Louise for a list of sympathetic endos/Gps.

JaneCx