Levothyroxine and feet burning : Wondering if... - Thyroid UK

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Levothyroxine and feet burning

Jacksthelad
Jacksthelad
4 Replies

Wondering if anyone can tell me if they experience a burning sensation on the soles of their feet?

I am taking Levothyroxine 50mg.

I am still very fatigued after 3 months although better than I was.

Are there any supplements I should be taking also?

Many thanks

4 Replies
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SeasideSusie
SeasideSusieAdministrator

Burning feet can be a symptom of hypothyroidism so you may not yet be optimally medicated, which is unlikely as you have only been on Levo for 3 months. I have had burning feet syndrome when in bed, it's very uncomfortable.

If you started Levo 3 months ago, was your starting dose 50mcg? You should have been retested 6 weeks after starting Levo and had an increase in dose of 25mcg, followed by retesting/increasing by 25mcg every 6-8 weeks until your levels are where they need to be for you to feel well. The aim of a treated hypo patient generally, when on Levo, is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well.

So if you've not yet been retested then arrange it as soon as possible. When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (both Medichecks and Blue Horizon advise to leave Biotin/B Complex off).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

You can always post your results on the forum for members to comment, always include the reference ranges with your results as these vary from lab to lab.

There are no supplements that are recommended for everyone to take. What you need to do is test the core vitamins and see what your levels are, if you have any low levels or deficiencies then that's what you supplement. We need optimal nutrient levels for thyroid hormone to work properly so it's important to test:

Vit D

B12

Folate

Ferritin

You can ask your GP who may be willing, if not we have recommended private labs who offer home testing by fingerprick or, for extra cost, venous blood draw.

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Jacksthelad

Many thanks. I have an appointment in a week.

I started on 25mg then put up to 50mg

My next test showed result of 4.13

As this is just in normal range they have said no further action.

I realise now I had just had my dose 7am that morning. I wasn’t told not to take it. It does make sense though.

Will update you at a later date.

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SlowDragon
SlowDragonAdministrator
in reply to Jacksthelad

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

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...

See GP and request 25mcg dose increase in Levothyroxine. Bloods should be retested 6-8 weeks later

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)

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Burning feet can be low B12

Ask GP to test vitamins and thyroid antibodies if not been done

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).

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

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 .

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endomad

I remember the pain of burning feet, felt like i had steam irons on soles of my feet. So grateful i no longer have it. For me it was going T3 only plus the addition of a good multi B daily supplement. I cant remember but it was deff B5 or B6 that is linked to burning feet and under medicated of course x

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