worsening of symptoms two weeks into 25mcg - should I ask endo to begin my 50mcg two weeks early?

[liaratsoni]

Hi everyone,

I started my 25mcg of levo two weeks ago wednesday for central hypothyroidism which I am aware is a very low dose. I was given two packs of 50mcg tablets to begin after 4 weeks on 25mcg. I don't have heart conditions and I am a tall 22 year old but the endocrinologist I saw seemed to be starting me so low in case I had any palpitations but the only 'side effect' I have had is that all my hypothyroid symptoms seem to have worsened. I am tired and much colder to the point I have developed chillblains on my feet with no temperature change and heating on and my mum was so worried she made me get into bed in the middle of the day with my heated blanket and two duvets because I couldn't stop shivering and couldn't get warm. My reflux and poor digestion which I had got slightly under control by small portions of plain foods in the month before has worsened dramatically again to the point the tiny amount of food I can manage is causing severe bloating, stomach discomfort, burping, lump in throat, sore throat and unbearable post nasal drip and I am more constipated than I was. It seems strange to me that I have gotten worse and I would be tempted to believe it's just because the medication isn't kicking in yet but I do seem to be worse than I was and I can pinpoint the bad digestive issues especially beginning only after starting. Do you think I need a stronger dose now or should I wait it out until my increase in 2 weeks. I don't want to seem impatient and of course if I was as I was before I began the medication I would be happy to stay on this dose but I feel so dreadful and the thought of enduring particularly my terrible digestion for another two weeks is incredibly demoralising. I'm also scared of my endo reacting negatively or withdrawing the medication etc if I tell him I feel worse. I have no hyper symptoms/palpations and I measured my heart rate the other days as 44bpm. He was a very kind and understanding man and said I could email him if I had any questions but I am so worried. Do you think I should email him and is the feeling worse on 25mcg a common/understandable thing? As a recap my levels at diagnosis were tsh: 1.73 (0.27 - 4.2) t3: 3 (3.1 - 6.8) t4: 12.8 (12 - 22).

Thank you so much.

[Treepie]

It is often the case to feel initially worse on a starting dose even 50 mcg.

This is because recognising the levo being introduced the pituitary orders less from the thyroid.At your age and without heart problems a bit odd starting so low.

With your reflux and digestive issues you should maybe talk to your GP about a gastroscopy.

[liaratsoni in reply to Treepie]

Thank you for the reply! That's quite reassuring to hear its normal to feel worse initially! I also don't know how having central hypo would affect it with the problem being in my pituitary or hypothalamus. I have already seen a gastroenterologist about it and got the verbal equivalent of a shoulder shrug and even had small bowel ultrasounds etc and its all clear. The digestive issues only began alongside my other hypo symptoms though and worsened alongside the worsening of my other symptoms and my endocrinologist said he believes my digestive issues are the result of my hypothyroidism and will resolve with correct medication . Just a case of waiting for medication to work!

[Treepie in reply to liaratsoni]

It is important to have blood tests every 6-8 weeks and adjust the dose as needed.Post results for comment.

[liaratsoni in reply to Treepie]

My next appointment with my endo isn't until January. He gave me medication until then including the two months worth of 50mcg but isn't doing blood tests in between?

[Treepie in reply to liaratsoni]

Perhaps you should use private testing as many do.See Thyroid UK for information.

[Lora7again]

That is a too low dose and won't do anything to help you ... you need to take 50mcg for 6 weeks then increase to 75mcg and keep increasing until you feel well.

[liaratsoni in reply to Lora7again]

I did think it was low. Do you think it would be worth contacting him about increasing if I have taken the 25mcg for two weeks?

[Hidden]

I'd email your endo and ask if you can increase now. It's virtually certain you'll need to in a few weeks anyway, so he may well agree. If you increase now without asking him, you may well sour what sounds like quite a promising working relationship.

[liaratsoni in reply to Hidden]

Thank you for your reply! I didn't want to increase without his knowledge which is why I wanted to see what others on here thought about emailing him. Yes he's already given me the 50mcg tablets to be started in two weeks so he was 100% putting me on them anyway so I really hope he would be open to me staring them a little earlier.