I have finally been put on levo from May 19 at 50mcg daily as my TSH was rising and I tested posted for thyroid antibodies ie Hashimotors. I was also put on folic acid and vitamin D as mine were very low. I have been getting B12 injections 8weekly since I was 19 so for 18 years.
In July my levo was raised up to 75mg as my levels had not moved from 5 for TSH. I had my blood tested 3 weeks ago and my TSH is at 2.02
Gp said it should be between 0.01 and 2 so she was 'happy with that' and my levo does not need raised.
I still feel very symptomatic- no energy, cold, waking up tired, no weight loss despite watching what I eat, no sex drive, heightened anxiety around period, etc Most recently I have been experiencing lots of migraines, especially around and after period. These come with nausea and severe pain. I went to the GP two weeks ago and explained how I was feeling. Asked if my levo could be increased slightly to see if it helps me feel better and was told no but given Sertraline 50mg(I'm not depressed!!), Sumatriptan to stop a migraine when it starts, Propranolol 40mg to prevent migraine and Cyclizine to stop the nausea.
I decided not to start the sertraline or betablocker as I had read they can increase hypo symptoms and I have an appointment with my own GP this afternoon to discuss. Is it reasonable to ask for my TSH to be lowered to about 1 and would that perhaps help? Or does anyone else get frequent migraines also? I feel like my sex hormones are all out of whack too as for the 10 days leading up to my period I feel unhinged and its not 'normal' PMT. It's extreme.
I don't know if that could be tied in with thyroid as in, the tiredness makes my mood fluctuations more severe.
Any advice appreciated. thanks
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sugarbee1981
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Ask GP for FULL Thyroid testing including FT3 and FT4
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
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
Ask GP to test ferritin levels if not been done
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
How low were vitamin D and folate?
What are vitamin D and folate levels now?
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 .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Is this how you do your tests?
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Also new NICE guidelines recommend that Levothyroxine dose should be worked out as 1.6mcg per kilo of your weight ......this might be handy to push go for dose increase
1.3.6 Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
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TSH Levels 2 Year Post Thyroidectomy
Hashi's in remission!
Ideal TSH when on levothyroxine? Does anyone with hypothyroidism feel well with TSH 2-3?
