New hypothyroidism diagnosis

[SimbaT]

Firstly, I’d like to apologise for my complete ignorance regarding the thyroid.

Visited my GP yesterday to talk about recent blood test, both my December and January tests show a low T4. Doctor gave me a prescription for 50mg of Levothyroxine daily, told to have further bloods done in 6 weeks then she ended my consultation.

I’m a long suffering psoriatic arthritis patient for which I’m prescribed Cosentyx and Methotextrate injections. Persistent fatigue and a host of other symptoms saw me also diagnosed with fibromyalgia around 2 years ago and I was given Amitriptyline.

I have monthly blood tests because of the medication, in December I was inadvertently also tested for my thyroid.

I’ve no idea where to start.... any advice would be greatly appreciated.

[KerriKerri]

Hello! Fellow hypothyroidism patient here, also taking 50mcg of Levothyroxine. One thing the doctors never told me, but needs to be remembered with taking levothyroxine, is to make sure you take it at least 30 minutes before food, other medication and caffeinated drinks. I’d been taking it for a good two years before I found that out and it surprisingly makes a difference. I hope other are able to offer you some more useful advice as well.

[Wetsuiter in reply to KerriKerri]

I d say an hour. and some things you have to give longer tbh

[SimbaT in reply to Wetsuiter]

Thank you Wetsuiter.

[jimh111 in reply to KerriKerri]

Just avoid large meals, some supplements, bran and coffee. It might be easier to take it at bedtime. You may find the fibromyalgia reduces once your hypo is sorted. Magnesium supplements are good for fibromyalgia but take them a different time to the levothyroxine.

[SimbaT in reply to jimh111]

Thank you for the advice. I think I may have been misdiagnosed with fibromyalgia, it may have been hypothyroidism all along. The only supplement I take is menopace. What’s the difference between taking the medication at night versus the recommended morning?

[SimbaT in reply to KerriKerri]

Thank you for the reply KerriKerri, any advice is greatly appreciated. The pharmacist did tell me to take it 30 minutes before food and caffeine. 🙏

[greygoose]

To be perfectly clear:

* levo is best taken 1 hour before food or 2/3 hours after food for maximum absorption

* Most other medications/supplements should be taken at least two hours away from levo (and other thyroid hormones)

* iron, calcium, vit D, magnesium and/or oestrogen should be taken at least four hours away from levo.

Did your doctor tell you to go back for a retest six weeks later?

When you go for your retest, make sure you:

* get an early morning appointment - before 9 am - TSH is highest early morning, and it's the TSH that most doctors look at, we need it as high as we can get it

* fast over night, but drink plenty of water

* leave a 24 hour gap between your last dose of levo and the blood draw

* always, always ask for a print-out of your results - best to ask at reception, rather than asking your doctor - if you live in the UK, it is your legal right to have a copy, they cannot refuse.

If you have any other questions, or need help interpreting your blood test results, don't hesitate to ask here. Always post the ranges with the results.

[SimbaT in reply to greygoose]

Thank you greygoose, your advice is really helpful.

[greygoose in reply to SimbaT]

You're welcome.

[SlowDragon Administrator]

As psoriatic arthritis is autoimmune it’s very likely your hypothyroidism is also autoimmune thyroid disease

Once we have one autoimmune disease it makes others more likely

Ask GP to test thyroid antibodies and vitamin D, folate, ferritin and B12 at next test in 6 weeks

50mcg is standard starter dose of levothyroxine

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 is in top third of range and FT3 at least half way through 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)

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

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 .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

Come back with new post once you get vitamin and antibodies test results....and thyroid levels retested after 6 weeks

Levothyroxine should always be taken empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more effective taken at bedtime

verywellhealth.com/best-tim...

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

[SimbaT in reply to SlowDragon]

Thank you so much for your very detailed reply 🙏