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[Kellyvi]

Iv been in 25mg Levo for 2 years now, and felt no change Iv had my yearly blood test and my levels have stayed the same so Iv been kept on 25mg, Iv noticed more recently that Iv been tired and heart palpitations. Has anyone just stopped taking there meds?

[SeasideSusie Remembering]

Kellyvi

25mcg is a starter dose for children, the elderly and those who have a heart condition. It sounds as though you have a doctor who doesn't have a clue.

The aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.

Please ask the receptionist (not the doctor) at your surgery for a print out of your test results. Don't accept hand written or verbal results, it needs to be a print out. In the UK we are legally entitled to our test results.

Post the results on the forum, including the reference ranges which will be on the print out at the side of the results, eg:

TSH: 2.5 (0.2-4.2)

For a full picture we need to see:

TSH

FT4

FT3

Thyroid antibodies

and because optimal nutrient levels are needed for thyroid hormone to work properly we also need the following tested:

Vit D

B12

Folate

Ferritin

[Kellyvi in reply to SeasideSusie]

Thanks so much for your reply, to be honest the doctor hasn’t really said much it was a case of I had symptoms and I had the test done and it came back abnormal so they put me on 25mg tablets, I don’t know what’s best to do cause when I read online it’s all mixed reviews x

[SeasideSusie Remembering in reply to Kellyvi]

You wouldn't have been prescribed Levo unless your results indicated hypothyroidism, in the UK TSH has to be 10 or above (well over the top of the range) to be given a diagnosis of hypothyroidism and prescribed Levo.

don’t know what’s best to do cause when I read online it’s all mixed reviews

Not sure I know what you mean by that, what mixed reviews?

As I said, post your results and we can comment further.

[Sandy287 in reply to SeasideSusie]

25 mg thyroid medication they mostly prescribe when someone wants to have a baby. Heart palpitation can be due to having more thyroid hormones and can be many other causes. Better check with doctor. How about having second opinion from another doctor? They prescribed me 25 mg and later 50 mg of Euthyrox and I was ok with that until new Euthyrox came into market and I got serious problem. I quit taking thyroid at all by first lowering dose and then totally end to it. I went to my house doctor he had no idea as my blood test came normal and all side effects I had vanished. Now I’m with University clinic at endocrinology department and they told me to not take anymore thyroid medication as my body is doing well without it. I’m eating 2-3 Brazil nuts everyday to get selenium and coconut too this maybe helping me to balance my hormones. One thing I noticed that when I started for the first time Euthyrox I got BP problem and now after quitting this medication my BP is in normal range and now I’m trying to keep it in normal range through vitamin D, magnesium but I read with these supplements I should also take K2 and Zinc. Not tried yet but will do that soon. Once again go for second opinion whether you really need thyroid medication or not.

[helvella Administrator Thyroid UK in reply to Sandy287]

The dosing of thyroid hormones is usually in micrograms (mcg) - not milligrams (mg).

The document linked below says it all, I hope:

dropbox.com/s/sgv815w8hkexl...

[Sandy287 in reply to helvella]

Yes you are right, but on my medication it says mg which is Mikrogramm in German and English I should type mcg. Thanks for the correction.

[helvella Administrator Thyroid UK in reply to Sandy287]

Fully understood!

[helvella Administrator Thyroid UK in reply to Sandy287]

I have updated the document to include mention of the various spellings of microgram in many European langauges.

[Marz in reply to Sandy287]

Are your Brazil nuts grown in Selenium rich soil ? It should say on the packet .

[SeasideSusie Remembering in reply to Sandy287]

Sandy287

The original poster hasn't mentioned having a baby or trying to conceive, and she's been on this dose for 2 years, in which case 25mcg is inappropriate unless she is elderly or has a condition when it would have been a starter dose.

Maybe you meant to reply directly to the original poster and not me.

[Sandy287 in reply to SeasideSusie]

Sorry it was to original post and by mistake I replied you as your was last reply. I’m not tech savvy 🙈. Yes she didn’t mention that she is trying to convince and neither I got an impression. I was just telling her that normally doctors recommended 25 mcg for this purpose. In her case she should get second opinion whether she really needs thyroid medication or not.

[SlowDragon Administrator]

First thing is, do you have any actual blood test results? if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Far too often only TSH is tested which is completely inadequate

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 vitamin levels and thyroid antibodies

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

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 you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

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

Post re getting dose increase

healthunlocked.com/thyroidu....

New NICE guidelines

nice.org.uk/guidance/ng145/...

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.

BMJ clear on dose required

bmj.com/content/368/bmj.m41