Hello I was diagnosed with underactive thyroid this year and started on 25mg after my 10 week blood test it showed my t4 was now in range but tsh still high so I'm now on 50 mg. I'm on day 10 of taking 50 mg daily when will I start to see any improvements? Such as weight loss, thicker hair, less tired.
Thankyou
Debbie
Could you possible give the actual numbers: results and ranges? Just saying 'high' or 'in-range' doesn't give us much clue what's going on.
Why did your doctor start you on such a low dose? The normal starter dose is 50 mcg unless you are very old, very young or have a heart condition. Starting you on such a low dose has slowed down your recovery. Now, you are on 50 mcg, you are really just at the beginning of your journey, and it can take a long, long time, with several increases in dose, before you start to feel better. It's different for everyone, but 50 mcg is still a very low dose, so patience is needed, I'm afraid.
Have you had your nutrients tested: vit D, vit B12, folate and ferritin? Hypos often have low nutrients, due to low stomach acid. And low nutrients can cause fatigue and hair-loss. So, very important to get those tested. 
Hi yes I've had all other tests suggested and everything fine except cholesterol is borderline. My levels in feb were t4 7.0 and tsh 6.16mu/l
I then started on 25mg and 2 weeks ago I had a repeat blood test and my t4 9.6 and tsh 3.9
GP wants tsh to be under 2.5 hence the increase to 50mg daily.
Unfortunately it runs in my family x2 sisters have it and my dad and niece.
Thanku for your reply.
My first symptom of something wrong was in nov last year when I had neck pain, gp put it down to a strain but after Christmas it was still there hence the blood test.
I'm only 40 x
Debbie, I did say we needed the ranges. They vary from lab to lab, so we need the ranges that went with your results.
I think you're going to have problems with your doctor, because a TSH of 2.5 is still too high. When taking thyroid hormone replacement (levo), the TSH should come down to 1 or under. So, you might have problems feeling well with the treatment she gives you. Once a TSH gets to 1, it's of little use for dosing, anyway.
Your cholesterol is so-called 'borderline' because your FT3 will be low with a TSH of over 3. It's low T3 that causes high cholesterol.
Your doctor saying that you nutrients levels are 'fine', doesn't actually mean they are fine, just means they're somewhere in-range. And, as discussed above, that means very little. I would suggest you post the results AND the ranges, and let us have a look. Doctors know nothing about nutrients because they don't learn about them in med school.
Have you had your antibodies tested?
If you're only 40 then your doctor started you on too low a dose, I'm afraid. And, retesting should be done after six to eight weeks. Ten weeks is too long.
When you have a retest, it's always recommended on here that you have the blood draw before 9 am, fasting. Leave a 24 hour gap between your last dose of levo and the blood draw. And tests always need to be done in the same way, if you want to be able to compare them. Is that how you had your tests done?
Yes my bloods were taken like that, my ranges on the print out I have are t4 (8.0-16.0) mine were 7.0 in feb and are now 9.6.
Tsh (0.38-5.33) mine were 6.16 and are now 3.9, she said this need to come down to 2.5 and under
I wasnt given any other information, i didnt ask as new to all this. I have my iron, folate b12 checked all the time because last year i was on ferrous sulphate because low in iron due to heavy periods.
On next blood test I will ask for a more detailed description of all levels including nutrients.
I take my meds in the morn can they be taken before bed instead? Thanku
OK, so your FT4 is very low. Only 20% through the range, and it needs to be more like 80%. So, you still have a long way to go. It takes time.
You could still get the details of your nutrient tests. Ring reception and ask them to print you out a copy. It is your legal right to have one. But, best to get a print-out, rather than just a verbal report, because mistakes can slip in, that way.
You certainly can take your 'meds' at bedtime, if it's more convenient, as long as your stomach is empty - 2 to 3 hours after a meal - and at least two hours away from all other medication or supplements.
Do you take iron? If so, that needs to be taken four hours away from levo.
Thankyou for all your help and advice, hopefully the 50mg will start making me feel better x
I'm no longer on iron tablets or any other meds now, and I had endometrial ablation last march so no longer have periods.
OK
Hello.. I’m afraid there’s no way to speed up your recovery - patience is the name of the game so try and find things that distract, amuse, enjoy, relax on the way back to your true self. It does take time, often months if not a year or so to be back to true normal. The problem with the condition of being hypothyroid is that it can make you depressed, anxious and even a bit paranoid. (I spent a lot on ‘alternative’ medicine and homeopathy in the search to feeling better). Wishing you the best!
Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients 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 note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
Bloods should be retested 6-8 weeks after each dose increase in levothyroxine
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
As family members have hypothyroidism too, it’s virtually guaranteed cause is autoimmune
Ask Gp to test antibodies and vitamins
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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin
medichecks.com/products/thy...
Medichecks often have special offers, if order on Thursdays
Thriva Thyroid plus vitamins
Blue Horizon Thyroid Premium Gold includes vitamins
bluehorizonbloodtests.co.uk...
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.
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_...
Heavy periods are classic sign of being hypothyroid
Levothyroxine is an extremely fussy hormone and should always be taken on an 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 convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
markvanderpump.co.uk/blog/p...
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. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
Teva and Aristo are the only lactose free tablets
healthunlocked.com/thyroidu...
Teva poll
healthunlocked.com/thyroidu...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
Debbie I was started on 25mg last year for 3 months and told I was ‘subclinical’ then 50, then 75 every 3 months by the time you get a blood test.
Now I know what I know from this site, it was cruel and has taken me a long time to recover, still problems with joints which suddenly started at 50 mg. All my toe nails dropped off at 50mg as my Thyroid was actually completely dead and I needed the equivalent of over 150mg Levo. Your GP is not following NICE guidelines as mine didnt. Point it out to them because the cost is your health.
Also nutrients are really really important to maximise conversion and your health, as lots of nutrutional deficiencies often accompany hypothyroidism. Great advise above x
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