Does anyone else experience daily vaginal bleeding while taking 50mcg of Levothyroxine?

[kayyyyla]

Hi, I'm new here and was recently diagnosed with Hashimotos. I've been on levothyroxine for 3 months and since I started taking the medication, I've been bleeding every day. Has this happened to anyone else? Sometimes the bleeding is light, other times it's really heavy. Does this mean my dosage is too little or too much? If anyone else has experienced this, please let me know what you/your doctor recommended.

[Lalatoot]

Kayla Have you seen your GP about this? Daily bleeding should be checked. It is not a common hypo symptom and could have other causes.

[kayyyyla in reply to Lalatoot]

Thank you for your response and yes, I have a sonogram scheduled for tomorrow. I just find it odd that this bleeding started once I began taking levothyroxine. I wonder if anyone else had similar symptoms.

[Lalatoot in reply to kayyyyla]

Thyroid symptoms are weird. They can affect every part of the body and come in ways you never would have considered. I am 64 - - went through menopause at 44- yet for years and years when my levels were off I would experience period-like pain and a dragging down feeling - like i was 16 again and my period was about to start. All internal tests were negative and it disappeared when my levels were properly treated. So I would never say it couldn't be thyroid related but I would always like to eliminate other possibilities too.

Any symptoms you have are more likely to be down to your thyroid hormone levels than the levothyroxine. Often when we start levo the thyroid which has been struggling takes a rest (as hormones are coming from elsewhere) so things can get worse on a low dose such as 50mcg.

[SlowDragon Administrator]

Definitely see your GP to discuss this

Likely to lead to anaemia (very common when hypothyroid too)

Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).

But you should have bloods retested 6-8 weeks after each dose increase

To have been left on only 50mcg for three months is too long

Have you had bloods tested?

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)

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

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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

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

Even if we don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose

NICE guidelines on full replacement dose

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.

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.

RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

[kayyyyla in reply to SlowDragon]

Thank you so much for this information. I have have my bloodwork tested recently and my TSH level is at 0.783 so it is good. I was wondering if the 50mcg could be too high of a dose?

[SlowDragon Administrator in reply to kayyyyla]

Was test done early morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?

Just testing TSH is completely inadequate

If you have low vitamin levels TSH frequently drops even when Ft4 and Ft3 are far too low

Examples of full private testing

healthunlocked.com/search/p...

healthunlocked.com/search/p...

[Petalrugbaba]

Thyroid medication can effect your level of sex hormone binding globulin ( SHBG). It may be wise to ask your GP for a test for SHBG and hormone levels as an inbalance may be triggering bleeding 😏.

[magsyh]

Low thyroid does cause bleeding. I didn't hit proper menopause till I was 61 and I was told eventually by a private gynecologist that it was due to years of low thyroid that had gone untreated. Don't be fooled by your TSH when I was started on levothyroxine my TSH quickly fell to 0.5 and the doc tried to tell me I was over medicated on 50mcg. It's only the initial shock to your body from the new source of hormones. Eventually it will settle. Mine settled back to 2.4 which proved I was actually still under medicated. I would suggest you get your adrenals tested before you up your levo as my adrenals were just not responding to stress and making all my thyroid problems worse. If your cortisol isn't high enough your levo won't work without glucose in your cells. All these problems contributed to my bleeding. It's all connected as low progesterone will also cause bleeding and progesterone is part of the adrenal/thyroid puzzle.