Just started thyroxine

[NB1967]

I have suffered with an overactive thyroid which had been treated with medication and radioine treatment at December 2019 I have now become underactive and been feeling awful after several blood tests have not been put on thyroxine as I am now severe underactive. I know it will take several weeks to start working but I am really struggling to function what is peoples advise to get me through ?

[pennyannie]

Hello NB1967 and welcome :

The thyroid is a major gland responsible for full body synchronisation, your mental, physical, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

RAI once ingested slowly burns out the thyroid in situ, destroying functionality and now slowly you will start to recover your well being as prescribed medication.

Your dose will take few weeks to take effect and you should get another blood test in about 6-8 weeks time to assess if you need another increase in a Levothyroxine if you are still symptomatic.

It is essential that you are dosed on your T3 and T4 blood levels as your TSH blood test result, looked at in isolation, is a very unreliable measure of anything, especially if you have Graves Disease.

T4 - Levothyroxine is a storage hormone and your body needs to convert this hormone into T3 - the active hormone that the body runs on. Your conversion can be compromised if your vitamins and minerals are not optimal in their ranges and so it would be sensible to arrange that your ferritin, folate, B12 and vitamin D are also tested to ensure these are supportive.

RAI s known to " trash " vitamins and minerals so I can't see the surgery objecting testing.

Once with all these results you can start a new post to update your progress and ask for more detailed help once you post back the blood test and ranges.

Remember to take your Levothyroxine with a full glass of water, on an empty stomach, and an hour before eating.

You will learn much just by reading other peoples post and the answers received.

There is also the Elaine Moore Graves Disease Foundation website that you might like to dip into if you don't already know of Elaine Moore.

You might also like to read a book - Your Thyroid and How To Keep It Healthy written by a doctor who has hypothyroidism - Barry Durrant-Peatfield writes in an easy to understand,

insightful way, and since we now don't have this amazing little gland we do need to understand all that it does so we can try and compensate accordingly.

.

[SlowDragon Administrator]

Welcome to the forum

Can you tell us how much levothyroxine you have been started on?

It’s not like taking an aspirin...each dose increase takes several weeks to have full effect

Do you have any thyroid and vitamin test results from before starting on levothyroxine?

Bloods should be retested 6-8 weeks after each dose change in levothyroxine (or brand change 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 with Graves’ disease

Ask GP to test vitamin levels

Getting vitamin levels optimal can really help reduce symptoms. ALWAYS get actual results and ranges on all results

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/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...

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 is a Marmite brand....some love it, others hate it

Teva poll

healthunlocked.com/thyroidu...

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).