Did anyone experience any side effects when starting Synthroid? I started this morning (I’m taking brand) and all day I have felt tired, a little nausea and a bit out of it. I normally do not feel like this, my thyroid has never really given me symptoms- well at least symptoms that I noticed or that have really bothered me.
*My free T4 and T3 are within normal limits although T4 is lower side of normal, my TSH is 96.50, negative TSI and antibodies over a 1000.
You have just started 25 mcg? This is a negligible amount and since we store a little over 10 days of levothyroxine in our blood it will have an insignificant effect. More likely your thyroid is failing more quickly.
However, you need to verify these numbers are correct by having TSH, free T3 and free T4 measured by a different assay. This is important as your TSH is inconsistent with your normal fT4 total T3.
Thanks for the response
Yeah I started 25mg today. Low and slow. Not really sure how they plan on playing it out but I’m curious how it will be once the dose gets larger. Not a giant fan of side effects or Yo-yo meds. Plus other than my Mom I don’t know anyone IRL who takes the medication or has thyroid problems so it’s hard to compare and contrast.
So last week when I had the labs pulled I went to a different lab location hoping maybe that would help. I asked my endo about the differences because I was concerned as well but she didn’t think anything of it. Said she sees it all the time and the tests are accurate. So not really sure what I should do? I do know the T4 is on the cusp of being too low so maybe it’s all heading that way?? I couldn’t believe that in two weeks the TSH jumped up to 96. I guess I still don’t understand how I could have such a high TSH but normal T4/T3. I see her in two weeks so I guess I’ll have to have another discussion with her.
I'm not sure what you mean by a different lab location. Was this a different blood test centre? If so it's possible they send the sample to the same lab or a lab using the same equipment / reagents. i.e. exactly the same test. If the TSH results have different reference intervals (numbers in brackets) then it would be a different assay.
If this is not the case I would see if you can get your TSH checked privately. It costs about £30 here in the UK for TSH, fT3, fT4 but it probably cheaper in the USA. You only really need TSH but beware checks done in pharmacies that simply give a yes / no answer, you need the numbers.
Your endo is wrong to say the tests are (always) accurate. They are reasonably accurate but in a small percentage of patients they can be completely wrong due to antibody interference.
Your low normal fT4 means you are safe taking a moderate dose of levothyroxine. I would get hold of the actual results with reference intervals, doctors have a habit of saying results are normal when they are very marginal or even abnormal. Demand the numbers. You really do need the TSH tested with a different assay to confirm it's a valid result.
I'm not sure how your care is funded in the USA. If it's under insurance or you pay then you are paying this endo and they should be prepared to follow your requests within ethical bounds. I would ask them to consult with the biochemist about this unusual TSH result and whether they have introduced a different assay recently which might explain the sudden jump in TSH. If it's at a hospital you could even ask to speak to the biochemist directly about a strange result, might upset the endo but depends on whether you could find someone else if needed.
Thanks!
I messaged my doctor this morning about the TSH and I’m just waiting for her response. I’m going to contact the lab as well and ask. The hospital lab where I got my blood drawn the last time does everything in house, they don’t send anything out, but this laboratory is part of the same hospital system I got the other blood work done so it’s possible they use the same methods, machines etc.
As far as our insurance in the United States it’s mostly all private but thankfully I have great insurance so it’s not an issue for me to go see someone else. However lab tests need to have a doctors order. There are no private labs, drug stores etc where you can go to request your own blood tests. Everything must go through a physician and have an order. But usually when a patients request something the doctors are good about ordering it.
Ask the biochemist at the lab. Put it in friendly terms, explain you have very unusual results and that with a similar fT3, fT4 your TSH seems to have jumped up dramatically, that you have heard that antibodies can sometimes interfere with the assay.
Thank you for the advice because I know I would have stumbled on what to say!! That is very helpful.
So if by chance my TSH is inaccurate yet they claim it’s not can taking the Synthroid mess things up especially when they up the dose of it?
Possibly but your fT3 and fT4 are safety nets. As long as they don't both go much above average it should be safe. fT4 is usually high normal on Synthroid with fT3 about average.
By the way if your fT3 and fT4 go up a little on Synthroid and your TSH stays up it really indicates something is amiss.
Thank you that’s good to know. So if it’s correct the TSH should come down right while the other two only come up slightly? I guess I don’t understand how they would correct this condition if my t3 and t4 are already in normal limits. Isn't the point of treatment to get them within normal limits?
I will be curious what the blood work shows in a few weeks.
You will need dose levothyroxine increased to 50mcg after 2-3 weeks.
Bloods should be retested 6-8 weeks after each dose increase in levothyroxine
Your high thyroid antibodies confirms autoimmune thyroid disease also called hashimoto’s
Hashimoto’s frequently leads to very low vitamin levels
Ask for vitamin D, folate, ferritin and folate tested
Likely to need to supplement to improve to GOOD levels. This can help tolerate faster increases in levothyroxine
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)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
Guidelines on eventual dose by weight is approx 1.6mcg per kilo of your weight
Tiffw28 has arrhythmia and is anxious so levothyroxine increase may be a little slower although her fT4 seems to be falling quickly which would indicate raising dose soon.
Thanks for the response!
So I already take Iron, vitamin D, B, etc and have gotten my levels to normal over the past year. We are now hoping to get them optimal instead of the lower side of normal.
It was the cardiologist who told the endocrinologist that I had to start at 25mg and work up because they didn’t want it to trigger any of my arrhythmias- the reason I’ve been nervous for sure. I didn’t actually know about it until that discussion was had and I was like what a minute. What. Lol
Now here’s the other question yesterday I started the medication and felt like crap all day. About an hour or two after I had taken it. Woke up still not feeling that well either. Do you know other people who had this issue? Here I was more worried about my arrhythmia and instead I got nausea, weakness and general unwell. I’ve never felt like this with any of my other mediations nervous or not.
It can be difficult to start on levothyroxine, especially at low dose
You may need to trial different brands. Certainly in UK many people find they may tolerate only one or two different brands of levothyroxine. Different fillers can affect how we absorb levothyroxine
The heart needs good Ft3.
Levothyroxine is Ft4 and Hashimoto’s to be converted in the gut, liver and cells into Ft3
It takes 6-8 weeks for each dose of levothyroxine to have full effect
Important to take levothyroxine every day, always on empty stomach and no other medication at same time, nothing apart from water for at least an hour after
No iron, calcium, vitamin D, magnesium, HRT for minimum of four hours after
Many people find taking levothyroxine at bedtime can give better absorption and more convenient
Thanks! thankfully I’m really good with following the directions of my medications because I take quite a few, I want to make sure I’m benefiting from them and they don’t interact. I thought about taking it at bedtime, I really would prefer it, but other medications I take wouldn’t leave a big enough window of time for it to be possible.
I just hope my body gets used to it because I’m not liking how I feel!
If you usually get up for the toilet in the night...quite a few members take their levothyroxine then.
Use a weekly pill dispenser and leave it by the bed
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