Hi folks. I had a total thyroidectomy approx 4 weeks ago. Having problems adjusting to levothyroxine

[Seagull101]

Biggest problem is my mood/mental state keeps crashing. Feeling Really low. They upped my dose from 125 to 150 and it's helped slightly. Also headaches, joint pain, cramps and no energy. My next app is about 10 days away. Anyone else felt like this when starting off?

[Lalatoot]

Your system has had a big shock and will take a while to settle down. It takes at least 8 weeks for the body to adjust to a change in levo dose. And your body is having to recover from the thyroidectomy as well.

[SlowDragon Administrator]

Ask your GP to test vitamin D, folate, ferritin and B12

Important for these to be at GOOD levels to help reduce symptoms

Add results and ranges if you have any any

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

Are you currently taking Teva?

Teva, Aristo and Glenmark are the only lactose free tablets

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

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...

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).

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like iron, calcium, magnesium, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Bloods should be retested 6-8 weeks after any dose change

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

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)

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 vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

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

monitormyhealth.org.uk/thyr...

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[Seagull101]

150mcg = 75kg? I'm 6'2" and 107kg

[Seagull101 in reply to Seagull101]

They upped my dose because I'd started having suicidal thoughts I was that low

[Seagull101]

Just checked the boxes and the brand name is Teva. Should I request a different manufacturer?

[SlowDragon Administrator in reply to Seagull101]

Obviously difficult to say ...if you have only had Teva

[Nanaedake in reply to Seagull101]

If it were me, I'd change brand until you are stable on levothyroxine. Lots of people have mentioned problems with TEVA.

[Seagull101 in reply to Nanaedake]

Typical, my surgery website is down so I can't contact them. Technology is great when it works

[Nanaedake]

In the meantime you could research alternative levothyroxine. helvella administrator on this forum has a list. Then ring around local pharmacies to find out which one they stock. Your prescription will just say levothyroxine and the dose. It's up to you to source your preferred brand. I always get 50mcg tablets to make up my dose. You can always split a 50mcg tablet to get a 25mcg.

[Batty1]

You need T3. I had a mental breakdown after my thyroidectomy until Endo reluctantly gave me T3 and mood lightened up.