Kindly help!

[Sheetal8]

I am hypothyroid, taking eltroxin 75mg.. For stomach problem gastro prescribed sompraz d 40 in morning 1/2 hr after taking eltroxin and at night prothiaden 25 mg.. For one month.. Now 17 days I have took these..right from first day of taking it I am getting whole body severe horrible pain whole day..even if I do basic work..and al time sleepy and headache... Is these due to these tablet ?

[SeasideSusie Remembering]

Sheetal8

Is these due to these tablet ?

Have you checked the Patient Information Leaflet for the listed side effects?

This post has appeared twice, I have deleted the duplicate post.

[Sheetal8 in reply to SeasideSusie]

Mam ... In side effects they have mentioned.. Headache sleepiness and muscle joint pain ... But stomach problem is some what okk after taking these pills

[SlowDragon Administrator]

How long have you been on only 75mcg levothyroxine?

This is only one dose increase up from starter dose

Majority of patients need at least 100mcg levothyroxine per day, unless you are extremely petite

guidelines on dose levothyroxine by weight

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

Being under medicated on too low a dose of levothyroxine frequently causes gut issues due to LOW stomach acid

Low stomach acid leads to low vitamin levels and low vitamin levels tends to lower TSH and result in poor conversion of Ft4 to Ft3

Low Ft3 often linked to fibromyalgia

Low Ft3 tends to lower vitamin levels further

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

Do you have Hashimoto’s

What vitamin supplements are you currently taking

When were vitamin levels last tested

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?

[Sheetal8 in reply to SlowDragon]

Yes.. Want to know these symptoms are due to tablet or thyroid low dosage causing it ?

[SlowDragon Administrator in reply to Sheetal8]

What are your most recent thyroid results and vitamin levels

How much do you weigh approx in kilo

[Sheetal8 in reply to SlowDragon]

I am 49.9 kilo mam

[SlowDragon Administrator in reply to Sheetal8]

So guidelines suggest you need around 80mcg levothyroxine per day....so pretty near what you are currently taking

But some people need more than guidelines say

So first step is to get FULL thyroid and vitamin testing done

Come back with new post once you get results

[SlowDragon Administrator]

Tired and headaches are common hypothyroid symptoms

List of hypothyroid symptoms

thyroiduk.org/signs-symptom...

[Sheetal8 in reply to SlowDragon]

Mam gidiness and full body pain ??

[SlowDragon Administrator in reply to Sheetal8]

Dizziness often low B12

Pain low vitamin D

Both EXTREMELY common when hypothyroid