Hi. From my previous post started levo 25mcg every other day for 3 months, then increased to each day, now 7 months later it now been increased to 50mcg a day just 3 days ago. The every first 2 prescriptions I had were teva 25 then the following prescriptions were MP 25 which I began to suffer joint pain which only got worse, so I spoke to the phamacist & got teva 25mcg which I found OK. But due to dr's not doing a prescription for the increased dose, & a different pharmacist sending MP 25 mcg its taken me 20 days to get teva 50mcg. (due to fillers being different I take 2x25 as I didn't what to make any changes)
Why being off medication for 3 weeks I have started with carpel tunnel. I have to date only taken 3 days of 50mcg, but feel very bloated.
Question, as anyone else had this, will the carpel tunnel & bloatness get better ?
To all thank you for reading
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Harlech
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Thank you for your reply. Due to missing 2&half week's of levo, I am hoping the bloating will go in couple weeks & its not side affect of taking 50mcg. Ref. carpel tunnel I fairly sure this started in March but due to lockdown there no none urgent appointment with gp's. I did request Teva to be written on my prescription but they said they couldn't do that it down to the phamacist, I am meant to be OK for the next 6 weeks ref. Teva but if its other phamacist who knows, as the pharmacists keep moving around.
Bloods should be retested after waiting 6-8 weeks minimum after increase to 50mcg every day
Always get all thyroid tests done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
When were vitamin D, folate , ferritin and B12 last tested
I already have b/Horizon kit will have them done at beginning of next year.
( Last blood tests 27th August 2020. I had done post ÷ Theses are B/Horizon results. )
Vit D 64. (50 - 175) I am using better you 3000iu at present, do have a monthly script of fultium 800iu which I have had still 2013 there about.
Folate 7.00. (8.83 - 60.8). It was stated low in the dr's comments but again my dr's & surgery said there wasn't anything wrong so on advice possible yours I purchased my own Methylfolate 1000ug but unsure how much I should take per day some days 1 some days 2tab's
**B12 1311. ( consider reducing to >569. B12. 1342 (. "" "" "" "" "" "" "" "" to>569 (15th-10-(2019 )**July 2018 B12 high at (735)
My dr's say the level fine they aren't concerned.
My surgery & Dr. Have had all my results hand delivered to them, 1 of the papers a Dr Sam connected to B/Horizon stated TSH to be 1, my Dr completely will not accept it.
I know I had some B12 injections so that may explain 2017 / 2018 being a little high 2019 & 2020 I have no explanation I didn't take any supplements.
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B is another option that contains folate, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
I had some b12 injections fews years ago, I don't have my paperwork to hand at the moment, I haven't supplement with b12 for appox 3yrs, the Dr's even though my B12 was over b/Horizon level in 2018 think it was near to 800 but since then 2019 & 2020 have been well over the range, I have questioned 2 dr's about this their answer its ok.
There are several possible causes of rising B12 which cannot be explained by supplementation. There are several people over there who have some sort of experience.
I meant to say my gp didn't do the increase to 50 it was done via phone call with endocrinologist. Comments from her letter to my gp, the increase to 50 is only 3 month trial she as given me this because I remain adament that I want the TSH at lower range of normal, but the endrorinlogist wants my TSH higher level of normal, she also states she is adamant that 50 is the highest & we meaning my gp & herself will never & not to increase dose, as I was doing well on 25 ? 🤔
Obviously need to look at finding a different endocrinologist then
Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private
tukadmin@thyroiduk.org
The aim of levothyroxine is to increase dose upwards until Ft4 is in top third of range and Ft3 at least half way through range (regardless of how low TSH is) ...important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
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 full replacement dose
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.
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.
I have the list from Dionne unfortunately it's the distance it's just to far, I also have the pulse paperwork. I have changed surgery's 4 times since 2012 as I had started this with Dr skinner, I have come to the conclusion it's the area. I also think when older & on your own doesn't help, remarks like well you have to accept theses things at your age, good job that wasn't a face to face conversation. With this covid, things are difficult as you cannot get gp appointments, I was lucky ref. endrorinlogist as when I spoke to my Gp they will not listen, they have there say then put the phone down.
Hopefully my next endrorinlogist appointment is with different 1 as the 1 in March was male
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