I’m quite new to taking my thyroid tablet when I first started I was on 25mcg levothyroxine which then needed to be increased to 50mcg, when I first started taking the increased dose I felt a lump every time I swallowed which lasted about 2 weeks, there was no lump to touch only when I swallow, I rang the drs and they were no help so I put it down to my thyroid gland being forced to work, I’ve been taking 50mcg for a few months now and this feeling has just started to come back again, I wasn’t sure if it was because of wearing a mask all day long- I work 8 hours and I’m only allowed it off for my breaks 2x15 mins and a 30min, I haven’t felt it or noticed it over the weekend or is it my thyroid?!
There is no visible lump, the leaflet doesn’t describe this as a side effect and I can’t find anything online.
Thank you
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Crazycatlady_101
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I put it down to my thyroid gland being forced to work
I'm afraid I don't know the cause of your problem, but I can guarantee it it not that. Levo does not 'force your thyroid to work'. It doesn't have any effect whatsoever on your thyroid. It is thyroid hormone replacement, replacing the hormone that your thyroid can no-longer make enough of to keep you well.
I would imagine that the cause is your thyroid becoming inflammed from time to time. Do you have Hashi's?
Thank you for replying, I’ve no idea what type I am, I feel very uneducated about how the thyroid works and how it’s helps the body how would I find out please?
To find out if you have Hashi's - autoimmune thyroiditis - you need to have your antibodies tested: TPOab and TgAB. If either of those is over-range, then you do have it. Your doctor should have tested those as soon as you were diagnosed hypo - but they rarely do.
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
Dose is increased slowly upwards in 25mcg steps, retesting each time
Unless very petite, likely to need to increase to at least 100mcg
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 near 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.
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
Ask GP to test vitamin levels and thyroid antibodies if not been tested yet
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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Hi Crazycatlady yes me and loads of others have this too. Lots of posts about it on here over the years. Mine started at 75mcg. My Endo said a lot of people cant tolerate Levo above 75. Are you having an U/S ? x
Thank you everyone, i order my prescription through well and get sent whatever brand so should I be tested for that?
I think my last blood test was October November time and never heard anything from the doctors so I figured 50mcg is working so should I be chasing that?!
Yes, you should book a full thyroid blood test at your doctor’s surgery. SlowDragon has listed out what that involves in a reply above, so I won’t repeat them.
Also a follow up appointment with your GP. A word to the wise: you will almost certainly have to be proactive from now on on this. In other words, do not expect your doctor to manage some process of care and recovery for you.
And no need to apologise for being uneducated!! I think many of us on this forum have been shocked at the amount of learning we’ve had to do in order to try to improve our health
Many people find Levothyroxine brands are not interchangeable.
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
If lactose intolerant, Teva is often best option
Teva, Aristo and Glenmark are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Note Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but beware 25mcg Northstar is Teva
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).
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
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
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
Oh my goodness there’s so much information there thank you!!
I do take desogestrel aswell but spaced out I take that at night and Levo in the morning, I usually take it an hour before I get up as I don’t sleep well but sometimes I get up at 5:30am and not always awake until that time meaning I’m not giving myself enough time before eating breakfast, I do try to give myself a full hour before eating or drinking anything so I may need to try and swap my tablets around.
Request receptionist at GP that you want online access to your medical records and blood test results
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
You are entitled by law to your blood results, and it is a good thing to keep them so you can see when you change dose what it does to your bloods. Many of us have found that the bloods were shouting we needed a change of dose, but the GPs did not do anything.
You have come to the right place to learn - I did not know anything, just accepted what the doctor told me, and was ill as a result. This forum changed that, and I honestly think I would not be here today if it was not for the lovely people here. Have a read through some posts, the more you know, the better it will be for your health. It is quite a steep learning curve, but so worth it!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
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