Levothyroxine time scale

[Bwrd]

In people's experiences how long did it take for levothyroxine to have an effect on symptoms? I've just started on 50mcg and my main symptom of hypothyroid was just extreme tiredness! I can't wait to have more energy!!

[shaws Administrator]

It may take longer than you expect, as it is the gradual increase of levothyroxine which in turn should convert to T3 (liothyronine).

Levothyroxine (T4 ) is an inactive hormone but T3 is the Active one which is needed in our millions of T3 receptor cells. Our brains and heart have the most T3 receptor cells.

Some people need larger amounts of T4 but some doctors seem to think that if it is 'somewhere' in the range we're on a sufficient dose. 'Sufficient dose' means that you feel well and have no clinical symptoms.

T3 Production

Only about 20% of the T3 in your body, about 30 to 40 mcg per day, is produced by the thyroid gland. The other 80% is produced from T4 within the tissues, particularly by your kidneys, liver, muscle, brain, skin, and, when applicable, the placenta. T3 is degraded much more rapidly than T4.

[Hidden]

It's a slow process. I'm 8 months in, on 100mcg, and I feel SO so much better that I did, I'm still not back to normal.

I've learnt that thyroid issues are not for the impatient. ... And I am terribly impatient.

Do you have any test results to share?

[SlowDragon Administrator]

So looking at previous posts you have Hashimoto’s

Which brand of levothyroxine

It takes minimum 2-4 weeks after each dose increase to start to see some improvement. Then often start to feel worse after few weeks, as your body gets ready for next dose increase in levothyroxine

Bloods should be retested 6-8 weeks after each dose or brand change in levothyroxine

The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is under 2

When adequately treated, TSH will often be well under one.

Most important results are ALWAYS Ft3 followed by Ft4. When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)

Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works

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 NOW

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 antibodies and vitamins

medichecks.com/products/adv...

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 down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

Also vitamin D available as separate test via MMH

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk