Bone pain and tingling in fingers

[jessica6]

Hello. I hope someone out there can help me. I had a thyroidectomy 18months ago and was put on 125mg of thyroxin daily, It was reduced after 8months to 100 on one day and 125mg alternate days. Due to COVID restrictions all my endo appointments were cancelled and my weight have increased alarmingly even through I have tried numerous diets. The bone pain and tingling in my fingers started to get worse about 6 months ago. Could this be caused by the reduction in meds? I feel I am ageing rapidly and some morning struggle to get dressed.

[Oatcake]

Have you had your calcium levels checked? Damage to parathyroid glands can cause a calcium deficiency. I suffered very achey fingers and tingling some months after thyroidectomy and blood tests showed low calcium. I was in tears at times! I've been on Adcal D3 since (18 years) but still get calcium checked with routine blood tests and have not had further problems.

[jessica6 in reply to Oatcake]

Thank you so much for your advise I will ask for my calcium levels to be checked.

[Oatcake]

Ah, you beat me to it.😀👍

[SlowDragon Administrator]

Strongly recommend getting FULL Thyroid and vitamin testing done ASAP

What brand levothyroxine are you currently taking

Do you always get same brand

Do you have the results from when dose was 125mcg

What vitamin supplements are you currently taking

When were vitamin levels last tested

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

For full Thyroid evaluation you need TSH, FT4 and FT3 tested.

Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Ask GP to test vitamin levels and also calcium levels

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

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/

Vitamin D NHS postal kit

vitamindtest.org.uk

[jessica6 in reply to SlowDragon]

Thanks you for your reply. The Levothyroxine I am taking is TEVA. I will have my vitamin levels tested as soon as poss. I tend to not take enough notice of my test results(they never go through them with me) so I just follow what the doctors tells me. I think I will have to start asking more questions about the results and press for better diagnosis.

[SlowDragon Administrator in reply to jessica6]

Have you only ever had Teva

Are you lactose intolerant?

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

But for some people (usually if lactose intolerant, Teva is by far the 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

List of different brands available in U.K.

thyroiduk.org/medications-f...

Teva poll

healthunlocked.com/thyroidu...

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.

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).

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...

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

[jessica6 in reply to SlowDragon]

thank you. I have only ever been offered TEVA. I am not lactose intolerant so I presume I was given this as the most cost efficient. I do take it in the morning I try to wait 1 hour before eating, but no alway possible. I didn't know there was an option to take it at night as this would suit me better as I never eat after 7pm. My appointment is 11am for the bloods so I will delay taking my does until after the text, and will ask for a copy of the results which are not usually available to me. Do you think I should try another brand?

[SlowDragon Administrator in reply to jessica6]

Yes probably should try different brand

Mercury Pharma is widely available and makes 25mcg, 50mcg and 100mcg tablets

Accord (also boxed as Almus via Boots or Northstar via Lloyds) only make 50mcg and 100mcg tablets

They all cost NHS the same whichever brand it is

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

[jessica6 in reply to SlowDragon]

Thank you