I've been feeling quite awful the past two months and symptoms haven't been improving. I've been experiencing extreme fatigue (much worse than the way I felt before having been diagnosed with hypothyroidism), light headedness, weakness and daily nausea. I've been taking omeprazole to help with my reflux symptoms but it has done nothing for me. I've done lots of blood tests this month and don't seem to be getting any answers.
April 1st:
Serum folate = 2.0ug/l (normal range: 3.1 - 20.5) - I've been taking folic acid for three weeks now and feel no different.
I want to add, I did the second set of blood test on the 22nd early in the morning before taking my 25mg levothyroxine. I've also had a pelvic ultrasound which didn't show any cysts on my ovaries so it's definitely not PCOS. Also, I stopped taking the progesterone only birth control pill on the 1st of February, and waited two months and three weeks before getting my sex hormones checked (I've had two periods since coming off the pill, one in march and another one this month). My testosterone level was also abnormal in October 2020, but it wasn't as high as it is now.
I'm just really confused and would love some advice/insight into what could be going on. Sorry for rambling!
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mdox
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If you want the full picture on your thyroid you need to get your t4 and T3 tested (T3 rarely done by nhs). I'd get them done privately via eg Medichecks (25% off today I saw) but there are many others... then post your results along with the ranges. What was your tsh pre diagnosis?
I've seen many say 25mcg often just makes your body feel worse and that it's not the correct starter dose (see NICE guidelines). Others will comment.
Levothyroxine doesn’t top up failing thyroid, it replaces it
Guidelines on dose by weight is approx 1.6mcg levothyroxine per kilo
As you are extremely petite, you’re likely to not need too many increases
40kilo is likely to need 64mcg levothyroxine per day....but initially starting on 50mcg
Some people find they need high dose of levothyroxine than guidelines
guidelines on dose levothyroxine by weight
Even if we frequently 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 eventually 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.
I've been taking omeprazole to help with my reflux symptoms but it has done nothing for me. I've done lots of blood tests this month and don't seem to be getting any answers.
Many thyroid patients have LOW stomach acid.
Omeprazole is for high stomach acid
Low stomach acid can be a very common hypothyroid issue
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 contain folate, but is large capsule
IMPORTANT......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
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
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New blood test results advice.
Any Advice on blood tests results and feeling rubbish 
