I am constantly sweating, have achy weak and stiff muscles, indigestion and feel unwell terrible mood swings. My TSH level is 1.44. Help!

[Cat-222]

Hypothyroidism, 75mg levothyroxine

[SeasideSusie Remembering]

Cat-222

The aim of a Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in theu pper part of their reference ranges.

Just testing TSH only is not an indicator of thyroid status. TSH is not a thyroid hormone, it's a signal from the pituitary. FT4 and FT3 are the tests you need, as T4 andT3 are the thyroid hormones, these tell us if we are adequately medicated or not. Low T3 causes symptoms.

Also, muscle and joint aches and pains could be low Vit D.

As we need optimal nutrient levels for thyroid hormone to work properly, testing core vitamins is also advised:

VitD

B12

Folate

Ferritin

You can ask yourGP if he will do all these tests, if he wont then we have recommended private labs which do full thyroid/vitamin test bundles.

[SlowDragon Administrator]

Do you always get same brand of levothyroxine Which brand

What vitamin supplements are you currently taking, if any

When were vitamin D, folate, ferritin and B12 last tested

Have you had thyroid antibodies tested, to confirm autoimmune thyroid disease also called Hashimoto’s

All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Just testing TSH is completely inadequate

[SlowDragon Administrator]

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

Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but doesn’t make 25mcg tablets

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

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex