My dose was decreased (just over two weeks ago) from 100mcg daily to alternating between 100mcg and 75mcg after my TSH came back as 0.02. I hadn't had many symptoms of being hyper, although did have a voracious appetite and was a little restless.
I was a little sceptical about the blood test result, as I had it in the afternoon (when all my others had been in the morning) and did not stop taking my b12, iron, or vit d, which I've since learned can affect the result. However, the change didn't seem too drastic, so I trusted my doctor.
My question is, how quickly am I likely to feel changes? I have been feeling more tired recently, constipated and feel as though I'm putting on weight, although I'm very aware of lot of this could be due to other causes, or psychosomatic, as maybe it's too soon to be feeling the effects of these changes?
My other question is, next time I have my levels tested, how long before do I need to stop taking my supplements?
Thanks in advance!
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ellerc93
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Its biotin that affects blood test results not b12 or vit D. You should stop taking biotin for one week before a blood draw. And yes always have the blood test as early as possible in the day, dont take your levothyroxine until after the blood draw.
TSH or thyroid stimulating hormone comes from the pituitary to tell your thyroid to produce more hormones. It is NOT a thyroid hormone. Did your doctor do a ft4 and preferable a ft3. These are blood tests for the level of thyroid hormones in the blood stream. Sadly there is some protocol for just doung the TSH and not measuring the thyroid hormones tht seems to being pushed.....saving money?. Treating by the TSH alone has been proven to lead to under treatment.
The full efects of any dose change whether up or down takes 6-8weeks. Your doc should then retest you.
Thank you for your reply. No, you're right, my doctor would only do a TSH test. I'm going to request a full panel at my 6 week check though to get a clearer picture as I also wondered whether my medication would have been reduced at all if I'd had the test in the morning
Thank you for your advice about preparing for the blood test as well, that's really helpful.
Ah, yes! I take a vit-b complex which has biotin in, so in my head they're associated as something I need to stop beforehand.
Yes stop the tablet for a week. You GP can request the full thyroid panel. Odds on the labs will veto it but may do Ft4. Many are testing privately. If you look on athyroid uk websie you can get a full thyroid panel done for around £27. Not right we have to do this but the nhs testing is totally inadequate!
Yeah, it's frustrating that we have to be such determined advocates for our own health and face being made to feel like a nuisance or hypochondriac when we ask for support with something we know is not right for us.
I think I'm going to see what the doctor says about the full panel. Hopefully they'll agree because I won't have had the full panel for a year, but if they don't I'll try the private one. Thanks again
from my experience of that sized reduction, you'll have a clue after about a week, but you'll need to wait several more weeks to see if you stay feeling how you do now or it it improves as your system adjusts to new dose. i went from 125 to 112.5 , that was perhaps helpful, but for the first 4/5 ? weeks i didn't like it. but then later on realised i was less jumpy , and had better sleep , and some pain i was having very slowly went away.
But with a further drop from 112.5 to 100 i became constipated within about a week and it didn't improve by the time of the 6 weeks re test. so it was put back up to 112.5 (after a bit of a struggle) and the constipation and other issues improve within couple of weeks.
Shame about the PM blood test . you might not have had a reduction if it was early AM ( depending on fT4 level), but it's worth giving it a reasonable try as some effects are slow to settle in , and at least then you have a good argument for putting it back up should you wish to.
I can't remember the proper supplement timing i'm afraid.....
that's really really helpful, thank you. I'm very anxious about getting the right dose (I have a long history of an eating disorder and while I'm now in recovery and I know it sounds ridiculous and vain I'm petrified of putting on weight if my dose is too low) so I'm quite prone to jumping on signs that it might not be high enough. good to read that it can take some time for my body to adjust.
I had exactly the same thought about the PM blood test, as I was juuust below the 'normal' range, although I kind of justified changing because a) I had had the few symptoms of over-medication and b) I know optimum isn't always the lowest of the range possible. Definitely going to make sure my next one is first thing in the am though.
p.s last time i booked a blood test and wanted to make sure it was at a particular time of day i had to wait about 5 weeks for an appointment at that time.... so maybe look at getting it booked in sooner rather than waiting till you want it , and then having to wait several. more weeks for a early AM appointment to be available... if you see what i mean
ahh, thanks for the tip! for where I am you just get the testing paperwork from the GPs and then go to the local hospital where there is a drop in for blood tests, so I can just go for when it opens and hope there's not already a queue
i've never though about that , i wonder if i can do it . ..the blood is tested at the big local hospital , which is not much further away than the Docs anyway..... next time i need one and they haven't got a convenient appointment i'll ask if i can get a form to go there instead instead of messing about.x
It's so much more convenient and can fit to your schedule/days. The phlebotomists there also do it literally all day every day so they're generally also very very quick, too!
I always pop up to my local hospital for my blood draw. I can go when I want! They are open from 7.30am too -currently free parking. Also the samples arent hanging around waiting for collection as they are sent straight through at the hospital so results are quicker.
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 have pancreatitis and I am prediabetic and developing a goiter thyroid problem I have been acute but through diet have now reduced to chronic. The drugs for thyroid would send me acute. I think I have Graves maybe Lupus as my sister is a throwback my family stem back to Australia but I look white. I have painful eyes, I tremble and have been exhausted. Nights are the worse the sweats have been terrible and now they happen days too. I get nausea in the day and urinate 5 times a night. Where do I go from here. I was losing weight terrible but have now begun gaining it. My mum had a goiter so did her mum so did my sister. Mum and gran had pancreatic cancer but I was tested negative for that. Just chronic pancreatitis as amylase always up. Our Gps are non existent through Covid. I’m still a young 56. I want to know what is happening to me?
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