Bloods should be retested 6-8 weeks after each dose increase
How long since you started on 75mcg
Which brand of levothyroxine are you currently taking
Many people find different brands are not interchangeable
75mcg is only one step up from starter dose
Likely to need further increases in levothyroxine over coming months, unless extremely petite
Extremely important to test vitamin D, folate, ferritin and B12
Request these included in thyroid testing
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
Thank you for coming back to me I started the 75mg 12 May. when I was on 50mg the brand was Almus the 75mg is Teva. I have felt ok but it feel like I have been hit with a bang over the last few days my main problem is being anxious and tired this is not me at all. I've had no get up and go since the new year. The doctor told me to see how I go on the 75mg for 3 months and re book my tests. I'm going to see how I go over the weekend and rebook.
Teva upsets many people….but if you were ok on Teva initially it’s more likely you simply need next dose increase in levothyroxine
Anxiety is EXTREMELY common hypothyroid symptom. Medics tend to think it’s only a hyperthyroid symptom
With Hashimoto’s we must get regular vitamin testing done. Frequently necessary to supplement continuously to maintain optimal vitamin levels. Always test first before supplementing
Strictly gluten free diet often a revelation….but get coeliac blood tests done BEFORE considering trial on strictly gluten free diet
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.
10th May to now is almost exactly 6 weeks….so you need blood test next week or week after
Return of symptoms is strong indicator you are ready for next dose increase in levothyroxine
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.
Better for me? I had RAI ( radioactive iodine) as I said before I had the information about anything else. ill on Levo I managed to wheedle some T3 from my Endo who seemed to know a lot less than I did about Thyroid problems. With the help and knowledge from the friends on here I am finally taking NDT and so far no problems. Regards Pp
Hi, it is hard to give you any advice, because we are all so different. Just met a lady who went gluten free and have not looked back since. She is 52 and started having symptoms of menopause, being diagnosed with Hashi, so her health started deteriorate and she got help and advice from Isabella Wentz books. I’ve been on Levo from 1997 and have never been 100%, can’t blame the tablet, just the way I am. All the advice given on Healthunlocked is good, correct, but you have to find your way. Shame the Dr’s are not taking us seriously :(, and people have to self medicate. Wish you good luck and a good dr :). You’ll find the way ❤️
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