Iv been having a few symptoms over the last couple of months, ie irregular periods, emotional, tiredness, hot flushes, aches and pains especially pelvic pain. I thought this could be perimenopause symptoms so before my Dr would consider HRT she wanted to check my bloods to see if anything else was happening.
My TSH has crept up to 6.54, and my Serum alkaline phosphatase level is also borderline which could be connected to my increase in TSH. (This has made me super anxious) Question is, do you think the symptoms I have been experiencing are thyroid related or menopause? I’m so frustrated as now I don’t know what’s causing all these symptoms!! I swore blind it was menopause!!
I’m currently on 100mcg Levo and also have Hashis.
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Henson1980
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Wow, thank you for the speedy detailed reply! So I take 100mcg in the brand Almus, I was prescribed 25mcg to top it up a few months back in brand TEVN but experienced bad palpitations so dropped back down to 100. Probably not the best idea! If I increase back up to 125 should both tablets be the same brand?? Attached my TPO results. I’m taking vit b complex, vit D spray and just about to add selenium 200 into the mix xx
Far more likely that it was the Teva causing upset
Accord/Almus don’t make 25mcg tablets
Ask for 50mcg tablets on prescription and cut in half
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
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
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
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
It's worth sorting out your thyroid first. You are very undermedicated to have such a high TSH and low FT4. The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges.
I would get an increase in Levo, retest in 6-8 weeks, very likely you'll need another increase so retest again 6-8 weeks after that. It's essential to get FT3 tested as well as FT4 and TSH. This is because T3 is the active hormone that every cell in our bodies need and it's low T3 that causes symptoms. Just testing TSH and FT4 wont be enough as you can have a good FT4 level but poor FT3 level. If GP cant get FT3 tested as well then do the thyroid panel privately.
Your Vit D level is also low and at the bottom end of the "adequate" range. The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.
If you're not already supplementing with Vit D then you might want to consider taking 4,000-5,000iu D3 daily for 3 months then retest.
Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Magnesium helps D3 to work. We need magnesium so that the body utilises D3, it's required to convert Vit D into it's active form, and large doses of D3 can induce depletion of magnesium. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
When thyroid and Vit D are optimal, see if you still think you have menopausal symptoms.
Thank you for the in-depth reply. I will look into the D3, K2 and Magnesium. Are these safe to take alongside selenium and vit b complex? I will take them in the evening and the levo in the morning first thing. Do you know if thyroid levels can affect liver enzyme function?
If you mean evening dinner then as I said before, B Complex is best no later than lunctime as it can be stimulating and you wouldn't want that in the evening and disturbing sleep.
Hi. I have Graves so the opposite to yourself. No fun at this end either. Yes is the answer with regards to your question with regards to thyroid levels affecting liver function.
Thank you that’s reassuring! Sorry to hear you have Graves…what’s the difference between the two? Sorry I’m not really clued up on it all hence why Iv come on here to ask the question xx
That’s ok. My TSH is totally suppressed at 0.0001. My T4 and T3 are very high. Essentially my thyroid is stimulated to over work and make excessive amounts of T4 and T3. I take a blocking drug to block or reduce the amount of hormone my body makes.
Sorry. I did see you had antibody testing for Hashimoto disease. I have the other antibodies for Graves which are Thyroid Stimulating Immunoglobulins or known as TSI and TrAb. Thyroid Receptor Antibodies. These antibodies confirm auto immune thyroid conditions albeit at the different ends of the disease. Your diagnosis is Hashimoto disease with your antibodies and mine is Graves’ disease with my antibodies.
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Not just peri-menopausal but in menopause!
Thyroid or peri-menopause?
Menopausal or over-medicated?
After advice under active thyroid or menopause?
Teenager under medicated 
