I finally managed to get the GP to try me on 25mcg Levothyroxine, which I have been taking for just under a month now. My results before starting were
TSH - 5.91 (0.34-5.60mu/l)
Serum free T4 - 10.2 (7.9-20pmol/l)
Serum T3 - 6.2 (4.00 - 6.60pmol/L)
I have also stopped eating gluten, and am also taking
-Vitamin B Compound
- Ferrous fumerate 322mg
- Vitamin D3 1000iu
-Calcium, magnesium, Zinc
-Vitamin C
Are there any other supplements I could start taking? I still feel as dreadful as ever, a bit worse if anything. I know it's early days, but I am desperate to start feeling some improvement. My next blood test isn't until the beginning of December, so I have no idea what my thyroid hormones are doing.
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Sleepybunny21
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Previous post confirms autoimmune thyroid disease also called hashimoto’s
How old are you
Standard starter dose Levothyroxine is 50mcg unless over 60 years old
Starting on 25mcg can make you feel worse
Make sure to get blood test 6-8 weeks after each dose change or brand change in Levothyroxine
Always test thyroid levels as early as possible in morning before eating or drinking anything apart from water and last dose Levothyroxine 24 hours before test
Likely to need several further increases in Levothyroxine over coming months
Many GP’s don’t understand….Levothyroxine doesn’t “top up” your thyroid hormones, due to feedback mechanism, Levothyroxine replaces your thyroid hormones
So starting on low dose can make you feel worse, push for next dose increase after you get blood test results
Dose levothyroxine should be increased slowly upwards in 25mcg steps
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.
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
Did you get any of these nutrients tested before starting supplements? If so, what were the results and ranges.
Although you need to take magnesium - most people are deficient, anyway, and taking vit D will use up your magnesium - it's unlikely you need calcium. It's very rare to be calcium deficient in the western world, and taking calcium supplements can cause more problems than it solves. They are very badly absorbed, and tend to build up in the arteries and soft tissues.
On the other hand, when taking vit D, you really need to take vit K2-MK7 with it. Taking vit D increases absorption of calcium from food, so you need to take vit K2 to make sure it gets into the bones and teeth and doesn't build up in the soft tissues and arteries.
Which form of magnesium is in your pills?
Zinc needs to be balanced with copper, but most hypos are usually deficient in one an high in the other, so really a good idea to get them both tested before supplementing either.
Do you take all these supplements at the same time? Because iron needs to be taken two hours away from everything, except vit C, otherwise it will block absorption of the other vitamins, and bind with the calcium. So you won't really be getting any benefit from any of it.
Vit D, magnesium and iron need to be taken at least four hours away from thyroid hormone. The others at least two hours away. Vit B12 needs to be taken two hours away from vit C. Sorry, but it's a bit complicated.
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