Advice on upping levo pls: Hi just want dome... - Thyroid UK

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Advice on upping levo pls

Stargazer4 profile image
9 Replies

Hi just want dome advice as I'm a little anxious .I'm currently on 75 mcg daily. I've been suffering tiredness ,aches anxiety depression .went to the doctors done bloods I'm not menopausal ,my TSH is 1.7. He suggested putting me on 100 mcg daily to get my tsh below 1.

But I'm nervous I may develop hyperthyroidism instead , help any advice as I'm due to start tomorrow.thanks in advance and sorry for long post .

Tracy

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FancyPants54 profile image
FancyPants54

No way will an increase of 25mcg Levo send you into the territory of the over medicated. You need your TSH below 1. You will be fine. Embrace the fact that your doctor seems to understand the need to lower your TSH further. So many would just send you away with the words "you're fine!" ringing in your ears.

fuchsia-pink profile image
fuchsia-pink

Welcome to the forum

First: if you are hypO (under-active) you can't become hypER (over-active). What you can do, is become over-medicated, if you take too much medication. But you are ONLY over-medicated if free T3 goes over-range - not if TSH is under-range, and certainly not if it goes to less than 1 - which is exactly where it should be :) Your symptoms are pretty typical of being under-medicated, so it is good that the GP is raising your dose.

So far, it seems, that your GP is only testing TSH. This is what they usually do, but now that your TSH is coming under control, you also need to see what your actual thyroid hormones are doing - and that means testing free T3 and free T4. And ideally you would also test key nutrients, as your levo works best when these are good: ferritin, folate, vit D and B12. I've had some success with my GP by saying that these are the tests recommended by Thyroid UK

Also, it's best ONLY to have early morning (before 9am) fasting blood tests, when TSH is highest, and leave a gap of 24 hours from your previous dose of levo (take the next straight afterwards). That means you have a good representative level of hormone in your blood, rather than the "spike" you get if testing just after taking your meds. Generally, if you don't already do this, you should take your levo on an empty stomach, just with water, an hour before or two hours after other food and drink, and well away from other medication, to ensure it is absorbed properly x

I'm new to this forum but one thing I have been told is that TSH should be below 2 and ideally below one, you are lucky your GP understands this, I only wish all GP's were so well informed. A lot seem to think once your in TSH range, even as high as 4, that you're ok now. no further dosage amendments needed.

Lalatoot profile image
Lalatoot

Tracy I was hyper had radio active iodine treatment and became hypo. I was so scared of becoming hyper again that I too was scared of taking levo. My endo was not clued up on symptoms and she was happy if my TSH was in range. So for years I was undermedicated on too low a dose of levo and I felt ill.I now know that my TSH should have been around 1 not the 4 that it had been for years. I became very ill as a result.

You do not need to take your levo in one dose. I have always taken it in 2 doses to create less of a spike when it enters the system. My GP is happy to prescribe 2 x 50mcg per day instead of 100mcg per day - that way I get 2 tablets and don't have to split any.

Stargazer4 profile image
Stargazer4 in reply to Lalatoot

Thankyou for your reply x

SlowDragon profile image
SlowDragonAdministrator

Your GP is very well informed and correct

The aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until TSH is around one. Most important results are always Ft3 followed by Ft4. Looking for Ft3 at least 50-60% through range, usually Ft4 is a little higher

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Also very important to regularly retest vitamin D, folate, ferritin and B12 at least annually

Have you had these tested

Are you currently taking any vitamin supplements

Always test thyroid levels as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Have you had thyroid antibodies tested

About 90% of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies

Anxiety and depression are extremely common hypothyroid symptoms and should improve as dose levothyroxine is increased

Come back with new post once you get next results after being on 100mcg for 6-8 weeks

Stargazer4 profile image
Stargazer4

Hi thankyou so much for your reply. This is a different doctor I had this time told him I can't carry on as I am. I'm normally given teva.ive had the brand northstar just one for that period my tiredness had diminished I had so much more energy. Chemist can't get it for me can't do it privately either so now I'm trying to find a way that I can with another chemist x

Gingernut44 profile image
Gingernut44 in reply to Stargazer4

Northstar is repackaged for Lloyds Chemist. The tablets are actually Accord brand. This is something your Pharmacist should know. There are lots of people who do not get on well with Teva.

helvella profile image
helvellaAdministratorThyroid UK in reply to Gingernut44

Northstar 50 and 100 are, as you say, Accord. But their 25 microgram tablets are Teva.

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