Hot flushes (but not menopausal!)

[Loobs39]

I am taking 75mcg of Levothyroxine daily. I have also been taking LDN for the past few months. I have recently started getting severe hot flushes, a severe one first thing in the morning then one or two slightly less severe later in the day. At 65 I am well past menopause and although I know women can suffer from them for many years, I have had several years without so assume they are nothing to do with that. Is it possible that, because of the LDN, I am now over-medicated with Levo - are hot flushes a symptom of that? or could it be because the chemist keeps switching my brand of Levo? I am not due a blood test for a couple of months which may be able to answer the question but just wondered if anyone else had experienced this?

[SlowDragon Administrator]

75mcg levothyroxine is only one step up from starter dose

How long have you been on just 75mcg levothyroxine

Which brand of levothyroxine do you prefer

You can/should insist on always getting same brand

Essential to regularly retest vitamin D, folate, ferritin and B12

As you have PA and B12 injections do you also take daily vitamin B complex?

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

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12

Presumably you have Hashimoto’s?

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Low vitamin levels common as we get older too

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 and last dose levothyroxine 24 hours before test

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 all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue too

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[Loobs39 in reply to SlowDragon]

Thanks for the reply - I do have Hashimoto's and take all my vitamins etc. plus have been gluten free for years now. Last blood test was in March and all levels fine except for Ferritin which was through the floor. I did purchase a good quality supplement but, strangely, was told by my doctor that taking it along with B12 could cause problems?? However, I don't think that has anything to do with my morning hot flush ? I haven't had a thyroid blood test for nearly 18 months so will arrange one asap. I simply wondered about the cause of the hot flushes being over-medication caused by the LDN as I seem to remember that being cold upon waking is a sign of under-medication. I have been on 75 mcg for several years now and this problem has only occurred in the past 2 or 3 months?

[SlowDragon Administrator in reply to Loobs39]

Unless you’re vegetarian or vegan…..Low ferritin suggests your thyroid is under medicated

Iron supplements must be minimum of 4 hours away from levothyroxine and at least 2 hours away from any other supplements

Remember to stop taking any supplements that contain biotin a week before ALL BLOOD TESTS (eg vitamin B complex)

Only do private test early Monday or Tuesday morning and then post back via tracked postal service

Levothyroxine can’t work well unless all four vitamins are optimal

Vitamin D at least over 80nmol and around 100nmol maybe better

Serum B12 at least over 500

Active B12 at least over 70

Folate and ferritin at least half way through range

Low vitamin levels tend to lower TSH because conversion of Ft4 to Ft3 gets worse

[Loobs39 in reply to SlowDragon]

Thanks again and I will get my thyroid etc. readings checked asap. However, I still cannot work out why being undermedicated would cause flushes - looking at symptoms of hypothyroidism, nowhere are hot flushes mentioned. Indeed, one of the main symptoms is being too cold. Plus the fact that I have been on 75 mcg for several years and have been fine - I just wonder if the LDN is making a difference and making me overmedicated. I will get tested and let you know.

[SlowDragon Administrator in reply to Loobs39]

Low B12 can cause

Hypothyroidism often causes poor temperature control….usually too cold…..but minority feel burning hot

[radd]

Loobs39,

I haven’t t taken LDN but Isabella Wentz suggests over medication of thyroid meds is possible as the LDN starts everything working better.

I had to reduce my thyroid meds after a liver flush once. I have no thyroid but my levels of need reduced and has remained on that lower level.

Your Levo dose isn't large so if this were me I would reduce by 25mcg alternate days and wait a month to see how you are feeling. Titivation will have to be on symptoms alone as apart from identifying under/over-range numbers, your TFT’s will become irrelevant until you have found your new baseline for well-being (ie no hot flushes).

Just ensure to keep notes on dosages & how you feel because thyoid hormone changes can confuse our thought processes/memory, and don't tell your GP regarding a prescription change yet incase you need to increase again.

LND is great at helping to reduce inflammation which can be a major inhibitory factor in allowing our meds to work effectively. There are many great articles on how successful LDN can be and the link below has good info.

.

thyroidpharmacist.com/artic...