I have been going back and forth between my GP (lovely, but conservative) and my Endo and the various tests.
I don’t think anyone officially diagnosed me as such.
However based on previous results I’d say I have Hashimoto. (Presence of TG antibodies over limit).
TSH under 6 (upper range is 4) - therefore only subclinical.
My cortisol was very low (around 140 at 8am) so I had an SST done and recently got results saying that all is normal. Meaning we’re back at hypothesis one proposed by some of you earlier that low cortisol is due to Hypo rather than Addisons.
Gp agreed to prescribe Levo trial of a mighty… 50mcg! 🤦🏼♀️🙄😂
She wanted to do 25mcg.
Now everyone knows that a dose like that is useless (based on weight I’d need closer to 175-200). But I’d even be happy to start at 100…
She emailed my endo asking if a higher dose can be started… no answer yet.
I have received my first 50mcg packet, it’s from a brand called TEVA Uk limited.
Any advice?
When and how to take my first dose?
Should I start slow at 25? Double? Any ideas?
Thank you everyone!
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OudMood
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Some people do not tolerate Teva well. Others find it the best UK levothyroxine. Pretty much entirely unpredictable.
helvella - Thyroid Hormone Medicines
I have created, and try to maintain, a document containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.
Be patient has to be one of the most important "rules".
See how it goes - it would very likely be much more unpleasant to start higher and struggle to cope.
The formulaic approach is not intended for those with thyroid function. They are a "best guess" when trying to provide a full replacement dose (after thyroidectomy) or, possibly, to see if a dose looks much too high or low for someone.
You need what you need.
I noticed some changes almost immediately - though subtle. It could be weeks or months before you notice significant changes.
It is often suggested that bed-time dosing results in slightly better absorption. It also seems slightly closer to the pattern healthy people have.
I have always taken my levothyroxine at bed-time.
For that reason, I cannot compare with taking in the morning.
Before diagnosis, my sleep was badly disturbed. Typically, I would fall asleep fairly easily. Then wake up after something like half an hour to two hours. Once woken I'd be unable to get back to sleep - often till dawn, or at all.
Once I started on levothyroxine, my sleep slowly improved. By the time I was taking an adequate dose, bad nights were unusual - just an occasional night where I might wake up for a while. Now, after years, I sleep very easily and deeply and rarely wake at all. If I do, I get back to sleep quickly.
We have some who prefer it; we have others who prefer other times. See our poll:
Take the full 50 (don’t faddle with 25 first that’s only if you are feeble/ very old or or have heart problems) on empty stomach no food/coffee/tea etc for c1 hr after or before. Plain water is ok. Some take with fruit juice or diluted cider vinegar as the acidity is supposed to help absorption . I did better with dosing on waking I could not sleep if I took it at night, but night time dosing is more effective so do that if you can. Good to get vitamin etc levels optimal too.
You will need blood test in 6-8 weeks and increase in dose of 25mcg as 50mcg is very unlikely to be adequate. You then keep going in that manner until you are optimised and you should feel much better. The T4 builds up gradually hence having to wait for a while before upping the dose if results indicate it is necessary.
The results that should be aimed for are TSH between 0.2-0.5 free T4 and freeT3 in top third of range, same if it’s just T4 and T3. If they are only testing TSH get your own private blood test with more extensive results for a much better idea of how effective the T4 dose really is.
Make sure you get a print out of your results with ranges which are in brackets (ask receptionist) or get access to them on line otherwise you might be told they are ok by the GP/Endo when they are not good enough.
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