Five weeks on increased dose of levo. Not sure ... - Thyroid UK

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Five weeks on increased dose of levo. Not sure if dipping again already

Loopnova profile image
Loopnova
•7 Replies

Morning😀

So after three months on 50mg levo, I was put up to 75mg and have been on that for five weeks. I started to feel better again after a week or so, got my energy back… and now, the last two days I’ve felt so tired again. Bit headachey, have been suffering a bit of shortness of breath which never got better anyway with the increased dose. Last time I got worse, I waited about three weeks before going to doc because I didn’t know if it was just general tiredness or anything else and I regretted waiting and suffering.

I’m back in the same position now. I could just be run down, have a general bug or something (testing negative for Covid). But I might need more doseage. I would just leave it a week but I have time constrictions as in I go on holiday a week on Friday. I really need to be well and have energy for my holiday and if I want to see a doc before I go, I need to make the appointment now.

Additionally, there are no available appointments with my usual doctor that has treated me throughout this problem so I don’t know how another one would feel about getting involved. As it stands, I’ve been left to see how I go and due a blood test and review next month.

Thoughts anyone? Worth speaking to another doctor before my holiday to see about increased dose? Or too soon?

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Loopnova
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greygoose profile image
greygoose

That is the usual pattern: increase dose, feel well for a short while, then symptoms come creeping back in. That is how it works, and it just means you're ready for the next dose increase.

Whether or not you will get it is another question entirely! Doctors don't seem to know about this pattern and what it means. And, as they left you for three months on the starter dose of 50 mcg, they might say it's too soon for an increase. In real life, increases shoud be every six weeks, but I don't think most doctors live in the real world anymore.

So, up to you whether you decide to make the appointment now and see another doctor. It might actually be to your advantage because your regular doctor doesn't seem to know how to treat hypo as he left you on 50 mcg levo for three months. That is inexcusable. A different doctor might have a bit more knowledge and understanding. :)

tattybogle profile image
tattybogle

Until you've been on a dose for 6 weeks ,a different GP wouldn't really be able to increase dose yet even if you saw them. They have guidelines and restrictions on how soon they can retest bloods.

To see the effect of a dose increase, they need to wait for the levels of TSH / fT4/ fT3 to settle down for at least 6 weeks before they can do blood test that is meaningful ..., and they wouldn't increase your dose without one .

Guidelines aside , it wouldn't be very wise to increase after just 5 weeks . from experience it's really a good idea to wait at least 8 -12 weeks before deciding how a dose feels.

The first 5/6 weeks are often a bit too changeable to be sure what's going on.

You might well be right that this feeling of 'less good again' after 5 weeks is an indication you will need more than 75mcg ....... i know waiting long enough is extremely frustrating in the short term, but finding the right dose is a like the tale of the Hare and the Tortoise.

Trying to go too fast and missing your sweet spot can make it take longer in the end .

Symptoms are hard to interpret on their own especially after just a few days/week of feeling worse. but if you have proper records of symptoms and blood test results . it is easier to see where you are and what to do next. and the information will be useful for the next time you don't feel quite so good again.

Pushing for blood tests too soon can also be counterproductive ..eg (theoretical example )

you increase to 75mcg . TSH might fall initially , due to more T4 .

Then after a few weeks, your body decides it's still not enough, and you feel as you do now . But it might take a few more weeks for the TSH to slowly rise again.

If you get TSH tested too soon, and since TSH level is what the GP mainly uses to decide if you can have some more Levo or not. , then a test done at week 5/6 might mean they say " you can't have an increase , come back in 6 months".

But a test at 8 weeks might mean you are given a 100mcg prescription .

SlowDragon profile image
SlowDragonAdministrator

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

As tattybogle says ….test minimum 6 weeks…..ideally 8 weeks after each dose change or brand change in levothyroxine

Have you had vitamin D, folate, ferritin and B12 tested

Loopnova profile image
Loopnova in reply to SlowDragon

I had vit D and all that tested once last year. I posted results at one point on here and I think it was you that told me that even though doctor says they’re in range, that’s not necessarily right. So I’m taking vitamin B and D.

I’ll be having a blood test next month anyway but doc was happy to increase my dose last time based on symptoms alone.

tattybogle profile image
tattybogle in reply to Loopnova

"...but doc was happy to increase my dose last time based on symptoms alone."

Because she already had blood test showing what your TSH and fT4 were on 50mcg . They won't increase to 100mcg without knowing what your bloods are on 75mcg .

Loopnova profile image
Loopnova in reply to tattybogle

Oh, so it’s pointless asking then. I’ll just have to wait another month. Well I hope this is just a blip then! I was dreading feeling rough on my holiday and was hoping timing would work out ok.

SlowDragon profile image
SlowDragonAdministrator in reply to Loopnova

Remember to stop taking any supplements that contain biotin (eg vitamin B complex) a week before blood tests as biotin can falsely affect test results

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