Increase Side Effects

[Huddy1234]

Hi,

Haven't posted in a while but just had some bloods done and thought I'd ask for advice here.

Been on Levothyroxine around 5 years, started off on 25mg for most part, then last year I increased to 50mg due to not feeling like the medication was doing anything to help.

I constantly feel tired, fatigued and no energy.

I know my age doesn't help - turned 50 in March so do expect to slow down slightly but not to this extent. I walk a fair bit and try to get to the gym a couple of times a week for my exercise.

Last month I tried to increase again by 25 (up to 75mg) but then the side effects kicked in, sore, tender breasts and not sleeping so went back to my 50 dose and the side effects went away.

I feel i'm a little stuck as what to do now - when I had private healthcare I did get to see a endo who went through a few different things but nothing helped.

My GP has said that my blood results were very good and just stick with what I'm taking (not much help at all) I did notice my Ferritin was on the lower end of the range so have brought some Iron Bisglycinate with Vitamin C and started taking them today, let's see if they help.

If there is any advice anyone can give me I'd be really gratful - sorry for long post xx

Blood results attached

[SeasideSusie Remembering]

Huddy1234

Ferritin: 37 (13-150)

I did notice my Ferritin was on the lower end of the range so have brought some Iron Bisglycinate with Vitamin C and started taking them today, let's see if they help.

Yes your ferritin is low but you should do an iron panel to include Serum Iron, Total Iron Binding Capacity, Transferrin Saturation Percentage plus Ferritin before taking iron tablets. This is because if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is toxic and as bad as too little. It's much safer when iron tablets are prescribed as the GP should then regularly monitor your levels. If you are going to continue with the iron tablets then I would stop them now, do a private iron panel if GP wont do one, then if you have iron deficiency your GP should prescribe. If you want to self supplement iron for low iron then you should commit to regular testing every 2-3 months to keep an eye on your levels. Iron tests should be done after a 12 hour fast (water allowed) so early morning is best for an iron test so you don't have to go without food during the day.

Iron panel with Medichecks:

medichecks.com/products/iro...

Discount code here:

thyroiduk.org/help-and-supp...

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

Symptoms of iron deficiency include:

◾Persistent fatigue

◾Pale skin

◾Shortness of breath

◾Headaches

◾Dizziness

◾Heart palpitations

◾Dry skin

◾Brittle hair and hair loss

◾Swelling or soreness of the tongue or mouth

◾Restless legs

◾Brittle or ridged nails

Your haemoglobin is good so doesn't suggest anaemia. You can have iron deficiency with or without anaemia. You could, of course, simply have low ferritin without iron deficiency.

TSH: 1.58 (0.27-4.20)

FT4: 15.5 (10.5-24.5)

My GP has said that my blood results were very good and just stick with what I'm taking

Your results are only good if you feel well with those levels.

The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.

Your TSH is higher than most of us are best with but your FT4 is only 35.71% through range, so your results are showing you need an increase in your dose of Levo.

Your low ferritin is likely causing your thyroid hormone not to work as well as it should, some experts say that the optimal ferritin level for thyroid function is 90-110ug/L and we always suggest here that it should be half way through range (which would be around 82).

If you have problems increasing your Levo then rather than increasing by 25mcg take it much more slowly, 12.5mcg or even 6.25mcg. See if that's better for you.

[SlowDragon Administrator]

Which brand of levothyroxine are you currently taking

When you increased to 75mcg was this same brand?

The only brand that makes 75mcg tablets is Teva

Teva upsets many people

When increasing dose, you could also experiment with splitting your dose ….taking 50mcg waking and 25mcg at bedtime (or vice versa)

Have you had folate and B12 tested

What vitamin supplements are you currently taking

[Huddy1234 in reply to SlowDragon]

Hi Slowdragon, thank you for your reply. The increase was with the same brand, it's either Wockhardt or Mercurypharma (a long white box with green/blue on it) I haven't tried splitting it - I guess that could help with the insomnia side but not sure about the breast tenderness?

I didn't get tested for B12/folate this time (not sure why) but had them in last years results and remember folate being on the low side also.

Supplements I take currently:

Evening Primrose Oil Capsules

Vitamin D

Lysiene

[SlowDragon Administrator in reply to Huddy1234]

So request test for folate and B12 or test yourself

Many thyroid patients need to supplement vitamin B complex continuously to maintain optimal B12 and folate