Levothyroxine

[Hillman51]

I have been on 25mcg of levothyroxine for some time , after a recent blood test it was increased to 50 mcg.... I know it’s not a high dose , but I am wondering if it’s too much .... I feel a bit “off”..... cold hands and feet , feel a bit like my body is beating , not palpitations .. rash on my chest ...light headed ... anybody else had this ? ....

[SeasideSusie Remembering]

Hillman51

What were the test results (including ranges) that prompted the increase?

Have you had a change of brand of Levo?

[Hillman51 in reply to SeasideSusie]

I wasn’t told any results , just a phone call from the doctor a few days after the blood test to say it was being increased to 50 mcg .... l have had different brands before and it hasn’t affected me... forgot to say ,feel very anxious too , I did before ,but even more so now , and also a bit shaky ..

[SlowDragon Administrator]

How old are you approx

Standard starter dose of levothyroxine is 50mcg unless over 60 years old

How long have you been on only 25mcg dose levothyroxine

Which brand of levothyroxine were you taking

Is the 50mcg tablet a different brand?

If you have been left under medicated it can feel a bit odd increasing the dose

See how you get on ….after a week or so your body should get use to the increase

But if it feels too much

You could divide the dose, taking half dose waking and half at bedtime

When were vitamin D, folate, ferritin and B12 last tested

Low vitamins levels are extremely common when been left on too low a dose

What vitamin supplements are you currently taking

Always get copies of your test results

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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 at least once year minimum

Likely to need further increase in levothyroxine over coming months

[Hillman51 in reply to SlowDragon]

I am 74 ..was on 25mcg for about 4 years, every time I had a blood test done I was told no increase needed,..... the old one I was taking was Wockhardt.... the new 50 mcg is Mercurypharma.... vit d and b12 were fine , ferritin wasn’t mentioned.... I take quite a few vitamins , but not close to taking Levo..

[SlowDragon Administrator in reply to Hillman51]

Try splitting the dose, half waking and half at bedtime

If that doesn’t help try going back on Wockhardt

Request new prescription for double the number of Wockhardt 25mcg tablets

Wockhardt only make 25mcg tablets

What were actual vitamin D and B12 results

[Hillman51 in reply to SlowDragon]

O.k ... I did read it’s not so effective at night time ,is that right ?... I don’t know any results , all I had was a phone call saying levo was being increased ..

[SlowDragon Administrator in reply to Hillman51]

ALWAYS request copies of results

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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 at least once year minimum

Taking levothyroxine at bedtime

Many people find it more convenient and possibly more effective

Levothyroxine must always be taken on empty stomach and then nothing apart from water for at least an hour after

Any other medications or supplements at least 2 hours away

Some like iron, magnesium, calcium, vitamin D, HRT or ppi at least 4 hours away

[humanbean in reply to Hillman51]

I did read it’s not so effective at night time ,is that right ?

I've never heard or read that. Many, many people take thyroid hormones at night and feel better doing so.

[Lalatoot]

Hillman, it is quite usual to feel off with a change of dose. I found increasing difficult because of this. My endo suggested I took my levo in 2 doses which I found helped.You could get a sharp knife or pill cutter and take half a tablet am and half a tablet pm. to see if that helps.

[Hillman51 in reply to Lalatoot]

I will try that .. thankyou ..

[JAmanda]

Try to hang on and let your body acclimatise to the new dose then ask for a retest 6/8 weeks after dose change. Then compare results with earlier ones (get from receptionist) and see if you need more or less.

[Hillman51 in reply to JAmanda]

Yes I did wonder if it takes time for the body to adjust.. been taking them for 4 weeks , but these feelings only started in the last week or so ..

[Lulu2607 in reply to Hillman51]

Hi Hillman. It sounds as if your body is adjusting to the new higher dose. I started on 50 and had to titrate up until my results came into range. It was hard going as I experienced side effects similar to yours. I asked to increase by 12.5 each time rather than 25. You can do this by alternating 25/50 each day or ask for 25s and take 1 and 1/2 each day. The clinical pharmacist at your Drs might be able to advise as I've found some of them quite knowledgeable. The side effects are similar to being hyperthyroid and can take a while to settle. I've been on levo for just over a year and my dose is still being fine tuned.

[JAmanda]

If you are at all worried, why not get a cheap set of tests to see check you're not overmedicated? (But cold hands and feet suggest you're still way under medicated.) Try Medichecks or Monitor my health or Blue Horizon. Take test first thing in am, before taking meds and leave off B vitamins with biotin in for a week as they affect the tests. Get ths t4 and t3 and see how things look.

[Hillman51 in reply to JAmanda]

O.k thankyou ..😊

[SlowDragon Administrator in reply to Hillman51]

Only do private testing early Monday or Tuesday morning, ideally before 9am and last dose levothyroxine 24 hours before test

Don’t test until been 6-8 weeks on constant unchanging dose or brand of levothyroxine

Stop any supplements that contain biotin a week before all blood tests

Exactly What vitamin supplements are you currently taking

[Hillman51 in reply to SlowDragon]

Be back later, somethings cropped up ..

[Hillman51 in reply to SlowDragon]

Is it o.k to take levo at night , I remember reading it wasn’t so effective if you took it at night ,,,, I take b12... vit d .... iron and calcium ..which I always take later on in the day so it doesn’t effect levo .....also zinc ..

[SlowDragon Administrator in reply to Hillman51]

Have you tested vitamin levels

You shouldn’t supplement iron, calcium or vitamin D unless tested and know you need them

Iron is extremely toxic in excess

Iron supplements must be taken at least 2 hours away from all other supplements and at least 4 hours away from levothyroxine

Unless vegan unlikely to need calcium.

Vitamin D important to test twice a year when supplementing

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

Many members take levothyroxine at bedtime or in night if regularly get up for the loo

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

[Hillman51 in reply to SlowDragon]

Thankyou slow dragon .. I will take this all on board... hopefully my body will get used to taking 50mcg of levo soon ....😊

[ICE187]

I felt horrible increasing from 37.5 mcg to 75 mcg for a week. Afterwards, I felt fine. I was originally started on 75 mcg and had bad heart palpitations. I bought a pill cutter and started taking a half dose for 6 weeks which ended my palpitations. My half dose made my tsh go even higher, but I still felt great. Now with my 75 mcg dose, I feel great. I guess it takes time for the body to get accustomed to the increase of horomones.

[Hillman51]

Think it must .. after being on 25 mcg for 4 years... then taking double the dose...thankyou for your reply ..