Side Effects in the first Week with Levothyroxine

[TOHcamp]

Hello! This is my first post and I am new to this forum. I have a family history of Hypothyroidism and my TSH score came in at 4.98. The GP put me on a dose of 25 mcg levothyroxine. Before the medicine, I felt like I slept all the time and was very lethargic. The first two days I was on the medicine, I felt FABULOUS! I wasn't always eating, I had a lot of energy like in the past, and I was happy. On days 3 and 4, I felt cranky and irritable; really off. On days 5 and 6, I felt like I did before the medicine; really tired and I ate all the time. Is this normal? Do I just need to wait until my body adjusts? Should I call my GP?

[greygoose]

It's probably because your dose is too low. The normal starter dose for your age is 50 mcg, and you can often feel worse, rather than better, if the dose is too low. But doctors don't seem to be able to get their heads around that. If you ring your GP tell him you want a dose increase to 50 right away.

[TOHcamp in reply to greygoose]

Thank you! 😊

[greygoose in reply to TOHcamp]

You're welcome.

[SlowDragon Administrator]

Standard starter dose of levothyroxine is 50mcg

Bloods should be retested 6-8 weeks after each dose increase

Likely to need several further increases in levothyroxine over coming months

Request doctor test vitamin D, folate, ferritin and B12 plus thyroid antibodies for autoimmune thyroid disease too

Are you currently taking any vitamin supplements

Assuming thyroid antibodies are high, this confirms autoimmune thyroid disease also called Hashimoto’s

About 90% of primary hypothyroidism is autoimmune thyroid disease

If you have Hashimoto’s, Request coeliac blood test before considering trial on strictly gluten free diet

[TOHcamp in reply to SlowDragon]

Thank you! I did request a vitamin D test and it was in the normal range. I will ask for the rest next time. All my blood work looked really good except for the TSH. I eat pretty healthily, more of a paleo diet. I don't do well with processed carbs. I still always have gastrointestinal issues. However, in the last 5 days, I've been taking the medicine, it has lessened. I do take a multivitamin.

[SlowDragon Administrator in reply to TOHcamp]

Having gut issues suggests you likely have autoimmune thyroid disease (hashimoto’s) ….usually diagnosed by high thyroid antibodies

Check test results, see if thyroid antibodies have been tested yet

With autoimmune thyroid disease, gluten intolerance is extremely common…might explain why paleo suits you

Probably no point doing coeliac test if you are already very low gluten

Multivitamins are never recommended on here

Most contain iodine not recommended for anyone on levothyroxine, and especially with Hashimoto’s

Better to just supplement what’s necessary

Can you add most recent vitamin D, folate, ferritin and B12 results

Levothyroxine is a replacement thyroid hormone, rather than a medication

[TOHcamp in reply to SlowDragon]

I called my GP because I started to get diarrhea and could not sleep at all. I then started to get nauseous. She told me to stop taking the medication and come back in two months for a re-evaluation. I'm worried about side effects but am hoping that the dose is low enough and I was only taking it for a week that it will be minimal.

[SlowDragon Administrator in reply to TOHcamp]

Which brand of levothyroxine was this?

Teva brand upsets many people.

[TOHcamp in reply to SlowDragon]

Looks like Amneal…

[SlowDragon Administrator in reply to TOHcamp]

Ahh ….your in USA

Sorry no idea on US brands

[TOHcamp in reply to SlowDragon]

Thank you this far- you’ve been very helpful ☺️

[helvella Administrator Thyroid UK in reply to TOHcamp]

There are quite a few other makes available. You might find that you tolerate one or other of them better than the Amneal.

However, it might not be due to the ingredients!

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.

From Dropbox:

dropbox.com/s/wfhrlmb5983co...

From Google Drive:

drive.google.com/file/d/12N...

[TOHcamp in reply to helvella]

Wow! This is AMAZING! You’ve done a lot of work! Thank you! 😊

[SarahJane1471]

Welcome! You’ve come to the right place for advice and support. This forum has been my bible for the last couple of years. The people here have a wealth of knowledge.What you are explaining is EXACTLY how I felt a year ago starting Levo. I too started on 25mcg. You are going to have ups and downs now you are on the Levo path. But it’s worth it when you get to the right dose. You will need to have patience.

Get a dose increase now to 50mcgs . You will then feel good again for a couple of weeks and maybe the symptoms will return again. It’s a rollercoaster BUT each time you increase it is likely the feeling good will last longer and the returning symptoms ( before your next increase) will be less severe.

You’ll be fine 😊

[TOHcamp in reply to SarahJane1471]

Thank you! I felt like I was all over the place! I will be patient. 😊

[Catseyes235]

25mcg is probably too low but don’t expect instant results (your first two days were probably a placebo effect!). as it takes a while for Thyroxine to get into your system which is why tests are at least 6 weeks apart. It can take months to get to optimal dose. Suggest to GP you’d like to double your dose but still don’t expect instant results, be patient and good to yourself!

[TOHcamp in reply to Catseyes235]

Thank you! I think I'm afraid my TSH numbers will be in the range when I retest, but I'll still feel lethargic. I have a new GP so we'll see how it goes! This forum is very helpful! 😊 I feel more educated!