dee mmmm

hi I’m on levothyroxine and feel worse now that before I was diagnosed feel spaced out joint n muscle pains only been on them 2 month maybe 3 so going doctors tomorrow.

[SlowDragon Administrator]

Welcome to the forum

How much levothyroxine have you started on

If in U.K., which brand of levothyroxine

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

Book early morning blood test, ideally just before 9am and last dose levothyroxine 24 hours before test

Have you had thyroid antibodies tested, or vitamin D, folate, ferritin and B12 testing

If not request these are tested too

Please add results from BEFORE starting on levothyroxine

[Hidden in reply to SlowDragon]

They have started me on 50 mg a day and now I’m on iron tablets I don’t know if I’ve been tested for vitamin D or B12

[SlowDragon Administrator in reply to Hidden]

It’s 50mcg (not 50mg)

That’s the standard starter dose, you need bloods retested

Book early morning blood test, ideally just before 9am if possible….and last dose levothyroxine 24 hours before test

You’re highly likely ready for next 25mcg dose increase to 75mcg daily

Which brand of levothyroxine are you currently taking

Iron supplements must be at least 4 hours away from when you take your levothyroxine

How much iron are you taking. Is it everyday or alternate days

Request that GP test thyroid antibodies for autoimmune thyroid disease, if not been tested yet

Also request vitamin D, folate and B12 testing

Iron and ferritin levels will need retesting after 2-3 months on iron supplements

ALWAYS get copies of your blood test results and ranges at each test

Keep good records of how you feel on each dose

Dose levothyroxine is increased slowly upwards in 25mcg steps until TSH is always below 2. Most people when adequately treated will have TSH around or under one

Most important results are always Ft3 followed by Ft4…..Ft3 at least 50-60% through range, usually Ft4 is a little higher ……and all four vitamins at GOOD levels

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

[Hidden in reply to SlowDragon]

Also the brand is. accord

[SlowDragon Administrator in reply to Hidden]

Accord don’t make 25mcg tablets

When dose is increased to 75mcg daily

Request increased number of 50mcg tablets per month. Cut 50mcg tablets in half to get 25mcg

Accord is also boxed as Almus via Boots or Northstar via Lloyds pharmacy

Beware Northstar 25mcg is Teva brand

Teva brand upsets many people. Best avoided unless lactose intolerant

[SlowDragon Administrator]

Approx how much do you weigh in kilo

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.