Thyroid gland on meds

[Sofie007]

I have a question about the thyroid gland. I read (Dr. Westin Childs) that when we take levothyroxine, our thyroid gland shuts down the production of the hormones it was still producing on it’s own, because now there is a new source of T4. My GP says this is not true. He says our thyroid keeps making T4 in addition to the Levothyroxine. I’d love to hear your thoughts on this.

[SlowDragon Administrator]

Dr Westin Child’s is correct

GP is WRONG

When we start taking levothyroxine……initially yes….there’s your own thyroid output and levothyroxine added

But very quickly the pituitary “sees” the levothyroxine that’s been added….TSH level drops and your own thyroid takes a rest ….lowers output

So levothyroxine does NOT top up failing thyroid….it replaces it

After 2-3 Months on starter dose …..you are ready for next 25mcg dose increase in levothyroxine

This repeats several times until (typically) on approx 1.6mcg levothyroxine per kilo of your weight per day

Some people need higher dose…..a few need lower dose

ESSENTIAL to test vitamin levels and maintain at optimal levels

Vitamin D, folate, ferritin and B12

[Aurealis in reply to SlowDragon]

I agree with slowdragon but I suppose theoretically if you can keep your TSH above zero there is some natural adjustment to the t4 level with your thyroid topping up t4. I assume this is why medics are so obsessed with TSH. Though if your thyroid is under active surely you would always be hypo?

It didn’t work like that for me. As soon as I started taking Levo my TSH went to zero and remained there no matter how much they reduced my dose, even to zero meds (very unpleasant, don’t recommend)

[Goforitmum in reply to SlowDragon]

thank you for explaining this. it explains so much.

[SlowDragon Administrator in reply to Goforitmum]

This is why the guidelines are to increase dose slowly upwards in 25mcg steps over 6-12 months

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.

See also at approx 16 mins into this YouTube clear info of dose levothyroxine 

youtu.be/8Xy5i2pMtNA(Not working as expected?)

Guidelines are just that ....guidelines.

Some people need more …….some need less

[Poppy_Ann]

Hi there, when my ex was told that she had cancer of the thyroid gland she stopped listening to the doctor but I was with her and listened to the end he had added that if you had to get cancer the best place to get it was in the thyroid gland as cancer of the thyroid can not grow anywhere else in the body and it can be removed with an easy operation and as long as they put you on a high dose of thyroxen that it stopped the thyroid gland from working and the cancer can only grow when the thyroid gland is working which is the reason that you are on such a high dose, but you have to make sure any different doctor you see does not lower the dose or the cancer could return to whats left of your thyroid gland so I believe that if you are on a high dose of thyroxen that it cannot manufacture any of what it use to before you started with thyroxen. I am not a doctor so you may be better asking your own doctor which is correct, regards Poppy Ann.

[helvella Administrator Thyroid UK]

I have been taking levothyroxine for around ten years. But my dose is still considerably lower than any calculation based on weight would imply.

It could well be that I only needed, say, a top up of 25 micrograms but have ended up on about 112.5.

For that reason, I am convinced that my thyroid continues to produce some thyroid hormone. But less than it would have done.

[Sparklingsunshine in reply to helvella]

Hi

I guess it depends on why you're hypo. I don't have Hashis so I'm guessing my thyroid might have produced some of its own hormones still. I reckon its packed up, shut up shop and gone home for a lie down now though.

[helvella Administrator Thyroid UK in reply to Sparklingsunshine]

I agree. If the thyroid gland has been effectively destroyed, it isn't going to make any thyroid hormones!

[montieth]

I had a partial thyroidectomy almost a year ago and was put on 75 mg of levo. After almost one year, I feel pretty normal again. I was reluctant to take any levo at firs because I read two studies that showed after partial thyroidectomy the other half of the gland makes up the difference and can make enough thyroid. I might still try to gradually lower it and go off it working with homeopathy.

[Sofie007 in reply to montieth]

I would love to know if you take the homeopathy route.. I am looking into it as well. But not a lot is known.. very intriguing

[Noona123]

It seems from these responses there is still doubt about whether the thyroid continues to make some of it's own hormone if synthetic T4 is added into the mix or it replaces it entirely. I've looked at Dr. Westin Childs website and he's marketing all sorts of supplements. Does anyone know of any scientific research showing that the thyroid stops working altogether when on thyroid treatment?

[Sofie007]

Yes he sells supplements. But he also gives tons of information that i needed on my thyroid journey. I think he knows so much because his wife had low thyroid. He seems very passionate about helping people, so I want to believe him 😊🤞🏻🤞🏻

[Noona123 in reply to Sofie007]

Yes I signed up to his site to receive info. as he seemed to know his stuff. I'm at the start of my thyroid journey as well. Was on 50mg for 2 weeks, then saw an Endo who put me up to 75mg which I've been on nearly 6 weeks now and have a blood test on Monday. I think I'll go with the thinking that Levo replaces whatever remnants you might have left as SlowDragon has confirmed!

[Sofie007]

How are you feeling on the 75mcg ?

[Noona123]

Hi Sofie007. I am better than I was thanks, but still have aches and pains and fatigue. But mentally, I feel much brighter (although still have 'off' days!) According to weight, my 'optimal' dose should be about 112mcg but I'm worried I'll be left on 75mcg, How are you feeling?

[Sofie007 in reply to Noona123]

I am happy to read you feel better with levothyroxine. Why do you think you’ll be left on 75mcg? Levothyroxine made me more tired, anxious and feeling “weird” but looking forward to add T3 (cytomel) next week.