Thyroxine

[Angelastu1212]

Hi ,this is my first post as i have just joined ,so i was diagnosed with an underactive thyroid in 2016 and was put on Levothyroxine 100mg ,for the past couple of years i was too low so upped it to l25mg then April this year too high so back to 100mg ,October to low again so the Gp has decided to alternate 125mg one day and 100mg the next and so on ,my question is ,could alternating cause a headache ? I looked up headache areas with thyroid problems and the area (side of my head above my ears )is were my headache is ,started 2 weeks after i started alternating ,2 weeks ago and never let up ,gp said it could be because i started Hrt a month ago too so im really not sure ,sorry for the long post ,just need some advice ,thank you

[greygoose]

Hi Angelastu, welcome to the forum.

When you say 'too high' and 'too low', what is this based on? Blood test results? If so, which one: TSH, FT4 or FT3? Or symptoms, maybe?

Sounds to me like your doctor is dosing by the TSH only, which is 100% wrong, and leads to what I call The TSH Seesaw Effect. You need full thyroid testing:

TSH

FT4

FT3

TPO antibodies

Tg antibodies

vit D

vit B12

folate

ferritin.

That said, I doubt your headache is due to alternating your levo dose. More likely to be due to under-medication, which often results from dosing by the TSH.

[Angelastu1212 in reply to greygoose]

Hi thanks for replying so Feb 22 abnormal T4 level _23.2

Feb 22 abnormal Tsh level 0.03

April 22 normal T4 level 17.6

April 22 normal Tsh level 4.24

October 22 normal T4 level 19.1

October 22abnormal Tsh level 5.05

Gp took full bloods and its seems everything caame back ok so she decided to alternate for 3 to 6 months

[greygoose in reply to Angelastu1212]

Sorry, but can you give us the ranges for the FT4 results, please. We always need to see the ranges because they vary from lab to lab.

A low TSH is of little importance, and certainly not proof of over-medication. On the other hand, a TSH of over 5 means that you are severely under-medicated.

Is your FT3 ever tested? Because that is the most important number, and you are only over-medicated if your FT3 is well over-range.

[Angelastu1212 in reply to greygoose]

I have no Ft4 ranges or FT3 ranges ,just those two ranges

[Jaydee1507 Administrator]

For a full thyroid tune up, people here really need to see some blood results along with their reference ranges.

Hypo people often suffer from low vitamin levels due to low stomach acid. Have you had levels of ferritin, folate, B12 and D3 tested lately? Low levels of these can affect how we feel and how our thyroid hormone works.

HRT can affect thyroid levels but I'm no expert on this. Just so you are aware.

[Angelastu1212 in reply to Jaydee1507]

I posted above some results i got back the last 3 blood tests ,i had a full blood count done and everything came back ok apart from Thyroid test ,could only being on Hrt for a month change these levels again so quickly ?

[Jaydee1507 Administrator in reply to Angelastu1212]

Yes being on HRT for a month could change your thyroid levels. I would get a test done 6 weeks from when you changed dose. Also ask for ferritin, folate, B12 and D3 levels to be tested.

On the 2nd and 3rd test you were undermedicated. Your TSH was far too high. Should be closer to 1 or just under, but hard to tell anything without a FT3 level which you will need to get done privately.

[Angelastu1212 in reply to Jaydee1507]

I had Ferritin folate and B12 taken just in my last test beginning of Oct and came backnormal ,not sure about D3 ,im going to check ,can i ask what D3 is for please ?

[Jaydee1507 Administrator in reply to Angelastu1212]

Knowing our vitamin levels are normal is not good enough, as if they are less than 50% of the range we will be getting symptoms. never rely on your GP or any doctor to tell you your vit levels are OK. Can you get the results and post them here with their ranges?

Vitamin D is known as the sunshine vitamin and most of the western world is deficient in it. Everyone is recommended to supplement vit D.

nhs.uk/conditions/vitamins-...

[Angelastu1212 in reply to Jaydee1507]

I will get them ,my results came back abnormal.for iron but when i questioned it she said it was normal on her results i didnt understand how i could see abnormal and she could see normal on her computer ,ive always been low on Vitamin D i have those in my cupboard to take but keep forgetting

[SlowDragon Administrator in reply to Angelastu1212]

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

optimal vitamin levels are essential

[Angelastu1212 in reply to SlowDragon]

Thank you for all your help ,just wish i had the money to go private ,i have took all your advice on board ,once again ,thank you

[SlowDragon Administrator in reply to Angelastu1212]

Come back with new post once you get previous test results and ranges done by GP

Just speak to receptionist to get printed copies of results or access to online results (best option if available)

Then come back with new post and we can advise what needs improving

[SlowDragon Administrator]

Chopping and changing dose levothyroxine inappropriately based on TSH frequently results in low vitamin levels

Request GP test full thyroid and vitamin levels 6-8 weeks after being on constant unchanging dose and brand of levothyroxine

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

What vitamin supplements are you currently taking

Do you have autoimmune thyroid disease also called Hashimoto’s usually diagnosed by high thyroid antibodies

ALWAYS test thyroid levels early morning, ideally around 9am and last dose levothyroxine 24 hours before test

Is HRT patches or tablets

HRT frequently results in needing dose increase in levothyroxine

[Angelastu1212 in reply to SlowDragon]

Im on everol patches and utrogeston 2 weeks on 2 weeks off ,i tend to get the same brand most times ,an orange box not sure of the brand ,im not on any vitamin supplements ,Dr told me blood test again 3 to 6 months after she alternated my Thyroxine

[SlowDragon Administrator in reply to Angelastu1212]

suggest you get FULL Thyroid and vitamin testing done yourself 6-8 weeks after starting HRT

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

Examples of Medichecks results

healthunlocked.com/search/p...

blue horizon results

healthunlocked.com/search/p...

[Angelastu1212 in reply to SlowDragon]

Thank you for your help

[Joant24 in reply to Angelastu1212]

I can’t comment on the thyroid side of this but many years ago (with no thyroid issues at the time) I was started on HRT and had to stop because of crippling headaches, even tried patches and pessaries. I’m not medically trained but if your GP is okay with it try stopping the HRT and see if it makes a difference. It’s just a thought. Whatever the reason you have my sympathy, a constant headache is exhausting. Good luck. 🥰

[Angelastu1212 in reply to Joant24]

Thank you ,im going to try and get another app on Friday because something is not working ❤️

[lesleyoc]

Hello, I have just had my Levothyroxine level adjusted, but no headaches and have never had headaches before when the doctor changed my dose level. It is most likely related to the taking of the HRT recently. My advice would be to go back to the doctor is the headaches continue. Headaches are not something to be ignored, but I hope this is just temporary for you.

[Angelastu1212 in reply to lesleyoc]

Thank you ,yes ive never had any problems with my dose / changing dose since i was diagnosed ,the Gp who i seen on Tuesday was not concerned about my headaches ,she lowered my dose of patch from 50 to 25 to see if that makes a difference ,i only changed it yesterday so we will see what happens with that ,i might try to get an appointment with the actual Gp who put me on Hrt tomorrow ,she only works Mondays and Fridays so bit of a gamble with 8am ringing up ,thank you