Hi Everyone
Been taking Levo for around 2 years and just recently following a blood test my doctor reduced my dosage from 175mcg to 150mcg. Pre diagnosis I suffered with air hunger and although not as bad as previously I still get a tightness to the left side of my chest and feel that I need to try to take a deep breath constantly. Has anyone else suffered with this and did they manage to get rid of it somehow.
Thank you in advance.
Air hunger, yes, most definitely. Had that for years. But, never had pains in my chest. 
What were your latest blood results for thyroid and vitamins?
I see a few years back your B12 was on the low side. Did you ever get that investigated?
I need to get another complete blood test. My doctor insists on only testing TSH.
Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine
Which brand of levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
Why was dose reduced
What were actual results and ranges BEFORE dose reduced
Never agree to dose reduction without FULL thyroid and vitamin testing
If vitamins were not optimal, improving these BEFORE considering reducing levothyroxine
Retest thyroid levels 6-8 weeks after improving low vitamin levels
What vitamin supplements are you currently taking
Reducing dose levothyroxine often results in vitamin levels dropping
Low iron/ferritin can cause tight chest sensation
Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
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...
If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
NHS easy postal kit vitamin D test £29 via
Only do private testing early Monday or Tuesday morning.
Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery
Thank you I need to sort a new blood test.
After my most recent blood test around 10 weeks ago my TSH was 0.31mU/L and my doctor in his wisdom thinks this is too low and reduced my levothyroxine from 175 to 150mcg. He'd previously increased from 150 to 175 after a blood test showed my TSH had increased to 1.88 and I was feeling unwell again. I don't understand his rationale so I've booked another blood test with my surgery to see my current level. Unfortunately they won't test for other things which is annoying so I will have to get that done privately with Thriva.
No point testing until been on constant unchanging dose and brand of levothyroxine for at least 8 weeks
Many many people have to find tune dose
just testing TSH is utterly useless
You’re only over medicated if Ft3 is over range and all four vitamins at optimal levels
If 175mcg was too much and 150mcg too low …..you might need 175mcg 5 days week and 150mcg 2 days week …..or 187.5mcg every day…..or 150mcg 6 days and 175mcg 1 day …on any other fine adjustment
Each time dose levothyroxine is reduced vitamin levels tend to crash out. Low vitamin levels tend to lower TSH
Never ever agree to dose reduction based on just TSH
Always test thyroid levels early morning, ideally just before 9am to get highest TSH
NHS England Liothyronine guidelines July 2019
sps.nhs.uk/wp-content/uploa...
Page 9
Test for Deficiency of any of the following: Vitamin B12, Folate, Vitamin D, Iron
See page 13
1. Where symptoms of hypothyroidism persist despite optimal dosage with levothyroxine. (TSH 0.4-1.5mU/L)
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
T4 therapy
ncbi.nlm.nih.gov/labs/pmc/a...
In a study evaluating tissue function tests before total thyroidectomy and at 1 year postoperatively when using LT4, it was found that peripheral tissue function tests indicated mild hyperthyroidism at TSH <0.03 mU/L and mild hypothyroidism at TSH 0.3 to 5.0 mU/L; the tissues were closest to euthyroidism at TSH 0.03 to 0.3 mU/L [48]. A normal serum TSH level consequently does not necessarily indicate a euthyroid state at the tissue level.
academic.oup.com/jcem/artic...
Interestingly, patients with a serum TSH below the reference range, but not suppressed (0.04–0.4 mU/liter), had no increased risk of cardiovascular disease, dysrhythmias, or fractures. It is unfortunate that we did not have access to serum free T4 concentrations in these patients to ascertain whether they were above or within the laboratory reference range. However, our data indicate that it may be safe for patients to be on a dose of T4 that results in a low serum TSH concentration, as long as it is not suppressed at less than 0.03 mU/liter. Many patients report that they prefer such T4 doses (9, 10). Figure 2 indicates that the best outcomes appear to be associated with having a TSH within the lower end of the reference range.
If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "
I've had both the feelings of tightness and chest pain along with feelings of having enough air ie air hunger. As my free t3 and ferratin levels improved my symptoms reduced
I has horrible air hunger.
Turned out I was deficient in ferritin! I had an iron transfusion which fixed the issue.
The air hunger is coming back now my ferritin is dropping again.
thank you
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