Menopausal, underactive thyroid with anxiety!

[Jaz3]

Hello, Ive been on Citalopram, levothyroxine for 3 years. I have just ordered Health and Her menopause multi nutrient supplement, has any one tried it? Can you take all together?

Thanks in advance. Jaz

[SlowDragon Administrator]

suggest you cancel/pause the order if possible while we find out what your recent thyroid and vitamin results are

Multivitamins are never recommended on here

Levothyroxine must always be taken on its own and on empty stomach and then nothing apart from water for at least an hour after

How much levothyroxine are you currently taking

How long on this dose

Do you always get same brand levothyroxine at each prescription

[SlowDragon Administrator]

Before considering adding any vitamin supplements we would recommend you ask GP to test vitamin D, folate, B12 and ferritin levels

Or test privately

Please add most recent thyroid and vitamin results

Do you always test as recommended

Have you had thyroid antibodies tested at any previous tests

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

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...

monitormyhealth.org.uk/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

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

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test 

healthunlocked.com/thyroidu...

Why Multivitamins not generally recommended

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

[Jaz3 in reply to SlowDragon]

Thank you for your response. My last blood test was two years ago, when my dosage was increased from 50 to 75. My doctor only offers phone consultations. Maybe I need to pay for tests,

[SlowDragon Administrator in reply to Jaz3]

75mcg levothyroxine is only one step up from starter dose

Unless extremely petite likely to be under medicated and/or low vitamin levels

are you taking a single 75mcg tablet or 50mcg plus 25mcg?

[Jaz3 in reply to SlowDragon]

I’m taking a single 75mcg. I’m not petite lol. I was really hoping to have another blood test when I had my last medicine review unfortunately it was over the phone.

[SlowDragon Administrator in reply to Jaz3]

That’s absolutely unacceptable

Ring up Monday explain your feeling unwell and suspect your thyroid levels might be off. That you haven’t had blood test done for 2 years

Please can they include testing TSH, Ft4, vitamin D, folate, ferritin and B12

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

Are you currently taking any vitamin supplements?

Guidelines on dose levothyroxine by weight is that dose levothyroxine is increased slowly upwards in 25mcg steps

Retesting 6-8 weeks after each dose increase

many people will eventually need approx 1.6mcg per kilo of your weight per day

So at least 100mcg levothyroxine per day is likely

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.

When adequately treated on levothyroxine looking at TSH usually around or under one

Most important results are always Ft4 and Ft3 …

At least half way through range

[SlowDragon Administrator in reply to Jaz3]

so you’re on Teva brand levothyroxine

[Buddy195 Administrator]

if you are considering private tests Medichecks have 20% off for the next 2 days. If you haven’t tested key Thyroid vitamins (ferritin, folate, Vit D and B12) for a while, it’s worth going for the thyroid test that includes these.

Regarding menopause supplements, it may be useful to have a look at Dr Louise Newson’s free Balance App, as I find it really useful for comparing medications/ options & having up to date research articles. There is also an ability to post questions.healthunlocked.com/redirect... 

I find that taking magnesium daily really helps with anxiety symptoms. I take it at tea time as it helps me relax/ sleep. I find magnesium glycinate easy on the stomach, although many other types are available. Taking utrogestan daily rather than 2 weeks on/ 2 weeks off. also eased my anxiety. It may be that your HRT needs adjustment.

[Jaz3 in reply to Buddy195]

thank you so much. I was never given the option of hrt I was put on anti depressants then my thyroid was diagnosed. X

[Buddy195 Administrator in reply to Jaz3]

It’s definitely worth getting both your thyroid levels and key vitamins optimal; doing this massively helped both my physical & mental health. Remember to post any levels as soon as you get them; we are here to help!

[carolinepetrie in reply to Jaz3]

You may very well find you do not infact need to be on antidepressants and that any issues you had were due to an untreated thyroid issue, infact I’m surprised no one has suggested this to you. It annoys me that so many women get put on antidepressants that don’t need to be.

[janeroar in reply to Buddy195]

great recommendations thank you 🙏🏼

[ThyroidalLinda]

Don't take vitamins with Levothyroxine.. take at least 2 hours apart. Also, don't consume calcium with Levothyroxine. I take Levo. In mornings.. vitamins if needed in afternoon and wild yam version of progesterone in eve.. Estradiol patches that stay on for days.

[Hidden]

I am on Levothyroxine and I am also on HRT patches. The requirement for HRT was found by a private health check. I was struggling really badly with brain fog and facial sweats both of which have now cleared up. The private health check also picked up on the need for vitamins. I now take B12, Vitamin D and folic acid.

My GP requires annual testing and after the thyroidectomy wanted to keep an eye on the meds more frequently than that to start with.

I think you should ask for your blood test and also discuss with your doctor what is their expectation on how frequent these should be. If your med levels are not right then this can have consequences. My meds levels were off last year and I had two episodes of heart pain amongst other things. I ended up hospital as I felt I was taking a heart attack.