I have recently been diagnosed privately with Hashimotos, results are:
Free T3 4.5 (3.1-6.8)
Free Thyroxine FT4 13.5 (12-22)
TSH 2.35 (0.270-4.2
Thyroglobulin Antibodies H 119.4 0-115
Thyroid Peroxidase Antibodies 9.5 0-34
Vitamin D 48
I have been backwards and forwards to my GP for years with worsening symptoms all the time, only to be told I was fine. I clearly did not feel fine so I went private, only to be told I was not ok and that I had Hashimotos and have been started on Levythyroxine 50mg and vitamin D. My B12 is 3
I am also taking Bisoprolol for arrthymia, but I understand that the Levythyroxine can cause this aswell, so Im scared. I am hoping it is going to help.
Ive been so poorly and was finally feeling vindicated, but Im just nervous, sorry to sound silly.
Many thanks as always
Written by
Mrss25
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Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
Thyroid levels will need retesting 6-8 weeks after each dose change or brand change in levothyroxine
Test early morning, around 9am and last dose levothyroxine 24 hours before test
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Many people find Levothyroxine brands are not interchangeable.
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz
Accord only make 50mcg and 100mcg tablets
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets
beware 25mcg Northstar is Teva
Northstar levothyroxine being phased out Feb 2023
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva is lactose free.
Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Teva is the only brand that makes 75mcg tablet.
So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Aristo (currently 100mcg only) is lactose free and mannitol free.
Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
don’t be sorry about asking questions or being worried. You should know that some people feel worse when they start on levothyroxine because the starter dose will often be less thyroid than their body was making naturally. This means they become more hypo, until gradually the dose is titrâted up. Feeling more hypo can unfortunately include palpitations. I felt really dreadful for the first 7 months of treatment. I felt like my brain was melting and I had palpitations for the first time in my life. I’m a lot better now, after 11 months but still not right.
A consultant that I eventually saw said he would have put me straight on 100mcg and not the slow agonising titration up from 50. However a low starter dose is used for people with heart issues so is probably unavoidable for you. It’s a catch-22 because low thyroid levels (which you have) can cause palpitations but of course there may be other causes, hence the low starting dose
Be prepared to feel worse for a while without concluding that you don’t get on with the levothyroxine. It is likely to be because you are, for the moment, under medicated
Thank you so much..I think its because Im just a bit over whelmed atm, and I have had alot of help on this forum before getting diagnosed and all the advice has finally got me to my diagnosis..thank you again for your kind words 😊
I was very relieved when I finally got my diagnosis after many years of suffering symptoms. However my relief was short lived. No advice and virtually a list of symptoms was given when I pushed for information. This is a very strange disease situation and it’s clear doctors know very little about it but I think you have found the best source of information here. It’s likely the treatment won’t always go to ‘plan’ so keep in touch with the forum. There is always support here.
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