Increasing my levo.dose

[patzi2021]

I have been on alternating 75mcg and 100 mcg for several years with blood tests in t he normal range!

I am 84 and depressed and anxious. Could I increase the 75 mcg levo to 100 mcg making it 100mcg daily. I do not want to deal with my GP

[SlowDragon Administrator]

First you need to get FULL thyroid and vitamin testing done privately yourself

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

 

See in previous post 2 days ago ….Teva brand upset you

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

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.

Do you have autoimmune thyroid disease?

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

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...

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...

10% off code here 

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

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...

Come back with new post once you get results

Low vitamin levels extremely common as we get older

What vitamin supplements are you currently taking

[patzi2021 in reply to SlowDragon]

Many thanks for this specific and detailed reply which I will certainly follow up.

[Jaydee1507 Administrator]

Do you have your latest blood results with ranges? Ask GP receptionist for a printed copy which you are legally entitled to. Noone can really comment without those numbers. I'm so sorry you're struggling.

[Ellie-Louise]

I have done that. Last June after my blood test one of the doctors rang me, he reduced my Levo down to 75 from the 100 I had taken for a very long time. I tried lowering as was told to but felt differently to how I always used to be in myself. So after that I tried adding 100 alternately during the week but I could never remember which days I had changed.

So I decided to give the 75 another go, a couple of months later and I was almost wiped out, my hair turned dry and straw like, my skin the same and it didn’t matter how much moisturising I did nothing made it any better. As for feeling tired, I couldn’t even walk across the room without needing to sit down for a rest. My eyes closed hours earlier in the evening than ever before in my entire life…

Just before Christmas I decided enough was enough, and put my self on 100mcg every night. 6/7 weeks later I was back to my old self. I even ordered more Levo hoping they wouldn’t notice it was an early request.

After that I told another doctor what I had done and how I was feeling much better now, then I asked him to change my prescription back to 100 which he agreed to. I shall arrange another blood test next week.

My TSH had been below normal range.

[patzi2021 in reply to Ellie-Louise]

than you for your detailed and scary reply. I hope you are OK now. I have changed levo brands and will stick to the precsribed dose for the time being.

[SlowDragon Administrator in reply to patzi2021]

Which brand levothyroxine are you now taking on 75mcg?

What brand was 100mcg

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 this month 

 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 

 

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Government guidelines for GP in support of patients if you find it difficult/impossible to change brands 

gov.uk/drug-safety-update/l...

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. 

academic.oup.com/jcem/artic...

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).

[patzi2021 in reply to SlowDragon]

I am taking 50 mcg of Mercury alternating with 75 mcg Mercury. I was taking the same strengths of Teva.