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Just diagnosed

Sammyd009 profile image
10 Replies

Hi all. I'm new here :)

Got diagnosed 7 days ago with a very under active thyroid and been out on 100 micrograms of levothyroxine a day until my next blood text which is being done every 4 weeks.

My question is has anyone else felt horrible when starting the medication? I've felt sick and been sick since day 4 of taking the tablets, got a pounding headache, I'm tired and feel off balance. Do the tablets just take time to get use to them or am I having a reaction?

Many thanks

Sam

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Buddy195 profile image
Buddy195Administrator

Welcome to the forum Sammyd09,

So we can offer better advice, can you tell us more about your blood test results (with ranges in brackets) for:

TSH

FT3

FT4

Plus any antibody and key vitamin tests (ferritin, folate, vitamins D and B12

Do ask your GP for copies of any test results, as you are legally entitled to these.

What brand of Levo have you been prescribed?

Sammyd009 profile image
Sammyd009 in reply toBuddy195

Hi I'm unsure as to most of what you just said lol. I can get a print out of my results but that does mean my surgery answering the phone which is a miracle in itself.

All i can remember from my chat with the doctor she said my under active thyroid is a 6 (she could of meant 0.6) and my other level is 55 and she said that should be between 0.2 and 0.5 but I don't know what that level is .

My folic acid level is also pretty low , she said that's 0.3 . I'm on 10 mg of folic acid tablets a day and 100 micrograms of levothyroxine the brand is teva

SlowDragon profile image
SlowDragonAdministrator in reply toSammyd009

Sounds like TSH was 55 (that’s high)

And Ft4 6 (that’s low)

Which brand of levothyroxine have you started on

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

verywellhealth.com/best-tim...

If you’re actually being sick, taking at bedtime might be better

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)

When you get blood retest book early morning test, ideally just before 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

ESSENTIAL to have B12, vitamin D and ferritin levels tested too

Very common to have low vitamin levels as direct result of being hypothyroid

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

patients-association.org.uk...

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 tested 

Also both TPO and TG thyroid antibodies tested at least once 

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Aim is to be on high enough replacement dose thyroid hormone to bring TSH at least under 2. Most people when adequately treated will have TSH around or under 1 and Ft4 and Ft3 at least 50-60% through range

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...

Buddy195 profile image
Buddy195Administrator in reply toSammyd009

Definitely get a print out of all results as this is far better than just been told levels over the phone. Do share with us as soon as you have them, so we can offer better advice and support.

SlowDragon profile image
SlowDragonAdministrator in reply toSammyd009

Teva brand may be causing issue

Request new prescription for 100mcg and try different brand

Either Mercury Pharma or Accord brand

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 

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).

Regenallotment profile image
RegenallotmentAmbassador

Hello and welcome 🤗

wow that’s a big starting dose! You poor thing. I was started on 25mcg and went up in 8 week intervals. It felt terrible. Others start higher and seem to ride it out.

Like Buddy195 says if you share your blood test results and the brand of Levo you have been prescribed then more people will comment.

🌱

Sammyd009 profile image
Sammyd009 in reply toRegenallotment

I posted a reply to buddy with what I know so far , I don't know to much unfortunately

shaws profile image
shawsAdministrator in reply toSammyd009

Welcome to our forum and don't worry too much as many members have gone through a similar phase when first diagnosed.

It takes some time to learn about the function of thyroid hormones and I hope the following link will be helpful. Members are very helpful..

btf-thyroid.org/what-is-thy...

hetrap profile image
hetrap

when I was first diagnosed - which was three months after I was told my thyroid looked as if it might be failing - I was immediately put on 50mcgs Levythyroxine. Well I appeared to start feeling worse and when I informed the Drs he said that is what can happen as it takes a few weeks for the levythyroxine to kick in so thyroid is continuing to fail. I felt that bad that I was written off sick at work for 6 weeks. The GP upped my thyroxine to 75mcg as well. Since I worked int he NHS and happened to do the clinic of the Consultant for these problems he said to me to ask the GP to refer myself to him which is what happened. Apparently they say that once diagnosed with a failing thyroid it appears it was probably failing for a few years until the antibodies eventually built up. I recognised this as for a number of years one of the symptoms - feeling the cold a lot - I had been sufffering with. So persevere and let the GP know when you have your boods tested again if still suffering

Honey1978 profile image
Honey1978

No I haven’t

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