Hi I am seeing my private endo soon and wanted advice as still have hypo symptoms. I have been diagnosed with central hypothyroidism about 12 months ago. Currently on Levo 75mcg daily x5days Levo 50mcg x2days per week
Recent test results medichecks
TSH 0.04 (0.27-4.2)
Free T3 4.62 (3.1-6.8)
Free T4 20.3 (12-22)
Antibodies fine
Ferritin 53.7 (13-150)
Folate 5.98 (>3.89)
B12 85.1 (37.5-150)
Vit D 56 (50-100)
I am thinking I may need T3 but heard it has more side effects than Levo and I have a sensitivity to many medications. I would welcome any suggestions and advice before my consultation please
Written by
Kayakingkim
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When I was first diagnosed as being hypothyroid I was given T4 (levothyroxine). It didn't suit my body at all as it gave me awful palpitations.
When I was prescribed a T3/T4 combination I felt a bit better but when I took T3 alone it was magical and I still have it prescribed today. I have no clinical symptoms and I feel well.
Sometimes - if on thyroid hormone replacements - small increases might lead us to an optimum dose where we feel well and have no symptoms. (we can adjust up or down).
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or eBay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
hi slow dragon many thanks for your response. Test taken at 9am last dose Levo 24hrs before and stopped b complex 14 days before. Will try supplementing with b12 and folate as suggested leading up to next test. Take Teva Levo and been on this dose for 6 months. Take ferrous sulphate, vit d 3000 , b complex recommended on this site.
okay will try different brand of Levo I have high iron in blood just above normal range but low ferritin gp monitors this every six months endo consultant also aware. Is there any Levo you recommend?
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, 50mcg and 100mcg ....but Accord doesn’t make 25mcg tablets
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.
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).
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)
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
Similarly if normally splitting your levothyroxine, take whole daily dose 24 hours before test
Increasing number of members find it smoother/more tolerable to split levothyroxine as two smaller doses, half dose waking, half dose at bedtime.
REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex
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