Levothyroxine 25mcg one week now constipated.

[ockerdoc]

I’ve been on this low dose now for a week and I had quite loose stools the first few days but now it’s turned into constipation. I’m on wockhart so lactose based and I’m wondering if this maybe the problem. It’s either that or it’s too low starter dose. I’m 91kg so maybe I should be on more. Anyone else have this problem? My TSH was between 4 and 5 so subclinical. I think that’s why the GP started me on such a low dose.

[SlowDragon Administrator]

Standard starter dose is 50mcg unless over 65 years old or heart condition

Levothyroxine doesn’t top up failing thyroid, it replaces it. Your own thyroid will now be producing less thyroid hormones, so now in effect more hypothyroid

Bloods should be retested after 6-8 weeks, and dose increases slowly upwards in 25mcg steps until on full replacement dose

Always test thyroid levels early morning and last dose levothyroxine 24 hours before test

Just read previous posts

So apparently negative for Hashimoto’s

20% of Hashimoto's patients never have raised antibodies 

healthunlocked.com/thyroidu...

 

request ultrasound scan of thyroid

As you are already taking vitamin D, recommended to be supplementing magnesium too

taking magnesium supplement can help with constipation

Any magnesium best taken at bedtime, but must be at least 4 hours away from taking levothyroxine

Calm vitality magnesium powder is cheap and easy to use. Start on a teaspoon, dissolve in water. Increase dose slowly until constipation improves. Too much can cause diarrhoea.

[ockerdoc in reply to SlowDragon]

That’s great thanks for the quick reply.

[Hidden]

Hi ockerdoc

Funny you should mention this.

I was started about 5 weeks ago on compounded desiccated thyroid extract (equivalent to nearly 3X 25mcg) and have had a noticeable slowing down in that same area. Even put on a few kilos.

Would be interested in other peoples' experiences, and a reason why.

[tattybogle]

to be honest, it's not surprising this happens after about a week when on a very small dose..

in theory .... you add 25mcg ~ fT4 level goes up a bit ~ the pituitary notices , and reduces TSH a bit ~ which reduces your own output of T4 a little ~ end result is similar / or even slightly lower T4 level than when you started.

This balances itself out as doses are increased , once the dose given provides more than the loss., and eventually a stable dose is found .

but pragmatically , since you were 'lucky' they have let you start levo with no antibodies while TSH was only just over range .. you'll probably just have to wait it out until you get on higher doses ... the constipation might improve a bit in a week or so as the body adapts.. so don't worry about it just yet.

[ockerdoc in reply to tattybogle]

Thanks for the advice and info I really appreciate it.