Beginning Levothyroxine (Dose?): Hi ladies and... - Thyroid UK

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Beginning Levothyroxine (Dose?)

HashimotoBro profile image
12 Replies

Hi ladies and gentlemen,

Guys, I recently got diagnosed with Hashimoto's thyroiditis (sub-clinical). I posted about it here: healthunlocked.com/thyroidu...

I am considering going into Levothyroxine since I feel so foggy and feel as if I'm dragging myself around.

It's available over the counter here in Thailand: Does anyone have an idea of how to go about calculating dose?

I'm not sure if starting myself on this without medical supervision is a good idea or not.

Any thoughts would be appreciated.

Cheers,

Dan

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HashimotoBro
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12 Replies
Lalatoot profile image
Lalatoot

The starting dose for someone under 60 and no heart condition is 50mcg. Stay on this dose for 6 to 8 weeks to allow the body to adapt then blood tests to look at thyroid hormone levels with a view to increase. Increases and decreases in levo are no more than 25mcg daily then wait 6 to 8 weeks.When you start levo or when increasing, it is common to feel better briefly then to feel worse for a while before things settle.

HashimotoBro profile image
HashimotoBro in reply to Lalatoot

Thanks for your reply.

SlowDragon profile image
SlowDragonAdministrator

previous post you said coming back to U.K. soon

2 blood tests with TSH over 5 and high thyroid antibodies and symptoms you would be started on levothyroxine

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

ALWAYS test thyroid early morning ideally just before 9am, only drink water between waking and test and (once on Levo) last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

You will need TSH, Ft4 and Ft3 tested

Standard STARTER dose of levothyroxine is 50mcg

Retest bloods 6-8 weeks after each increase in dose

Dose will need to be slowly increased in 25mcg steps over next 12-18months

Have you started daily vitamin B complex

HashimotoBro profile image
HashimotoBro in reply to SlowDragon

Thanks for your reply. That’s right, I’m back in the next month or so since my school finishes this Friday. The initial plan was to wait until home to make any big changes; such as starting levothyroxine. I’m just getting a bit impatient: We had reports to write and I noticed that I was taking a lot longer to write them than usual. When I really thought about it, I thought of other things and realised that I’d slowed down quite a lot.

I have been taking B12 complex consistently for the last month or so. I have also been eating very well (clean - no gluten, soy, dairy or nightshades), but I’ve not really noticed a palpable difference. If anything, a slight worsening, which has been incredibly disheartening.

Thanks for the information.

humanbean profile image
humanbean

If you are still in Thailand and can buy Levothyroxine over the counter, you can import thyroid hormones into the UK, usually without penalty. If you buy huge quantities you might be suspected of wanting to sell them in the UK and would have them confiscated.

I think what is considered an "acceptable" amount to import is not actually defined, although I have read that three month's worth is considered acceptable.

But how is the average customs officer going to know what is a "normal" dose for thyroid hormones and how much someone will use in three months?

Daily doses might range from 25mcg per day up to 500mcg or more per day, although an "average" dose might be somewhere from 100mcg - 250mcg per day?

You could post some Levothyroxine back to the UK, and then bring some back to the UK in your luggage. When posting I think you have to make a customs declaration declaring what is in the package and what it's value is. When I have bought Levo from abroad it has arrived described as a "health product" by the seller, but I can't remember the value the parcel was given.

You might have to pay VAT and an import fee, but again I'm not sure. Hopefully someone else might know.

What I would suggest is that you buy 100mcg tablet in preference to 25mcg or 50mcg. With a current dose of 50mcg you can buy a pill splitter or buy a scalpel from Amazon or both - they aren't expensive. Then you can cut tablets to your dose, if you are careful, and make what you buy go a lot further.

Since you have mentioned coming back to the UK to live, your biggest problem is probably going to be that doctors in the UK will say you must come off thyroid hormones altogether for a few months so that they can confirm your diagnosis - and getting a diagnosis and a prescription for thyroid hormones in the UK can be tough.

HashimotoBro profile image
HashimotoBro in reply to humanbean

I suspected that might be the case. This is certainly food for thought. Therefore, I might just set up an agreement with a friend to keep sending it. It’s cheap over here.

helvella profile image
helvellaAdministratorThyroid UK in reply to HashimotoBro

It is actually cheap in the UK!

NHS prices for levothyroxine start at a few pennies over 50p for 28 tablets.

The excess cost over that sort of price would be getting it on a private prescription - where there would be a fee for the prescription and pharmacies add to the basic NHS price when dispensing against a private prescription.

humanbean profile image
humanbean in reply to helvella

It is actually cheap in the UK!

I just wish it was available over the counter.

helvella profile image
helvellaAdministratorThyroid UK in reply to humanbean

I know there are many issues, and this idea really doesn't address many of them, but...

I wish we could be issued a "Hypo" certificate which allows us to buy levothyroxine - with freedom to go to any pharmacy and request any make and, within some sort of limit, any amount.

humanbean profile image
humanbean in reply to helvella

Sounds like an excellent idea!

RedApple profile image
RedAppleAdministrator in reply to helvella

'buy levothyroxine'

Needing levo means it is supplied free on the NHS, so we just need the certificate as proof of diagnosis to enable us to 'claim' our medication rather than 'buy'!

helvella profile image
helvellaAdministratorThyroid UK in reply to RedApple

That's true and I agree with the principle that essential medicines must be available without charge - but if we had to pay (at current NHS Drug Tariff prices) to get the freedom, I think quite a number would accept that provided they could afford to.

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