Why am I so sleepy?

[Benjipuss]

I’ve been taking levo for around three weeks and have been diagnosed with Hashi’s (though still feeling conflicted as to whether I should be taking it and have I just had a lot of infections recently?) and trying not to be overwhelmed with too much info so apologise if not responded promptly to everyone who is so kindly replying . Sometimes, it just feels too much and I just have to leave it for a while. Worringly, I felt really unwell yesterday , bone crushingly tired, nauseous, out of kilter as if everything was grinding to a halt and barely ticking over . slept quite a lot as I have again today, though am now beginning to feel that I’m emerging back in to the land of the living. Oddly, the day before yesterday I felt full of beans, fewer unpleasant symptoms and was wide awake and energetic, almost my old self . Is this normal?

[helvella Administrator Thyroid UK]

To keep my reply simple and to the point, I'll ignore everything previously discussed.

When someone starts taking levothyroxine, their TSH will likely drop and their FT4 rise.

After a short time, the body starts to adjust to this new situation and reduce its both TSH and its own production of T4. At this point, the dose of levothyroxine should be increased.

But the blood test results taken in this initial time between starting or changing a dose are still changing - possibly every day a little. So it is usual to defer doing another test for around six weeks.

There can be a point at which a small dose of levothyroxine (such as 25 micrograms) can result in a drop in your own production of T4 by at least the equivalent of a 25 microgram tablet.

This is one reason that it is often a good idea for a starting dose to be 50 micrograms. That seems just enough to make sure most people don't actually go backwards.

[Benjipuss in reply to helvella]

Thank you! I have started on 50. So everything has maybe suddenly changed again? So is normal ?

[Benjipuss in reply to helvella]

I have another test, after four weeks , this week, at drs request

[helvella Administrator Thyroid UK in reply to Benjipuss]

It is fairly common.

If you had started on 25, it might have happened sooner.

See what that test shows and post back.

As a light-hearted comment, I think you have to avoid the word "normal". So much isn't normal when you have a thyroid issue. It is fairly usual for people to find themselves ratcheting up doses repeatedly. Sometimes feeling pretty good until they need the next increment.

I suggest you make notes of everything - dose changes, tests, makes of levothyroxine, etc., how you feel, symptoms.

[Benjipuss in reply to helvella]

thanks, I will do!

[FallingInReverse]

Hang in there Benjipuss ! While overwhelming, there is always something simple and comforting for me to know that once you are on your dose, that it’s “set it and forget it” for 6-8 weeks.

You’re on the middle of it, there will be ups and downs, but you are on the right path. So ride it out, post whenever you need support or reassurance or advice.

Big virtual hug to you!

We are all here for you.

[Benjipuss in reply to FallingInReverse]

Thank you , your kindness mean a lot as unusually for me generally, i an feeling extremely weepy at the moment too

[FallingInReverse in reply to Benjipuss]

We all do at times… it’s tough to let this all sink in, not to mention low Ts make us depressed & anxious on their own.

I promise you, deeply and truly, it really does get better from here. The Ts get better, slowly, and you WILL feel better.

[Benjipuss in reply to FallingInReverse]

Thank you 🙏

[Forestgarden]

To add to the other comments... yes, its quite usual to have a 'good' day followed by 'exhausted' days. We learn to pace ourselves and try not to overdo things on a good day. As things settle down and you reach your optimum dose there should be more good days than bad. Give it time and listen to your body.

[Benjipuss in reply to Forestgarden]

Thank you! I think I was so happy to have fewer symptoms and to feel a little more ‘normal’ that that was how I spent my day thinking normal transmission resumed. This is so like long covid in so many respects, I wonder what the crossover is , or misdiagnosis possibly. I’ve read research that quite a bit of long covid is leading to thyroid issues. I felt so good over the summer after three years of a slow progression to optimum health and am so cross with myself/ my body /my thyroid!! Sorry to sound so sorry for myself, more gumption needed !