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dose increase?

BethBeezle profile image
9 Replies

Good morning

I’m looking for a bit of advice about whether I should increase my Levothyroxine dose now, or wait a little while. I currently take 125/137.5 alternate days. I took a test after 6 weeks and have attached a picture of the results. I also had an iron panel done at the same time and, as per the advice of some kind people on this forum, have just started taking Three Arrows Iron. I am also trying to up my Vit d and folate, because these have been low for quite some time. My question is then, should I go for it and up my Levo a bit now, or wait and see if working on my iron and vitamins helps before doing this? I am an annoying mix of impatient and anxious so keep going back and forth on the subject!

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BethBeezle
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SlowDragon profile image
SlowDragonAdministrator

Free T4 (fT4) 17.1 pmol/L (12 - 22) 51.0%

Free T3 (fT3) 4.4 pmol/L (3.1 - 6.8) 35.1%

Was test done as recommended, early morning and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

is your hypothyroidism autoimmune and are you on strict gluten free diet and/or dairy free diet

BethBeezle profile image
BethBeezle in reply to SlowDragon

thanks for reply - yup, tests done all as advised on the forum. I take whatever they give me at the pharmacy to be honest. Seems to be a mixture of Teva, Mercury, Hillcross and accord. Pretty sure different makes of levo don’t seem to make a difference to how I feel. I could be wrong though. I was diagnosed Hashimoto's about 15 years ago, with high thyroid peroxidase antibodies but I’m afraid I’m not gluten and dairy free. I am officially on a dose of 75mcg with the GP but source extra from an online pharmacy which I’ve been using to carefully up my dose over a few years, whilst referring to advice on this forum. Although I know dosing isn’t an exact science, I weigh 95kg.

SlowDragon profile image
SlowDragonAdministrator in reply to BethBeezle

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

Or buy a test online, about £20

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator in reply to BethBeezle

Levothyroxine

Suggest you try to get same brand each prescription

Test results suggest you have plenty of room to increase your dose

Up to 137mcg daily

Retest in 8-10 weeks

BethBeezle profile image
BethBeezle in reply to SlowDragon

Thanks, I appreciate your help. Will try these suggestions.

revitalise profile image
revitalise

I take Teva Levothyroxine but have always waited for GP to confirm if I need increase or decrease. It is important that your vitamins are at optimal level and at least half way through the various ranges. If not it can affect the absorption of the Levothyroxine. I have insisted on Teva brand as that what I was started on. Get your pharmacy to put a note on your a/c as to which brand you want.

BethBeezle profile image
BethBeezle in reply to revitalise

Thanks very much for your reply - I have found that increasingly most of my prescriptions have been Teva in recent months, but I will ask my pharmacist to add a note to my account. I didn’t realise it could cause so many issues for patients until I read about it here. Better safe than sorry. Thanks again.

BuzzBuzz12 profile image
BuzzBuzz12

Hi I am no longer on Levothyroxine medication and do feel a lot better for it I could not tolerate the medication so my gp decided to take me off it and apparently my blood test levels was normal without medication on three occasions and I feel well so unfortunately I can’t really give you any advice but I wish you good health

BethBeezle profile image
BethBeezle in reply to BuzzBuzz12

Thanks Buzz. That’s brilliant - I really hope you continue to stay well.

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