I posted a while back before I first saw a private GP and was put on 50mg of levothyroxine.
Weeks 1-3 or there abouts I felt that things were going well. I felt rested after a nights sleep for the first time in years, increased mental acuity, diminished itching of the skin, decreased thirst, and found that things like abrasions and spots were healing quickly. However, the last 5 weeks I’ve felt like these have all come back and it’s been a bit brutal. I also stopped eating gluten 8 weeks ago in the hope that too would reduce my TPO antibody levels.
I’ve just had my next lot of blood test results back (8am, levo taken 24hrs before, no biotin for previous 5 days etc), and the results are interesting. I’m not 100% sure what they mean save for the vitamin D and B12 supplementation has clearly worked as hoped. My TPO levels aren’t much different (70.4 vs 74), and I’m not sure what to make of my thyroid levels in general - any guidance before I see my GP again next Monday would be greatly appreciated 🙂
No ferritin or folate results this time around due to haemolysis issues with my blood sample I’m told, in case anyone wondered why they’re absent.
New results posted here. I’ll pop the previous ones in the comments 🙂
Thank you to anyone who is happy to help - it’s invaluable to have support from you!
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TheMudRunner
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Well, 50mcg levothyroxine is a starter dosage. I would say, given it’s been 2 months, it’s time to consider an increase to 75mcg. Your TSH is still above 2.0.
Re the antibodies, I wouldn’t stress about them too much. They’re going to do what they’re going to do—you can’t really gauge whether you’re slowing down the autoimmune attack on your thyroid by the level of antibodies. It doesn’t really work like that. Going gluten free is about reducing the autoimmune attack, not about reducing antibodies.
Thank you for this SlowDragon & Jazzw . I was a little concerned I might not have much luck getting the dose increased based on the TSH, and I really don’t feel great atm.
Is it usual to feel better, then worse when starting to take levothyroxin?
I understand that it is usual to go through some less than pleasant side effects when increasing dose - would be helpful to know in what way you don't feel great though? I am in the process of very slowly titrating up from 25mcg (after recovering from the horrors of starting on 100mcg which had me feeling totally hyper within 3 weeks, unable to sleep, crazy irritable, toilet all the time etc). Personally, I found I felt super hypo after 6 weeks on 50mcg (tired, brain fog, cold, no appetite). Now I'm on week 4 of 75mcg and feeling significantly better! Are you feeling not great hypo not great? Or not great hyper not great?
Hi RuthieRuth . I felt much better for weeks 1-3 (roughly). Energy was up, brain fog down, waking up feeling refreshed and rested, itchy skin stopped, even my dishydrotic eczema had cleared up..! Since then fatigue is back so not good Hypo not good, worse than before (though that might just be because I had 3 weeks of feeling a lot better than I have in years!), brain fog and motivation are down, skin dry and itchier again, and spots / eczema are back, It’s frustrating but I suspect due to having increased availability of thyroxine for the first few weeks and then lower levels as SlowDragon has suggested below.
I’ve glimpsed a world where I have good energy levels again and want it back 🫣😆
I hope you’re feeling better than you were? Being Hyper sounds no more fun than being hypo. It’s a delicate balance and I know it’s going to take time. Hard not to be a bit impatient though.
Initially body welcomes extra hormone and your metabolism starts to pick up…..then your body realises after few weeks that you’re not taking enough replacement thyroid hormone so hypothyroid symptoms start to return
As dose increases over coming months this see-saw will diminish and it will often take longer between dose increases
That was my thought process, but I’d half convinced myself I was just having a psychosomatic uplift for the first while..! Phew. I’m definitely looking forward to getting the next step started on Monday. Would it be reckless to go up to 75mg by splitting a 50mg tablet (so taking 1.5 tablets) before then..?
Lactose free brands - currently Teva or Vencamil only
Teva makes 25mcg, 50mcg, 75mcg and 100mcg
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free.But 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 (currently) 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)
Vencamil (currently 100mcg only) is lactose free and mannitol free. 25mcg and 50mcg tablets hopefully available from summer 2024
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).
I’m on Almus, though from a local pharmacy rather than Boots. Useful to know that Boots may also stock it, and I will make a point of asking my GP to state the same brand again (though sounds like Accord is the same which is useful to know).
I’ve ordered a pill splitter as sounds like that may well be necessary if I stick with the Almus brand - one that does 1/4 tablets if necessary. Sounds as though good fortune has meant I have started on a generally well tolerated brand at least. Perhaps one less thing to think about for now which is a bonus.
Thanks again, and I will post an update after I see my GP on the 22nd July. Not far off at all now 😀
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