Just started Thyroxine

[_Spanna_]

Hello I wanted to follow up a previous post to say I have started Throxine 125mcg am on day 3 and this afternoon just collapsed on sofa watching the Olympics. I have also been diagnosed with pernicious anaemia and had a Vitb12 injection. I think I read that after starting Thyroxine may feel worse before better.

[J972]

Congratulations on the diagnosis, but, I probably speaking for many on here when I say: *starting* dose of 125mcg!!!? That’s likely to be way too much as you start out on this journey. Was it an NHS GP or did you see someone privately?

[_Spanna_ in reply to J972]

thanks it was my GP so NHS

TSH 5.31

T4 10.5

Thyroid peroxidase antibod lev:

315 kU/L

[Sparklingsunshine in reply to _Spanna_]

I'm going to hazard a guess that 125mcg is probably too high a dose to start with. It can be a shock to the ole system starting Levo, especially if you've been hypo for a while. Normally we start on 50mcg and increase in 25mcg increments every 6 to 8 weeks.

Some sensitive souls have to do it even more slowly, only increasing by 12.5mcg or even 6.25mcg. Maybe you could have coped with one bodily assault, but also starting on B12 jabs as well is just too much. Its a lot for your body to deal with.

I've heard of patients starting on a full replacement dose in theory but you are the first actual person I've encountered.

[SlowDragon Administrator]

Although guidelines do say it’s possible to start at full replacement dose levothyroxine, many, many people would struggle to tolerate this

Therefore it’s much more common to start on 50mcg daily and increase slowly up over several months

Starting on 50mcg ……waiting 6 weeks….retesting thyroid and vitamin levels

Then increasing up to 75mcg …..repeat thyroid test in another 6-8-10 weeks

Etc

What were thyroid results before starting

And vitamin D, folate and ferritin results too

Presumably you are having several B12 injections initially before settling to one every 2 or 3 months

[_Spanna_ in reply to SlowDragon]

thanks it was my GP so NHS

TSH 5.31

T4 10.5

Thyroid peroxidase antibod lev:

315 kU/L

[_Spanna_ in reply to _Spanna_]

I don’t really understand but they are all abnormal I think

[SlowDragon Administrator in reply to _Spanna_]

You need to add the ranges on the results

TSH is above 5

Ft4 may be below range. Typically most common range is 12-22, but different labs have different ranges. Range could be (for example) 7-14

Same applies to TPO. Usually TPO over 34 = high confirming autoimmune thyroid disease also called Hashimoto’s

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common when hypothyroid

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

[FarmerDJ]

When I had rai and my output dropped to zero within a week, I was put on an emergency dose of 100mcg of levothyroxine. Only after the next blood test did they increase to 125mcg. Probably too much for you too quickly as it should be gradual to find your bodies balance.

[dansus]

Too much, too quickly. I would drop to 100mcg for 4 weeks and test.

[Sleepman]

Its very slow acting takes more than 6 weeks to reach a steady level in your blood. So if you dropped to 100 or lower you are in first few days.I am only 2 years in and there are some star forum advisors saying take it slower above.

No surprise being on sofa with PA/b12 and ua thyroid. Do not try to fight the fatigue would be my advice. ... rest to aid recovery.

T4 of 10 is low but not too bad your body is still making some.

Your thyroid as it being attacked can release a load of T3 and T4 so you could swing over active with any extra.

T4 converts to T3 which is the active hormone that helps power your body. I think the wise ones are saying do not go from nearly stalling to full revs just like that.

Let things start up gently and sort themselves out.

Good you are tolerating levo, some don't ... some it is ingredients some have poor adrenal glands.