Levothyroxine

[Brigland27]

I should be 10 stone but went to the doctors complaining of constipation & weight not budging from 12 stone, after blood test showing I was border line hypothyroidism I was advised that taking levothyroxine could help my symptoms, well in the first month my weight shot up to verging on 15 stone, what the hell does this medication contain that it makes me gain weight? fast & makes me feel like crap? 4 yrs on & now taking over 100mg of levothyroxine & my weight is 14stone 5 pounds & now being advised to take 60mg of prozac to cure my depression...just feel like where is this condition heading? ...is there light at end of the levothyroxine/hypothyroidism tunnel?

[Sparklingsunshine]

Depression and weight gain are both common hypo symptoms. Have you got any recent thyroid blood tests to share with members? Low FT3 levels are responsible for most hypo symptoms.

As a really rough guide to dosage and its only a guesstimate we times your weight in kilos, 95 by 1.6mcg of Levo, the formula is 1.6mcg Levo per kilo of bodyweight. Which gets you 152mcg. So the chances are you are undermedicated. If you were taking enough Levo then all things being equal and assuming you can convert Levo into the active FT3 hormone, then you might feel better.

But until we can see actual blood results then its all speculation.

[helvella Administrator Thyroid UK in reply to Sparklingsunshine]

Agreed - it always helps to know what the lab results are as a start for discussion.

[Sparklingsunshine]

The other issue that springs to mind is you could be taking enough Levo, as I was at pains to point out the dosing by weight theory is very crude, and certainly not true for many. We have members who if they dosed by bodyweight would feel very overmedicated. And others who in spite of not being overweight require more Levo than their weight would indicate. Its very individual.

That said the status of B12, folate, ferritin and Vitamin D can all affect how much Levo we absorb and also convert. When hypo we need excellent levels of these and low levels will additionally make you feel rubbish. Do you supplement any or all of these?

[greygoose]

Levo is the thyroid hormone, T4. T4 is basically a storage hormone that doesn't do much until it is converted into the active hormone, T3. But not all hypos are very good at conversion, so end up with low T3. T3 is needed by every single cell in your body to function correctly, so if there's not enough to go round, that's what causes symptoms like weight-gain, difficulty losing weight, depression and constipation, and a whole host of others.

Are you still only on 100 mcg after four years? Doesn't sound like your doctor is taking a very active part in your treatment. So, time to start checking up on him. And the first step, as Sparklingsunshine has said is to get hold of your blood test results and see exactly what he's been testing, and exactly what the results were. We can help you understand them if you post them here, with the ranges.

It's not the T4 itself that has made you put on weight. The problem with doctors is that they think if you're 'only' borderline hypo (and their definition of 'borderline' would not be mine!) then you only need a small dose to 'top it up'. But that's not how it works. When you start taking levo, or any other thyroid hormone replacement, the thyroid will slowly cease it's production of hormone until you are entirely reliant on the pills you are taking. So, if you're not taking enough, you become more hypo, not less. I'm afraid that's far too complicated for a doctor to understand, though.

So, you start on a low dose, give your body time to adapt to it, then slowly increase the dose until you reach your sweet-spot. However, if you're a poor converter, it becomes even more complicated than that. I won't go into details right now, don't want to over-load you, but the only way to know how well you convert is to get your FT4 tested at the same time as the FT3, and doctors won't do that. (Conspiracy? Who knows.) But, cross that bridge when you come to it, first step is getting hold of your results. If you live in the UK, it is your legal right to have a printout, they can't refuse. So, ask at reception, and then post your results when you get them.

[Jaydee1507 Administrator]

Have you got your latest blood results to share with us? You are legally entitled to a printed copy of your results, ask at GP reception. In England you can get the NHS app and ask for permission to see your blood results on that by asking at GP’s reception.

Have you had your vitamin levels tested and what were the results?

Some recommendations were made here:

healthunlocked.com/thyroidu...

[elaar]

I've read a few papers fairly recently that have found Levo dosing according to musle mass is more accurate than bodyweight.

But of course muscle mass is a tad harder to determine. But something to bear in mind if you're more stocky/muscular than average.

[HowNowWhatNow in reply to elaar]

More muscle mass, more levo?

Or less mass = more?

[Litatamon in reply to HowNowWhatNow]

Since the comparison was with weight, I would think more levothyroxine for more muscle mass. Interesting, eh?

[HowNowWhatNow in reply to Litatamon]

I think the indicator is total lean body mass - more levo for more lean body mass - and not body weight. And as men have more muscle proportion than women this usually means more % dose of levothyroxine for them.

I am 61kg and on 150 mcg of levothyroxine and 10 of lio. This always feels to me a high daily dose for a person with a low BMI / low body weight / (now) low total lean muscle mass.

[Litatamon in reply to elaar]

Wow how wonderfully interesting.

[HowNowWhatNow in reply to Litatamon]

this is interesting, too:

arthritis-research.biomedce....

[helvella Administrator Thyroid UK in reply to elaar]

There are lots of different formulas and some take into account factors other than just weight.

But, to me, the very fact that there are several formulas make me extremely suspicious of all of them. At best, only one would be likely to work well across lots of different people.

helvella's calculation document and spreadsheet can be can be found by following this link:

helvella - Estimation of Levothyroxine Dosing in Adults

A discussion about the use of formulas to estimate levothyroxine dosing. Includes link to a downloadable spreadsheet which calculates several of these.

helvella.blogspot.com/p/hel...