Doctor review app

[Andypandy30]

After a call from my doctor about how I am getting on on the increase from 75 mcg to 100 mcg levothyroxine .he has insisted I stay on the 100 mcg even though I told him how it was causing me so much anxiety he said to give it another two weeks then retest .but I had already been trying to decide how to do this at a slower pace for me.but he would have none of it and said not to mess about with the dose .he also said I should take levothyroxine first thing in morning .is this correct as I always take at night

[humanbean]

You can take your Levo at whatever time you want. Most people do settle on morning or evening, but some do split their tablets and take more than one dose per day, E.g. splitting a 100mcg dose into 50mcg in the morning and 50mcg before bed. I don't know how many people split dose Levo, but I know it has been mentioned a few times.

It is important to take thyroid hormones at a time when you have an empty stomach, and you have avoided caffeine for an hour or two. Also, avoid eating for 30 minutes to an hour after you have taken your pills.

There are some supplements and medicines that should be taken separately from thyroid hormones.

Magnesium

Vitamin D

Iron

HRT

Calcium

It is a good idea to take medicines and supplements an hour away from thyroid hormones, but the above list is things which should have a 2 - 4 hour gap.

[Andypandy30 in reply to humanbean]

Thank you I don't know what to do now .I only took 75 yesterday but still have anxiety today

[Minimol in reply to Andypandy30]

When I first was diagnosed and started taking Levo I was put straight on 100mcg by the Endocrinologist as a starter dose (aged 36) my GP was surprised given how poorly I felt and how high my TSH was that I hadn’t been put straight on 150mcg. In the end I ended up taking 175mcg daily.

I was going to suggest a ‘you do you’ approach but if your FT4 & FT3 are particularly low (are they ?) maybe you could just try the 100 daily dose sooner rather than later? You mention anxiety and that is a symptom of being under medicated.

[Andypandy30 in reply to Minimol]

Hi I have been taking the 100 for almost three weeks now .I have felt the anxiety since taking the increase from 75

[Minimol in reply to Andypandy30]

OK. Do you know what your latest FT3 & FT4 are?

[Andypandy30 in reply to Minimol]

I only know my T4 was 14 and my TSH was high

[Minimol in reply to Andypandy30]

You’re entitled to more detail than this and for many of us knowing where our results sit in their respect ranges helps us to understand how our bloods correspond to how we are feeling. For some of us, the more we know and understand the less anxious we feel too. You might ask for the ranges for both TSH and FT4 because that varies from lab to lab. Personally I’d want to see a print out of my blood test with lab ranges included.

[Sparklingsunshine]

Your GP is there to offer advice and support, not dictate what you do. He cant insist on anything, he can offer his opinion, end of. You take your Levo when its most convenient, it might be morning, evening or nightime.

Some split their dose, others prefer to take it all at once. There is some evidence Levo is better absorbed at night. The goal might be to get you to 100mcgs but if its causing unbearable anxiety then it might need to be done very slowly and gradually. At a slower pace than your GP might like, but tough, you have to live in your body, your GP doesnt. He doesnt have to cope with the side effects, you do.

I think someone needs to send medics the memo that the age of unthinking compliance and deference from patients is well and truly over.

[Andypandy30 in reply to Sparklingsunshine]

Thank you .I am at the stage I am frightened to take the 100 as I only took 75 yesterday but still have anxiety

[humanbean]

Do you think thyroid hormones are dangerous? If you do, then you really need to read this thread :

healthunlocked.com/thyroidu...

[Andypandy30 in reply to humanbean]

Thank you for the thread humanbean.no I am frightened of how I am feeling .I have been on the 100 for almost 3 weeks but have been having awful anxiety .and nervousness low appetite and weight loss .don't know what is causing what .and I thought if I took the 75 yesterday then I might not feel it today .but i did this afternoon so now dont know what im doing

[helvella Administrator]

Entirely your choice when you take your thyroid hormones.

If he says you "should take levothyroxine first thing in morning", then it is his duty to tell you why! It is not his duty to dictate without anything to back it up and to make you feel forced into doing something because of the pressure he is applying.

I simply try to point out that bed-time dosing is an option. All I care about is that you know it is a possibility, you can see that there is some evidence, and that you make your own choice. And feel as well as you can with whatever choice you make.

helvella - Bed-time dosing of levothyroxine

Discussion about taking levothyroxine at bed-time. Several linked references to relevant papers.

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

[Andypandy30 in reply to helvella]

I always take it at night and will continue to do so helvella

[HealthStarDust]

In my experience, 100mcg was too much either as a starting dose and a final dose titrating slowly.

Listen to your body. Try to go for a smaller increase of 87.5mcg which might help, but since you are already feeling terrible I’d also suggest first stopping your levothyroxine for a few days first.

It’s so important to go by how you fell, and you’ll only know through trial and error, as waiting for lab work is not always a perfect solution either. I can not explain the agony I have had waiting for both NHS and private blood tests only to have to repeat them due to some error, which only prolonged my suffering.

You do you. You never have to take the advice of your GP and can also seek a second opinion with another GP if you are a able.

[Andypandy30 in reply to HealthStarDust]

Thank you for replying .I am trying to work out if I can go back to 75 for a few days as it has been horrendous .and is it feasible to add in 25 mcg evety few days to get uo to 100 .do you know if this can be done

[crimple]

Andypandy30 has the brand of levothyroxine remained the same whilst moving from 75 mcgm to 100 mcgm? The fillers in tablets vary according to brand!

[Andypandy30 in reply to crimple]

Yes still same brand

[Johnprinefan in reply to Andypandy30]

I've heard somewhere that the additives in different strengths can cause issues too and that the 25mcg is the purest with no colours whereby the 50mcg can have colour added to it and some people react badly to that. Are you still on 25mcg tablets or on higher strength that you're cutting up?

[Andypandy30 in reply to Johnprinefan]

Hi I am getting bloods done today