Constipation

[Clarendon55]

I always suffered but since I’ve been upped from 75mg to 100mg it seems to be worse. Could this actually be the case do you think?

[Obsdian]

This is an aspect that has never followed the textbook for me. So, I personally think yes, it's possible.

Excluding before I got rid of dairy (as that causes issues)... I've had softer or loose stools the whole time until recently changing to 100. I find that odd. I am npt constipated but something in my body has changed in this respect.

[SlowDragon Administrator]

It could be, especially as 100mcg is likely high enough dose to significantly reduce your own thyroid hormone output completely…..but 100mcg Levo may not be high enough replacement dose

what are your most recent thyroid and vitamin results

Which brand of Levo are you taking

Do you always get same brand of Levo at each prescription

Exactly what vitamin supplements are you taking

Approx how much do you weigh in kilo

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

Lower vitamin levels more common as we get older

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

VERY important to test TSH, Ft4 and Ft3 together

What is reason for your hypothyroidism

Autoimmune?

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[Clarendon55 in reply to SlowDragon]

Wow! Thank you 🙏

[SlowDragon Administrator]

Sorry ….didn’t realise this is your first post on Thyroid forum

Welcome to the forum

How long have you been on 100mcg

Bloods should be retested approximately 8 weeks after dose increase

what were your thyroid levels on 75mcg before dose was increased

AFib can be linked to being hypothyroid

healthline.com/health/hypot...

Heart needs good levels of Ft3

[Clarendon55 in reply to SlowDragon]

This is mine on 75mg, not been tested since 100mg in November.

TSH levels

[SlowDragon Administrator in reply to Clarendon55]

Just testing TSH is totally inadequate

Essential to test Ft4 and Ft3 and test correctly, early morning and last dose levothyroxine 24 hours before test

Unfortunately NHS rarely tests Ft3 and increasingly doesn’t even test Ft4

Many patients find they are adequately treated when Ft3 is approx 50-60% through range, often Ft4 (levothyroxine dose) will need to be a bit higher at 60-70% through range

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) it’s important to maintain GOOD vitamin levels

[SlowDragon Administrator in reply to Clarendon55]

not been tested since 100mg in November.

Get yourself a full thyroid and vitamin test in January including thyroid antibodies

Which brand of levothyroxine are you taking

Were you on same brand previously

Exactly what vitamin supplements are you taking

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

[humanbean]

I used to get episodes of both constipation and diarrhoea, but now it is just constipation.

I don't know if you live in the UK but I do, so anything I mention refers to things available here.

I don't stick to the same products all the time to deal with my constipation - I deliberately try as many different things as possible.

1) Prunes - I buy either bags of prunes from the dried fruit section of Tesco or I buy tinned prunes in juice. I find that 5 or 6 prunes a day keeps things moving. They might or might not have stones in, so be careful not to break your teeth on them!

tesco.com/groceries/en-GB/p...

tesco.com/groceries/en-GB/p...

2) I buy Inulin powder from Grape Tree, which I take in plain water - it doesn't have a lot of taste.

grapetree.co.uk/inulin-powd...

It recommends taking not more than 2 teaspoons a day. One works for me.

3) Sodium Picosulfate or Pico Liquid (different names for the same thing). These are only available from pharmacies. I usually take this as a last resort - it is fairly powerful stuff.

4) As a general rule I would suggest that optimising nutrients and your thyroid hormones will probably help.

[Clarendon55 in reply to humanbean]

Do live in the UK - prunes have literally no effect. Laxatives just cause wind.

[SlowDragon Administrator in reply to Clarendon55]

Sounds like inadequate dose Levo

Approx how much do you weigh in kilo

Magnesium citrate can help improve constipation

Calm vitality magnesium powder is cheap and easy to use

nutrizone.co.uk/p45678-natu...

Simply add to small glass water at bedtime (or early evening if you take Levo at bedtime, must be minimum 4 hours away from Levo)

Start on half teaspoon, increase dose slowly upwards until you get desired effect. Too much can cause diarrhoea

[Clarendon55 in reply to SlowDragon]

I take mag citrate! I weigh 60 kg.

[SlowDragon Administrator in reply to Clarendon55]

So that suggests you are on approximately the correct dose

However you could have poor conversion of Ft4 to Ft3

Next step ….get thyroid and vitamin levels tested 8-12 weeks after being on 100mcg

Which brand of levothyroxine are you using

What other vitamin supplements

[Clarendon55 in reply to SlowDragon]

Accord and multivitamin

[SlowDragon Administrator in reply to Clarendon55]

Multivitamins never recommended on here

Most contain iodine not recommended for anyone taking levothyroxine as Levo has all the iodine in it you need

Never supplement iron unless tested with full iron panel and found to be low/deficient

Stop multivitamins at least a week before retesting thyroid and vitamin levels

[SlowDragon Administrator in reply to Clarendon55]

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

[elaar]

It's frustrating when you see websites list a symptom of Hypothyroidism as Constripation, and Hyperthyroidism as Diarrhea, I wish it was that simple.

I don't know about everyone else, but I seem to have had every poo variation possible during this process (sorry for the crudeness), and it doesn't always correlate directly to under/over medication.

[Mlinde]

For what it's worth and maybe it won't work for you but following a (negative, thank goodness) prostate biopsy, I've been suffering from more mittant than inter, constipation and discovered that drinking 6-8 glasses of water a day, works extremely well. It can't ddo you any harm and it's good for digestion, so what's to lose?

[Clarendon55 in reply to Mlinde]

I’ll give it a go!

[RedApple Administrator in reply to Mlinde]

'drinking 6-8 glasses of water a day, works extremely well. '

How much is 'a glass' of water?

'It can't ddo you any harm and it's good for digestion, so what's to lose?'

Whilst it's true that the amount of water you're suggesting Mlinde, is unlikely to be harmful for most people, it's important to be aware that there is such a thing as 'water intoxication'. A body can only process and eliminate so much liquid at a time. A search engine will offer plenty of links to info about this, but here's one for starters. medicalnewstoday.com/articl...

[Mlinde in reply to RedApple]

A regular size glass, 3-4 in the am and 3-4 in the pm. To get 'drunk' takes an awful lot of water, several gallons, not 2-3 litres, you sweat out a litre or more, every night.

Acording to the article you ref:

"The authors of the study report that hyponatremia symptoms can develop if a person drinks 3–4 liters of water in a short period. However, they do not give a specific time estimate."

So not a particularly helpful article, in fact it's extremely misleading.

[RedApple Administrator in reply to Mlinde]

'A regular size glass'

I still don't know how much water that is! I have a cupboard full of glass drinking vessels, but they all hold varying amounts of liquid 😊

[Mlinde in reply to RedApple]

A regular size glass is 250ml, so 8 a day would be 2 liters.

[RedApple Administrator in reply to Mlinde]

Thanks, that amount seems entirely reasonable. It's better to quote quantity rather than simply saying 'glasses'. These days, everyone seems obsessed with hydration and I regularly see young people holding huge drinking containers from which they apparently are constantly sipping.

40oz tumbler

[Dgoebel]

Hi, maybe you should try N.P thyroid. It helps, and also,, potassium over the counter( potassium citrate 99mg).Sometimes it helps

[Clarendon55 in reply to Dgoebel]

NP?? I’ll investigate potassium citrate 👍