I'm on 50mcg levothyroxine,awaiting blood tests next week, and possible dosage increase.My question is, I've been unable to swallow the levothyroxine since being prescribed and have been crushing it and taking it with water when I wake in the middle of the night to go to the loo.
These past 2 weeks I've been crushing the tablets before I go to bed to save doing it when I wake during the night, so it's been standing sometimes 5 or 6 hours crushed.
I don't know if it's coincidence but I feel my symptoms have returned with a vengeance these past few weeks
Does anyone know if this could have affected it
Thanks Susan
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Blackcat122
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You should probably be explaining this to your GP as there is also liquid Levothyroxine that might suit you better. GP might be reluctant to prescribe as it is a lot more expensive than tablets.
50mcgs Levo is only a starter dose, so no wonder you're not feeling good. You can work out an approximate final dose if we know your weight in kilos.
1.6x weight in kilos = approx final dose
Get a copy of your blood results next week and post them here in a new post and members can make suggestions. 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 key vitmins tested yet - ferritin, folate, B12 & D3?
Do you do tests as per the protocol recommended here? Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).
Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
Thanks for your reply I'll post my results when I get them next week. I do follow the protocol for blood tests.I also asked about the liquid levothyroxine a while back,but the prescription receptionist said I couldn't have it as it's too expensive.
Unfortunately I couldn't get any further than the prescription receptionist.
Her advice was to speak to the pharmacist, and his advice was to take the tablet with a jelly type gummy sweet, but that got stuck in the throat too! Plus I thought it had to be taken with just water?
Indeed it needs to be taken alone. Patient information leaflet should explain although that said, if you do the same everyday your results will just fall in. Its not good to do that though.
Keep pushing them and try the government directive.
Thanks Jaydee for your advice. I will ask again about the liquid levothyroxine. There must be a big price difference for it to have been refused! Susan
You had dose increase to 50mcg roughly 2 months ago?
So you need next blood test and likely ready for next dose increase to 75mcg
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)
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
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should always be under 2 when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Hi humanbeanSince just before being diagnosed hypothyroid I started to have swallowing problems, food and tablets getting stuck at the back of my throat.
Previous to that I could swallow any pills without water with no difficulty.
I take farxiga and candesartan on a night time with a glass of water and they just sometimes sit at the back of my throat for ages before dissolving, so I think it's a thyroid problem possibly
Levothyroxine deteriorates if exposed to oxygen, light, humidity (and probably many other things!)
Crushing would be likely to increase the impact of all three.
However, I cannot give you any guidance as to how much any of these would affect your levothyroxine in your circumstances.
I take Aristo Vencamil and some people have reported being disturbed by the fact that it tends to dissolve before they can even take a sip to swallow it. Is it possible that would be sufficient to enable you to take it in that form? It definitely does disintegrate very speedily - but it has never seemed an issue to me.
Helvella, thanks for the replyWhat you've described with aristo vencamil sounds as if it would be too my advantage taking it. I'll wait till my next increase and then request that brand
If you wait the same rough time each time then even if it did loose a bit of "efficiency" it would be the same each time and you will end up on a slightly? higher dose than if you were not crushing.
My tongue and mouth were a swollen mess and that went as levo started kicking in and dose increased - so as above it may resolve ??
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