Levo increase

[ChickieBaker]

Hello again.If by some miracle my doctor agrees to increase my Levo from 75mcg how long before I notice an improvement in my symptoms, specifically bloating and constipation ?

Many thanks.

[GlowCoach Administrator]

Looking at your last results your FT3 is very low, so although you may improve it may not be as good as you're hoping.

Give it a good 4-6 weeks before assessing where you're at. It can take even up to 12 weeks for full effects.

[SlowDragon Ambassador]

Retest 2-3 months after increasing

[Buddy195 Administrator]

Are you gluten free ChickieBaker, or completed a GF trial to see if this benefits you. I ask, because eliminating gluten resolved all my previous gastric issues.

As I’ve had adverse reactions to increasing thyroid medication too quickly, I now like to adjust by increments of 12.5mcg Levo. It does take me several weeks/ months to reach my optimal level.

[ChickieBaker in reply to Buddy195]

I have been completely gluten free for a couple of years now. I am on the first day of a two week dairy free trial. I am a bit worried about increasing too quickly as the hyperthyroid symptoms sound bad. I’ll see what the doctor says and go from there. Thanks 🙏

[Buddy195 Administrator in reply to ChickieBaker]

You could experience ‘hyper like’ symptoms if you increase medication too quickly, but this is not the same as hyperthyroidism.

If you are concerned at all about increasing your dose, think ‘tortoise’ not ‘hare’ and make gradual adjustments. Yes, this takes additional time, but has the advantage that you are less likely to miss your ‘sweet spot’ where you feel most well.

[ChickieBaker in reply to Buddy195]

Thanks very much. I'm tempted to increase by 12.5mcg even if the doctor refuses to increase my dose as the bloating and constipation is really bad, along with other symptoms of under medication.

[Levy24 in reply to ChickieBaker]

I increased from 100 to 112.5 around a year ago, I am SO much better for it.

[Levy24 in reply to Levy24]

I have diverticular disease.

[ChickieBaker in reply to Levy24]

Hello. I'm seeing my doctor on Tuesday but regardless of what she says I'm going to increase today by 12.5mcg as I'm sick of the symptoms I'm currently dealing with. Thanks.

[tge1230 in reply to Buddy195]

Hi Buddy have you tested for coeliac disease, or did you just cut out gluten anyway?

[ChickieBaker in reply to tge1230]

Not sure if this question was for me but I did get tested a couple of years ago and I was negative for coeliac. Thanks.

[Buddy195 Administrator in reply to tge1230]

I was negative for coeliac but am definitely gluten intolerant, so wouldn’t touch it again!

[tge1230 in reply to Buddy195]

Thanks, that's interesting. As advised on here I've tested for coeliac disease and am not coeliac. I believe I eat very little gluten so wonder whether I eat enough of it to obtain an accurate result. I am pleased by the result, and am not looking for more things to be wrong with me, however am still curious to find the root cause of my HT.

[DippyDame]

Your FT3 is far too low

I'm not sure 100mcg will be the answer, you may need a further increase to 125mcg....but your FT4 may then be over range and that should be avoided....it can cause further problems.

You need to remain on 100mcg for 6 to 8 weeks before testing again and revising the dose

I don't think you'll notice a great improvement until your FT3 is approaching 75% through the ref range.

You may eventually need to add a little T3

Quick calculator....enter results in relative boxes

thyroid.dopiaza.org/?utm_so...

Post any new labs if you wish help

Good luck

[ChickieBaker]

I've no idea what to ask the doctor for according to these figures. This is all quite new to me as I haven't increased my dose for probably 2 years.

Thyroid test percentage.

[GlowCoach Administrator in reply to ChickieBaker]

At this point you just need a Levo dose increase as FT4 needs to probably be in upper quarter of range and now its sitting at 48% which is too low.

Many hypo people find they have to push their GP for an increase. Ask for it on a tria basis which often goes down better. If one GP says no then keep asking different ones until you get the answer you need.

In time you may well need to get some T3 added to your Levo but need to first raise FT4 further and also what about your vitamin levels?

Low thyroid hormone mean low vitamin levels and they have symptoms all of their own.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.

Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...

There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

[ChickieBaker in reply to GlowCoach]

Here are my last results which I posted under a different heading. Please excuse the confused layout !Feb 2025 May 2024

CRP. 5.77 4.33

Ferritin 249 234

Folate 16.2 10.8

B12 150 54

Vit D 170 105

TSH 3.960 mlU/L 0.758

Free T3. 3.9 pmol/L 3.9

Free Thyroxine 16.8 19.9

Thyroglobulin

Antibodies 363. 454

Thyroid

Peroxidase 122 169

[DippyDame in reply to ChickieBaker]

Just noticed you posted %ages

As I suspected your FT3 is abysmally low.

Your T4 to T3 conversion in the body is impaired so FT3 is low. High(ish) FT4 compared to low FT3 indicates poor conversion

Yes increasing levo may help but be careful that you don't go over the ref range.....

I suspect you will be hard pushed to add enough Levo to relieve symptoms without exceeding ref range.....but try Levo first

If increasing Levo doesn't help raise FT3 to a therapeutic ĺevel then....

I'd ask to be referred to an endocrinologist with a view to having T3 prescribed ....on the basis of poor conversion!

For good health every cell in the body must be flooded with T3 by way of a constant and adequate supply.....this isn't happening.

More hormone required

[ChickieBaker in reply to DippyDame]

Hello and thanks for your comments. I am currently taking 75mcg and was contemplating increasing by 12.5 to start with. Don't really know how gradually to increase. My weight is 70kg so if I use that method I should be on around 112mcg. I'm not sure my doctor will refer me to an endocrinologist as my TSH isn't massively high. I'm lucky to be on Levo at all, my named doctor said that I wasn't eligible for Levo until my TSH got to 10 😱 I went back and saw a different doctor !! I find the whole thing really confusing so I need to read up so I know what I'm talking about in case my new doctor is reluctant. Thanks again.

[DippyDame in reply to ChickieBaker]

I'd be inclined to raise to 100mcg....wait 6/8 weeks then test again......your GP might not agree but then if they talk rubbish like TSH having to be 10 before medication is initiated they haven't a leg to stand on!

However I'd first talk to your GP before increasing your dose rather than putting his back up! You need him to write the prescriptions unless you wish to self medicate!!

You need to play them at their own game!!

If properly understood there is nothing confusing about using thyroid hormones....the problem is that med students nowadays are only taught half the story, as it were, so they themselves are often flying by the seat of their pants

They are overly concerned with numbers while neglecting to consider the vital clues, the symptoms, which were used in diagnosis before testing was developed.

As our much missed thyroid scientist the late Dr JohnMidgley/diogenes wrote In his history of thyroid testing...

For the moment mechanical thinking has traduced medical diagnosis.

thyroiduk.org/testing/histo...

This might help

bmcendocrdisord.biomedcentr...

Time for a reassessment of the treatment of hypothyroidism

John E. M. Midgley, Anthony D. Toft, Rolf Larisch, Johannes W. Dietrich & Rudolf Hoermann

...........

thyroidpatients.ca/2021/07/...

You're not at the point of requiring endo intervention but if increasing T4 to near the top of the reference range doesn't help ( by T4 to T3 conversion) to raise your FT3 to somewhere approaching 75% through the ref range then you will need to add some T3.

Calculating your dose by weight is fine if conversion is robust....your conversion is impaired.

I'd suggest your bloating and constipation are the result of your low T3

It's late now....hope some of this resonates.

My use of T3 is explained in my bio

[Lulu2607]

Hi ChickieBaker . Looking at your results, your TSH is too high and T4 too low for someone on levothyroxine. If you are also symptomatic then your Dr has no reason not to try an increase. I have always had discussions about my medications with the clinical pharmacist at my GP surgery. They seem more clued up about dosage and symptoms etc, particularly thyroid. Better than any GP I've spoken too. Could that be an option for you?

[ChickieBaker]

Hello and thanks for your comment. I haven't been to this surgery before so I don't know how receptive the doctor will and if they have a pharmacist who can help. I'm going to increase by 12.5mcg tonight and we'll see what she says on Tuesday. I'm also getting a CT colonograph done next month to see if the bloating and constipation are due to something else 🤔