New to hypo - timeline for Levo review?

[momo81]

Hello,

I don't have my test results to hand unfortunately, but wanted to seek advice on when my results should be reviewed. Timeline roughly is:

- Diagnosed with hypo mid November last year and started on 50mcg of Levothyroxine

- Retested in mid Jan which included vitamin and iron levels, increased to 75mcg + bumper dose of Vitamin D for 7 weeks (apparently everything else looked ok but I'll ask for the detailed results)

My doctor's notes say to retest three months after starting the new dose (so mid April). However, I'm five weeks in and my fatigue is getting worse week on week. I guess my question is, is there any likelihood that I might be feeling better given more time to settle in, or if I'm feeling progressively worse at this stage is it better to review sooner than three months? If so I'll call the doctor again and ask more strongly for a medication review... I'm taking it first thing with water, not eating for an hour, taking any other supplements in the evening etc.

Thank you! I've found this community so helpful already.

[momo81]

Not sure how to edit! Just to add - based on my weight I'd potentially need somewhere in the 125-150 mcg range.

[SlowDragon Ambassador in reply to momo81]

You may not need that much, certainly initially

It can take 2-3 years to slowly get dose increased.

We have to increase slowly and wait for levels to settle after each increase

[SlowDragon Ambassador]

Which brand of levothyroxine are you taking for 75mcg

Some people find they only tolerate one or two different brands of levothyroxine

Have you got 50mcg plus 25mcg tablets or single 75mcg tablets

Are you taking Levo first thing or bedtime

common to feel worse initially on increased dose while rest of metabolism tries to catch up

No point testing until at least 6-8 weeks after any dose change or brand change

Always test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

Are you taking vitamin D at least 4 hours away from Levo

Vitamin D tablets should be taken with high fat meal to improve absorption

How low was vitamin D

What dose has GP prescribed

Retest levels at end of prescription

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average as maintenance dose

Once you Improve level by this prescribed loading dose from GP very likely you will need on going maintenance dose to keep it there.

NHS Guidelines on dose vitamin D required

panmerseyapc.nhs.uk/media/2...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[FallingInReverse]

Welcome to the forum!

What you’re experiencing is very common. Personally me and a few others here have found week 5 after a dose change the worst, then week 6 and beyond settle down.

You need to stay on a steady dose for 6-8 weeks in these early days. When you get close to your full replacement dose (roughly 1.6 mcg X kg body weight) some of us find waiting longer (like 10-12 weeks or more) is helpful.

This whole process in the beginning can take months to a year until you feel out of the woods. It can be a long slow process, although we are all different , but over time things stabilize. See the picture - it’s like that!

You need to get copies of your blood tests on a regular basis. Being “in range” or “normal” is completely useless!

Healing