Energy slump after a few days on 75mcg Levothyroxine

[NortherlyRose]

On 28 Jan I started taking 50mcg Levothyroxine (Accord). I was just under the TSH 10 cut off, but my GP believes in treating symptoms not blood test readings luckily. More info in my profile.

I was also prescribed a 7 week loading dose of vitamin D, and I have been taking B12, D3+K2, and magnesium daily. I am eating a gluten and dairy free diet.

I’ve continued to be extremely fatigued. I felt slightly better around the 6 week mark on 50mcg Levo but then went downhill again.

Dithering about taking a B vitamin because of thyroid blood tests. I have a private one I haven’t used yet.

Had a scan of my thyroid a couple of weeks ago and the report said “Satisfactory. Subtle heterogenous parenchyma.”

I am finding it difficult to decide if I have any iron issues which might be adding to my exhaustion. Tests results on 27 Jan were:

Serum ferritin 80.1 (UgL) [30-400]

Serum folate 5.7ng/mL [3.3-99999.00]

Not sure if/how these blood test results relate to iron levels - there was a full blood count and differential white cell blood count done too. Struggling to make sense of the information on the NHS app.

Any advice on whether I need to request more blood tests to check my iron levels would be appreciated.

Since 25 March I’ve been taking 75mcg Levo (50mcg Accord + 25mcg Wockhardt). I am hoping that once I get over the 75mcg hump and get a slightly higher dose of Levo my energy levels will start to improve. I’m 78kg so expect to need quite a bit more.

Thank you.

[Tina_Maria]

Your ferritin seems a bit low, have you had an iron panel or anaemia test done recently? If your GP is willing, it might be good to check that. If both your iron and ferritin are low, you may need to supplement.

Your folate is also low and it might help if you would supplement with a good quality Vitamin B complex (Igennus or Thorne B vitamins recommended, as they have bioavailable forms of vitamins) on top of your Vitamin B12.

Your Vitamin D might also still be low, as levels rise slowly, but it is good that you are supplementing. It might take a while until you reach 75 or 100nmol/L, depending where you started from.

75mcg is still a fairly small dose and if you are 78 kg, you should eventually be titrated up to 125mcg levothyroxine, so you still have some way to go. 75mcg is a funny dose, as you might feel better sometimes and then worse again, but these fluctuations are normal but will get better, once you have enough levothyroxine available. Just be vigilant and test again after you have been on this dose for 6-8 weeks, so you can get your next increase. It is all a bit of legwork at the beginning, but it will get better!

[NortherlyRose in reply to Tina_Maria]

Thank you so much Tina_Maria that’s really helpful advice. I am going to start the B complex vitamins now and next time I speak to my GP I will ask whether my recent blood test results exclude the possibility of iron deficiency.

I’ve improved my diet significantly since learning more about hypothyroidism but I know how vital it is to consider taking supplements as well. If only the NHS acknowledged this. I am spending a fortune on vitamins that should really be prescribed.

It’s still early days but I’m hopeful that things will get better as the dose of Levothyroxine increases. Progress seems painfully slow and I’m experiencing the zig zag pattern other people have described where I begin to feel a little bit better and then start to feel worse again.

Knowing what to expect is such a help. I’d be totally confused if it wasn’t for this forum. Thanks again for your reply. I really appreciate it.

Best wishes

Rose

[Tina_Maria in reply to NortherlyRose]

No problem at all!

We can all be a bit lost at the beginning, and knowing where and with what to start can seem very daunting at first, but once you learn more about it all and know what to look out for, it will become much easier! Just make sure that you will be on an optimal dose of levothyroxine (with both T4 and T3 between 65 and 85% through the range), as only this will guarantee that your metabolism has the amount of thyroid hormones your body needs to run efficiently. And you will feel better for it as well!😉

[NortherlyRose in reply to Tina_Maria]

Thank you so much Tina Maria.

I have ordered the B complex supplement now and I will check what my FT4 and FT3 are after 6-8 weeks on 75mcg Levo.

I am addressing a whole host of health issues at the moment. Got a new prescription for my glasses a few weeks ago as I was getting double vision sometimes. Adding a prism seems to have fixed that. Went to ENT/Audiology yesterday for a hearing check and got prescribed hearing aids.

I’ve been on a gradual decline health wise for quite a long time but had more or less given up. Such a relief to finally be getting everything sorted.

[Tina_Maria in reply to NortherlyRose]

Gosh, it seems that you had quite a few things to sort out recently, sometimes it can feel that the wheels are coming off left, right and centre and you don't know where to start! 🙄

Nice to see though that you have had some good results already, just remember one step at a time and with some patience, you will get there! And be kind to yourself, it is quite a lot that has been thrown at you, so give yourself a bit of TLC too! 😉😍 Take care x

[Tina_Maria in reply to NortherlyRose]

Just another thought, are you taking a magnesium supplement as well? Bioavailable forms of magnesium are Mg-citrate (can be slightly laxative), -glycinate, maleate, taurate or threonate. You can get them on Amazon.

Magnesium can also help to increase energy levels and if you take some magnesium with your Vit B complex and also some with your Vitamin D3+K2, this will help with better absorption as well! 😉

[NortherlyRose in reply to Tina_Maria]

Thank you Tina Marie. In the early days when I was overwhelmed by everything I bought the only magnesium supplement the pharmacy had in stock. It turned out it wasn’t one of the most bioavailable ones, so I have bought a better one now.

There’s such a lot to learn along this journey and the learning curve can be steep!

[Tina_Maria in reply to NortherlyRose]

Yes agree, it is a minefield at the beginning as to what to do and where to go. And the learning curve is steep, as there is quite a bit to learn and understand, but once you know how it is all interconnected, it starts making sense. And the added bonus is, that you can spot if your GP is trying to tell you something that is not quite right! And you know your body as well, and if something does not feel right, it probably isn't!

Take care and let us know how you are getting on!🤗