Underactive thyroid

[lola71]

Wonder if anybody can help. I have been taking 75mg of Levothyroxine for the last couple of months, I do feel better than I did at the start, but some symptoms are still there like constipation ,brain fog and cold intolerance, not as bad as before though. My latest blood test says my ft4 is 13.8 which is in the normal range. I wonder if anyone is in a similar position to mine....Thankyou.

[jinglebellmel]

Hi lola, yes, I’m all within normal ranges now (and I’ve seen the results, they are where they should be rather than just scraping normal) and I don’t really feel much different to be honest. I always just thought it was normal to feel this way as I have for so long, I was only diagnosed due to recurrent miscarriages - so I wonder now if it is normal (for me at least) to feel this way and isn’t down to the thyroid after all

[kaytee87]

Your normal f4 might be higher than 13.8. You should probably get a review after 3 months, ask your gp if they would consider upping your Levothyroxine.

[lola71]

Thankyou ladies. My energy levels are definitely up, the constipation is super annoying and the brain fog. I am sure my brain was sharper before. I am only 48. :(

[jinglebellmel]

It maybe that they’ll up your dose after next lot of bloods, but they tend to increase it slowly.

[lola71]

Does anyone know if 75micrograms is considered a high dose? Seeing my gp on Wednesday and I need to argue my case in case she doesn't agree to up my dose...

[FunkySnidge]

My thyroid doesn't work at all since birth so I have taken thyroxine all my life. My daily dose is 150mcg. Generally, I have found during my life that I need to take a higher amount that necessary for basic 'normal' readings to accommodate the fact this is hormone replacement. I have no natural ability to regulate the level of thyroxine in my system, whereas in a normal person the amount would fluctuate as necessary with normal changes in weight and diet etc, I have this one flat level going in. So while my levels have indicated in my teens and twenties that 125 would be an adequate dose, my consultant has kept me on 150 as an adult to see me through those changes. The dose did not change in pregnancy.
I still experience some periods of sluggishness and struggle but it usually sorts it self out after a while. Also if I miss doses for some reason, it can take two weeks to feel the impact and two weeks to feel things are better after resuming a regular dose. So be patient, your system may still be adjusting and it take longer to feel the benefits.
Good luck getting it right.

[NaToth]

Even without knowing the reference range, I can tell you that your FT4 is way too low and FT3 will be too.

You should be going back and getting retested every six weeks or so until TSH is under 1 and FT4 is towards the top of the reference range.

[lola71]

Does it always have to be in the top of the range? I have been on Levothyroxine for 2 months now, so I would want all the symptoms gone, especially the brain fog and the constipation. Spent the whole weekend exhausted too with pain in my muscles. Thankyou for your advice.

[SauvingnonBlanketyBlanc]

I'm on 125mg and I've only got a slightly underactive one as far as I've been told

[lola71]

That's interesting! Do you feel better now?

[Doublethecuddles]

I had my thyriod removed 3 weeks ago and have been put on 100 mg levothyroxine. I was told to take my tablets at last 30 minutes before I eat anything first thing in the morning, if taking multivitamins take these in the evening.

[yikesanotherbooboo]

It is usual to keep your TSH towards the lower end of the range by gradually increasing the levothyroxine . It takes a good few weeks to see whether the dose is correct so a blood test every 6-8 weeks is quite normal. 75 is a common starting dose in younger adults and many people stay on it but it isn't a particularly high dose. It is great that you are already feeling a lot better.see what your doctor has to say.

[PorterBella]

It can take months and months of being on your optimal dose before your body recovers from having low thyroid level. The body needs time to adjust from being starved of thyroxine - the longer you were hypothyroid the longer it usually takes from my experience of researching hypothyroidism online.

Research has shown that the best time to take thyroxine meds [ for better absorption] is last thing at night on an empty stomach.

Some people find supplements have a positive effect too. I take pregnenolone and a good liquid B vitamin supplement among a few others..

[FunkySnidge]

Just highlighting that not many people will have an empty stomach last thing at night and so for the sake of regularity it’s generally recommended to take the meds first thing in the morning before you eat anything.

[PorterBella]

Drinking coffee in the morning or taking other medications could affect morning absorption. Plus the general advice of a 30 mins wait after taking Levothyroxine before having breakfast is suggested not long enough.
The bowel slows down at night as well as other changes in the stomach so providing a better absorption go Levothyroxine.

If you don't eat for a couple of hours before going to bed research shows a better absorption rate for Levothyroxine.

'Based on the results of our study, clinicians should inform patients with hypothyroidism that levothyroxine intake at bedtime is a good alternative to levothyroxine intake in the morning, provided that levothyroxine is taken on an empty stomach. For patients who do not attain normal thyrotropin or FT4 levels with morning levothyroxine intake, a switch to bedtime is recommended.'

There's been a few studies for more information one of the studies is here: jamanetwork.com/journals/jamainternalmedicine/fullarticle/776486

[SauvingnonBlanketyBlanc]

Yes I feel normal

[LittleCandle]

I'm on 125mcg and struggling at the moment. Endo is not interested. He says I am over medicated and wants me to drop my dosage. I had my thyroid removed because of cancer. GP is sympathetic, but not willing to do anything else. I am currently taking a higher dose than usual because I got extra pills when I had to order a top up of them recently. (That was a lag from the doctor not changing my repeat prescription for more than a year.)

I find if I take my drugs at night I find it difficult to get to sleep, so I always take it in the morning. If I miss a dose, I can be out of sorts for a couple of weeks. It can take a long time to get your levels right.

[FunkySnidge]

That's exactly the experience I have, I have been doing this my entire life, and if I miss a dose or get irregular, it takes yonks to recover. You have to be kind to yourself as sometimes your routine will be disrupted due to normal life; you eat later than usual; you forget to take it after a night out; you have a lie in etc.

[lola71]

Thankyou ladies. At the moment I put the alarm clock at 6am to take my meds and then fall back asleep till my normal wake up time of 7. Seeing my gp tomorrow, so let's she what she says.

[Hadenoughofitall441]

I have congenital hypothyroidism, I take 175mg every morning, living with this my whole life I can tell you you never fully get rid of all the symptoms. I’ve just grown resilient to it. If your levels are normal the doctors won’t change anything, I’ve tried... just gotta learn to live with it 😩

[lola71]

It's hard isn't it? Gp today agreed to alternate between 100mcg and 75mcg . Just hoping the constipation improves...

[Hadenoughofitall441]

Lol well some weeks are better than others. My biggest problem is the yo yo between insomnia and fatigue and pins and needles 😖 a whole array of problems, if it’s not one then it’s another.... just gotta crack on though right 😊

[NotSureWhoIAmToday]

I was coming on to suggest exactly what your GP agreed to @lola71.

I was on c ft413 on 75mcg and still felt pretty rough. 100mcg took me over the 19.8 limit though. I am now on 3 days of 100mcg and 1 day of 75mcg - suits me perfectly. ft4 is19 .

I did have to have a bit of a (verbal, polite) fight with my old GP though as she was not happy and wanted to take me back down to 75mcg!

I use my periods as a base line. Super heavy/flooding = too low a dose. Manageable and feel bright and breezy = good.

One thing I have seen advised is to not take your levothyroxine just before your blood test - take it afterwards.

[thyroidmad]

Has anyone been recommended a special diet for thyroid management? A friend of a friend claimed to cure her thyroid in six weeks by changing diet and taking supplements. She's been cagey about exactly what she did (she's a nutritionist so expect she's looking for clients). But from what I gather she eliminated gluten and soy plus some sort of supplement regime. She claims she hasn't had to take thyroxine at all since then.

[FunkySnidge]

That will be of zero use to anyone with no thyroid or a damaged thyroid