Underactive thyroid / hypothyroidism

[Tribe85]

TSH is 27 and T4 8.9
Dr has prescribed levothyroxine 50mg and test again in 3 months. They’ll also test for antibodies then - not sure what this is for? Is this standard? All new to me and the thought of being on medication forever is slightly daunting. Mid 30s. Thanks

Hello, diagnosed with hypothyroidism and Hashimoto’s about 8 years ago. The antibody test is because some cases of hypothyroidism are caused by the body mistaking the thyroid for a foreign object and attacking it. TPOAb is the most common of these antibodies and often indicates Hashimoto’s disease, basically an autoimmune disorder which causes your thyroid to stop working because the body has attacked it. Were you experiencing symptoms before you were diagnosed? The levothyroxine should improve those fairly quickly. 50mcg is quite a low dose, your dr will keep an eye on that and increase it if the TSH doesn’t go down sufficiently.

I started on 50mg - don't remember being told my readings - over the years (10+ and I'm post menopausal) it has gone up to 100mg. It's unlikely to spontaneously improve- this is why you can get a medical exemption certificate if you ordinarily pay for NHS prescriptions but the medication works, I don't experience side effects and it is so important to get regular blood tests to make sure the dosage is correct

Oh and you’ve probably been told this, but do make sure you take the Levothyroxine with water (not with anything containing caffeine or milk) at least 30 minutes before you eat in the morning. It will quickly just become the first thing you do when you wake up. You qualify for free prescriptions with hypothyroidism so make sure you apply for the exemption certificate too.

@EsotericMnemonic Thanks, really useful info. Can I ask if they do anything different if you do have Hashimotos?

I started having blood tests because of fatigue and was found to have low iron. TSH slightly high then but gone up massively now.

As far as I know, there isn’t anything additional that can be done in treating Hashimoto’s beyond replacing the thyroxine. However, it’s helpful for you to know if you have it as people with one autoimmune disorder are more susceptible to others, so you keep an eye on symptoms of, say, type 1 diabetes, particularly if you have a family history. Speaking of which, you don’t mention having children or planning on them? Pregnancy is consultant led to keep an eye on levels. My TSH was >150 when diagnosed (ie so high it couldn’t be measured) but I felt enormously better after a couple of weeks of taking levothyroxine. Hopefully you’ll have more energy soon.

@EsotericMnemonic That makes sense, thank you. We’re all done having kids.

Low vitamin D often goes hand in hand with Hashimito’s, would recommend taking vitamin pills. Your TSH is very high, levothyroxine takes a while to build up in system, however is transformative.

Don’t worry about being on medication- it’s actually such an easy to treat condition with just one pill a day. You will be on them for life, however should feel miles better soon and very manageable. You also get all other prescriptions for free as well with an exemption certificate (a card) as a previous poster has rightly said. I’m not sure why we qualify for this, I guess because our body is not producing a hormone that we need for good health, a bonus though.

I have hypothyroidism and I've never been told I qualify for free prescriptions, is this in England? Is it just the Levothyroxine that you can get free, or all medicines? I'm on quite a lot of meds, so I do have a prepayment certificate already. My mum has hypothyroidism too and she can't be aware, otherwise she'd have told me! Thanks

@HerbieFluffyDumpling yes in England. It falls under myxoedema. Exemption means you get all prescriptions for free, not just Levothyroxine. You can usually claim back payments made for certificates within 3 months of getting the exemption if I remember correctly www.nhsbsa.nhs.uk/check-if-you-have-nhs-exemption/medical-exemption-certificates

@HerbieFluffyDumpling I’m surprised your pharmacy hasn’t told you. Once my certificate had run out so I didn’t tick the exemption box and they questioned why I was paying for Levothyroxine.

You get them free because being hypothyroidism often leads to other conditions such as high blood pressure and type 2 diabetes. Also as it’s not considered to be a condition which was caused by poor lifestyle choices, they let you have free prescriptions. That’s how it was explained to me.

I’ve had this since I was 7 years old. I’m 47 now. It’s extremely important to keep to a healthy diet and weight in order to help prevent other conditions. I’ve been prediabetic since my early 40s even though I’m not overweight. I’m trying to keep it from turning into type 2 for as long as possible.

It's worth getting a full vitamin panel if you haven't had one as it's pretty common for hypo to come with vitamin deficiencies. There are recommendations for supplements and generally good advice on the Thyroid UK forum on Health Unlocked. I'd also say that it's not guaranteed that you'll feel better quickly on the Levothyroxine - not because I want to worry you, but equally don't want you to worry if that's not the case! I was put on 50 last November, 75 in Jan, then my TSH was so high the GP bumped it to 150 in May. It's taken that dose for me to really start feeling better so push for increases if you need to. I was struggling with the length of time between appointments and have ended up getting a couple of private blood tests - I'm going to have one next week in advance of a doctor's appointment or it'll be medication review, then a week to get the blood test appointment, then last time it was 5 weeks to get an appointment to discuss the results. As others have said though, it's super easy - there are no negative side effects as its just hormone replacement and I keep them by my bed with some water to take as soon as I wake up. I hope you feel better soon.

@Winterymix is there a specific multivitamin that you’d recommend? I’ve read on Thyroid UK and it has lots of info but doesn’t mention one specific multivitamin. I’m generally quite bad at remembering medication so one tablet would be ideal! ill ask for full vitamins at my next blood test and get one private if they won’t do it.

The dr never mentioned about the risks of diabetes etc. Lots to get my head around, really nice to hear that it’s a very manageable condition though. And as I haven’t been feeling too bad before (just a bit of fatigue) hopefully I’ll notice a difference.

I didn’t mean to worry you, I’m sorry if I have. Just eat healthily, exercise and keep an eye on your weight. That’s all you can do and we should all be doing this anyway.

Low vitamin D can make you feel terrible. Try and get your magnesium blood level checked as well as magnesium is needed to activate vitD and if your magnesium is low you won’t be able to get your vitD up.

Yes, it’s very easily manageable, just take a vitamin pill a day and try to keep your weight down as other posters have said. It can predispose you to high blood pressure so keeping BMI to a healthy level is important.

@LadyWestStar You've not worried me, it’s good to know these things 😊

Only skimmed the replies so sorry if I've missed this. But as a head's up, iron impacts your levothyroxine absorption rate. So if you get your iron levels back to normal, your dosage might need to be tweaked.