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1150172 tn?1302132501

Can Levothyroxine INCREASE fatigue?

Hi - I've had symptoms of hypothyroidism for a few years now, but bloodwork remains just within normal limits. Since we've tried everything else, my doctor grudgingly agreed to try Levothyroxine in case it was indeed, hypothyroidism. He started me very low, and gradually increased the dose to .100MCG 2x per day.

...but I have NO improvement other than I'm sleeping somewhat better at night. Beyond that, if it's doing anything at all, it's making me MORE TIRED during the day.

I am SO desperate and confused; if my thyroid was normal, shouldn't this dose make me hypERthyroid? Shouldn't I feel SOMETHING? In all honesty, I could be taking tic-tacs for any difference in how I feel, and I don't know if I should continue this medication or not.

I've been through so many medications, anti-depressants, tests, tests and more tests - I am completely desperate and honestly begging for advice or suggestions of any kind; I'm so tired I can't function. Whatever this is, it's destroying my life.

I truly believed when I started thyroid hormone, I'd either feel better or get sick, either way it would've been an answer and we could move on to something else - never once did I think it would do nothing; I've been straining every day to detect a change, any change, bad or good - ugh.  

I cannot stand this. It is beyond me that I can feel so awful and have NO abnormal tests other than low b-12 and marginally normal thyroid function.

ANY help or advice on this would be ENOURMOUSLY APPRECIATED
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Avatar universal
Im not a medical person at all but Im been reading holistic medical stuff for a long time so something I came across today. There is a book called the medical medium. I briefly skimmed it and the author says that a lot of illness, especially the mysterious ones ie. fibromyalgia/thyroid disorders/ etc is actually caused by the Epstein-Barr virus setting up shop in the body and in fact Mono is just a stage 2 version of this virus but it can remain hidden creating all sorts of havac as it moves around. Ive been working with a naturopath and Accupuncturist who is trained in BIE. I just found out I have thyroid issues but Im so friggin fatigued its ridiculous. Next time I see my Accupuncturist/BIE practitiioner Im going to have her muscle test me for this virus. My body also has shown thats its been fighting a low grade infection for a long time so who knows...maybe its that.
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2 Comments
What was the low grade infection you were fighting?  I can't find a Dr.  That will test my for Epstein-Barr. They Dnt even want to know about or help me with my Hashimoto. The Endo. Gave me Levi and now won't see me for 3 months but I'm still exhausted.
What are your thyroid related test results and reference ranges shown on the lab report?  What symptoms do you have?  What is your thyroid med and dosage?
Avatar universal
My first TSH test came back within normal limits.  Months later I went to a new doctor because I wasn't feeling any better.  I still felt depressed and extremely tired all the time.  This new doctor did blood test for TSH, free T3, Free t4 and antibodies.  I was diagnosed with Hashimotos.  I read that people usually have Hoshimoto's before it becomes hypothyrodism.  I hope this helps.
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Avatar universal
I finally had labs again yesterday.  I asked for both FT4 and FT3 this time!  Here's my results.  Doc says all normal and to continue current dose.

TSH: 2.75 (Std Range 0.27-4.2)
FT4: 1.2  (std range 0.9-1.7)
FT3:  2.7 (std range 2-4.4)
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Avatar universal
Hi there!  I'm glad to hear that both my mother and I are not alone with the fatigue actually getting WORSE once starting levothyroxine!  I am happy to say that I no longer feel this way, however, my mom is still adjusting and needs frequent naps.
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Avatar universal
24 - holy crap!  When first diagnosed with Hypothyroidism, was a 9.27 and I thought that was dramatically out of range.  Yea, but tell your mom that this Levothyroxine will make her horribly fatigued as her body adjusts to this stuff.  I've slowly built up from 25 mcg to 50 mcg and am constantly tired.  So tired, in fact, my doctor told me to take it at bed time (but a couple hours after I eat as it works best on a near-empty stomach).  FYI:  I'm a 220-lb man.
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Avatar universal
I really think it would be better if your mom started out on a lower dose.  Maybe she could ask her doctor about that.  When I started meds, I was over 50, had been hypo for about 18 months and have a heart arrhythmia.  My doctor started me at 88 mcg, and it was way too much.  

Belly pain is not a typical symptom, but if her thyroid is off, it can exacerbate something already there.  For example, old injuries will often flare up when hypo.

I'm familiar with "passive with doctors"...my in-laws.  She just has to insist on FT3 and FT4.  Once on meds, TSH often becomes useless.  Good luck with that...maybe as the daughter, rather than the DIL, you can make an impression.
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Avatar universal
I thought that seemed very high to start with as well.  My doc started me at 50 and I tried that for a week and couldn't sleep and felt achey.  So I had to take 25 and increase to 50.  My mom is 52.  I believe she has arrhythmia as well - her heart skips beats, but her doc has never been concerned with that.

She has been experience belly pain for about a year.  It's to the right of her belly button, and hurts her more often than it doesn't.  She says it really hurts when she presses on it, or if there's any pressure on her tummy.  Sometimes she has to visit the bathroom very shortly after eating, due to tummy upset.  So she's been looking for answers.  She had a colonoscopy, and had seen her GYN and they didn't find anything.  She saw her primary doctor to see if he could figure it.  He sent her for some blood work for that, and she requested to have her thyroid tested.  When he called her yesterday, he said her TSH is so high that it's likely been causing whatever this belly pain is.  (Really?  I haven't read anything like that, but then again, I've been trying really hard to NOT google symptoms.)  So he decided to hold off on the CT scan until she's been on the thyroxine for a few months.

My mom is very passive with doctors.  She never asks questions, and just does what they say.  Opposite of me, that's for sure!  I will see if she will get a copy of her labs.  He did not test FT3 or FT4.  She goes to a different practice than I do.  Seems that doctors around here just medicate based on initial TSH results.
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Avatar universal
I'm glad to hear the heart workup came back good.

That might be a very high starting dose for your mom.  How old is she?  Typically, starting dose for people over 50 or people who have been hypo for more than a few months or people with a history of heart arrhythmia is in the range of 12.5-25 mcg, increasing as needed and as tolerated.  

She should ask for a copy of all her labs and start keeping her own history.  Did her doctor test FT3 and FT4 as well?
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Avatar universal
Stress and echo all came back really good today!  Thank goodness for that!

I have asked around about physicians, and have one I am going to check out.  I think I will switch.  Or ask to see an endocrinologist.  However, I don't feel confident with how my doctor is handling this, so how would he handle something else?  Much less if I ever had a crisis!

Another piece of news...my mom decided to go get her thyroid checked.  She's had some similar symptoms as mine, and some very different.  Results back today, and her TSH is 24.  She's starting on 100mcg tomorrow morning!
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Avatar universal
No, adrenal testing would be totally separate from the tests you listed.

So, all we have is your TSH to work with.  It has come down, from 9.9 to 3.65, but it's still too high.  

Thyroid very definitely affects the heart.  I have a congenital heart defect that has caused me to have intermittent tachycardia all my life.  Before thyroid meds, it was totally under control without any kind of meds.  Once on thyroid meds, all hell broke loose.  

I have had angina when overmedicated.  For me, that was more of a "tiredness" across my shoulders.  Your chest pains are probably meds related, but you should definitely have a cardio workup just to be sure.  If nothing else, it might allow you to relax and stop calling Dr. Google!  
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Avatar universal
I do not believe I've had adrenals checked.  Unless that shows on a CBC or lipid or metabolic panel.

I do have labds from before I started meds, however, my doctor didn't check FT4 at that time.  He only checked this once my TSH initially came back at 9.9 and after I had been on thyroxine for 6 weeks.  Unfortunately, there is nothing for me to compare it to.  And, I think I mentioned before, he has yet to check FT3.

Have you ever experienced chest pain with any of this?  Mine is mild and intermittent.  But yesterday, it was happening more often and it worried me.  (Possibly because now I am looking for it and causing myself anxiety - who knows.)  So, I made the mistake of turning to Dr Google last night while I was laying in bed, and I have myself worried that I have something wrong with my heart!  I had no idea that thyroid can affect the heart.
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Avatar universal
I'm sure vitamin D is contributing to your fatigue.  Fatigue isn't a "side effect" of levo, but if you're not on enough levo, you can feel more fatigued (and other symptoms can worsen, too).  That's because the pituitary sees the extra hormone that you're taking, cuts back on the amount of TSH it puts out, and your thyroid produces less.  So, overall, your free levels might actually go DOWN a bit.  Worsening symptoms is a very common complaint on starting meds.

Levo is very slow acting and has to build in your blood over time.  So, the cyclical fatigue you describe most likely is not from the levo.  Have you had adrenals checked?  When we're hypo, our bodies compensate for the lack of thyroid hormones.  Adrenals are infamous for stepping in and trying to compensate for lack of thyroid hormones.  Once on thyroid meds, the adrenals have to rebalance.  Adrenal hormones (cortisol) are very fast acting and can change how you feel from minute to minute.

Do you have your labs from before you started meds?  Has your FT4 changed at all?  
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1 Comments
Goolara your medical description, explains exactly why a person who is newly on levothyroxine would feel periods of tremendous fatigue. The pituitary cuts back, the adrenals try to compensate and the thyroid is trying to get recharged and up n=and running again. I would suggest that if she's having this much trouble with her doctor, perhaps she needs to invest the time to find a new doctor that she feels comfortable talking to. Disease's that are chronic require a lot of time in a Doctors office and you want that to be someone you can easily communicate with and trust.
Avatar universal
Well, he has yet to even check FT3, so that leads me to believe that he doesn't (a) doesn't see the importance of it, or (b) doesn't realize that he should order this in conjunction with the others!

I just find it odd that I feel very sluggish for most of the day, but start to feel better at night.  I take thyroxine around 7am, and by 11am I can barely keep my eyes open.  Around 5 or so, it seems I finally start to wake up.  Any thoughts on if the Levothyroxine is making me feel fatigued as a side effect?  I don't understand why I feel worse now than I did a few weeks ago.  (Or, as in our other posts, the vitamin d may me the culprit)
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Avatar universal
You may have to go doctor shopping...any doctor who can't interpret FT3 is going to leave you feeling miserable.

The problem with increasing on your own is that you'll run out of meds before you're due to refill, won't you?  It's always best to have a doctor you can work with.
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Avatar universal
Thank you for the info!

He is sending me for a stress test and echocardiogram on Tuesday, since I complained of very mild intermittent chest pains.  I am sure everything is fine!  

I was thinking I would wait for him to call me witht those results and tell him I am still feeling so terrible that I am having a hard time getting through my day.  And will request Vitmain D recheck and Free T3. Although I venture to guess that he wouldn't know enough about the free T3 to even interpret what the results mean.

I was considering increasing my own dose by 12.5 mcg, but I hate to do that without a physician being on board and monitoring things.
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Avatar universal
Your dose should have reached its full potential in your blood at this point; it's been over 6 weeks since you started. I disagree with your doctor; I think that you need to increase.  Your FT4 is only at 25% of range, and most of us find that it has to be right around 50% before we feel well.  The need for an increase is reinforced by the fact that you still have hypo symptoms.  Many doctors believe that everyone feels well anywhere in the range, and that couldn't be farther from the truth.  We all have a level that we feel best at.  Meds should be increased until symptoms resolve.

Doctors love to blame hypo symptoms on depression.

You're absolutely right; he should be test FREE T3 as well.  

Vitamin D is necessary for thyroid hormones to be able to work properly in your body.  Once again, some people can tolerate some deficiency in the winter, but many can't, especially people who are also hypo.

Oh, believe me, I've fought my eyelids, too.  LOL  You're a long way from being overmedicated.  If you increase slowly (typically 12.5-25 mcg each time), retest at 4-5 weeks and increase more as necessary you should be able to avoid hyper symptoms.  I've been overmedicated, and though unpleasant, being a little hyper for a short period of time is not the end of the world.  Slow and steady increases work out best in the long run.



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Avatar universal
This is what the lab results say:
TSH -  value 3.65 - Std Rang 0.27-4.2
T4Free - value 1.1 - Std Range 0.9-1.7

I have been on the thyroxine since 3/20.  Is it possible that it hasn't accumulated enough to give the full effect?  Perhaps that is why my Dr didn't want to increase my dose?
I was a little concerned that he didn't test T3, after some things that I read here.
As I was leaving, he made a passing comment that fatigue is the #1 symptom of depression.  Pretty bizarre - I certainly do not think that is or ever was an issue!  It just worried me that he may be dismissing how I really feel.

I feel worse now than a few weeks ago.  Maybe it's the vitamin d deficiency.  (Which he also somewhat dismissed.  I live in upstate NY.  He said that we are all deficient until summer.)

My vitamin d level was 15 last year around this time.  He did prescribe me 50,000 IU per week for 12 weeks.  Then never tested again.  My GYN did, sent the results (20) to my primary, and he said to take 2,000 IU a day.  Maybe I will have him recheck.

I don't want to be over medicated for the thyroid, as I've read that can cause a host of issues as well.  But, I started searching for some feedback today because I am sitting at work today fighting with my eyelids.  AWFUL feeling!
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Avatar universal
What's the reference range on your FT4?  Ranges vary lab to lab, so you have to post them with results.  It looks on the low side.

AACE recommended many years ago that TSH range be changed to 0.3-3.0.  Given that somewhat more updated range, your 3.65 would indicate you are hypo (under medicated).

That's a serious D deficiency as D often has to be well up into the range for thyroid to function properly.  Many doctors will prescribe 50,000 IU per week until levels start to rise.  You might ask your doctor to retest, see if your numbers are improving and adjust dose if not.

If you're not being adequately treated, your symptoms can get worse.  However, skipping one dose does little to lower your levels since your levels today are an accumulation of everything you've taken in the past 4-6 weeks.  



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Avatar universal
Hello,
Not sure if anyone checks this.  Looking for advice.
For the last year, I have gained weight (22 pounds), hair falling out, constipated, and had cold intolerance.  I was seeing my GYN for several months last year trying to get to the bottom of this.  I had my birth control pill switched numerous times, thinking that was the case.  I stopped going to the doctor, and only went back in early March because I started forgetting things and couldn't concentrate at work.  Finally then, my GYN ordered bloodwork for TSH and Vitamin D.
She called me with results.  TSH was 9.9 and Vitamin D was 20.  She told me I had to see my primary to be treated.

My primary Dr started me on 50mcg of levothyroxine, and 2,000iu daily of vitamin D, which I have taken every day since March.

I went back to the doctor this week because I am not feeling much improvement.  The constipation has gotten slightly better, my hair isn't falling out as much, and I can concentrate better.  However, there are some days where I feel MORE tired than I did when I first start thyroxine.  It hurts to keep my eyes open.  Yesterday I forgot to take my thyroxine for the first time, and I actually felt less tired.  Took it this morning, and I am struggling to get through my day.

Anyways, my Dr checked did some blood work, and TSH is 3.65and T4 Free is 1.1  He did a CBC and said that since everythign in CBC was within normal range, there is no reason to believe I am deficient in iron or anything else.

I am wondering if the levels above are normal.  He says they are.  And, if it's possible for the thyroxine to make you feel more tired than if you didn't take it.
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Avatar universal
Your doctor is dead wrong...once on thyroid meds, it's absolutely essential to have FREE T3 and FREE T4 tested every time blood is drawn.  TSH is totally inadequate to be used alone to manage meds.  TSH is a pituitary hormone.  As such, it is subject to many influences other than thyroid hormone levels.  It's an indirect measure of thyroid status, not nearly as useful as the direct measures of the actual thyroid hormones, FT3 and FT4.

How much levo do you take?    
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Avatar universal
I have a question if anyone still checks this. I have seen over five different Dr's over the span of 9 years for thyroid. The first Dr. was trying to help me with my daily headaches, did a blood test and called with the results saying that everything was normal other than my thyroid was a little low but nothing they were worried about. About a year later I see another Dr. with symptoms thinking I'm pregnant, only to find out that I had an underactive thyroid. He then tells me that the headaches I have been having were caused by the thyroid. Go ahead and I see another Dr. who wants to help me lose some weight by increasing my medication a bit. Seemed okay got pregnant which threw everything out of wack. Had the baby and they kept me on the increased dose because they said it worked with my levels, trying to figure out why I wasn't feeling good still. Dr. sent me to a specialist a year later to have them tell me I was on the wrong dose for over a year and because of the increased dose it was causing me to gain weight. Now my new Dr. just did a test and said my TSH was .59 I think and I was wondering if increasing my dosage would help with my fatigue and the fact that I still can't lose any weight and they tell me that it will just make me more tired!! I asked about the T3 and T4 when they did the last test and they told me that they don't need to do them because they all tell you the same thing. I'm just trying to figure out how some many Dr's can all tell me something different. What do I need done so I can feel normal and not continue to gain weight all the time. I'm even on the prescription diet pill to help with the weight loss but it isn't working as well this time like it did before. Please help if you can and if you know any sources to print off information to take to the Dr. to get some strait answers. Thank you.
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649848 tn?1534633700
COMMUNITY LEADER
If you're having that much trouble, your levels are, most likely now high enough for you, even if they are in the "normal" range.

If you have a copy of your lab report, please post your levels, with reference ranges, so we can better assess your situation.
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6540474 tn?1382244233
i have been on it since i was pregnant i had my son and i cant loose weight for crap im walkin 8 miles aday and gaining weight they say im in normal range its killin me i cant even get out of  bed im so depressed on  it and they say its my fault im not loosing weight and i am mean on it i want to get off it i was loosing weight off it and gaining it back off it but now that im on it i cant loose weight at all
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649848 tn?1534633700
COMMUNITY LEADER
This is a very old thread and Ginger has not participated in the forum for since this was posted, so it's unlikely she will respond.

As far as doctors go, there are some very good ones out there and not just the holistic ones.  Some people have to change doctors several times, before they find one who will test/treat them adequately.  

I see you're Canadian.  We've had some members who have had trouble getting testing/treatment because of guidelines of your health care system. Is that a problem for you?
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