Is this normal in the beginning of using Levothyroxine?

[Guppy70]

So, I posted here a few months back as I was going through a terrible ordeal with Subacute Thyroiditis.

In July I started to go hypo as my levels dropped drastically. My endo said we will just keep on monitoring your levels. My latest blood test on 8/28/14 was:

TSH 18,70 (0,47-4,68)
Free T4 0,39 (0,78-2,19)
Total T3 0,94 (0,97-1,69)

They just called with my results but offered still no meds. My face blew up like a blowfish with the biggest under eye puffiness I ever seen. I was (am still) tired, depressed, lethargic and so on.
3 weeks ago I just called my endos office and pretty much begged for meds and so she called in Levothyroxine 88 mcg, no problems.

I'm not seeing her until end of October and that's when I'm having my next thyroid panel done as well. But I do have a few questions already now, almost 3 weeks on medication.
I can't say that I feel much better. Sure, I was hopeful in the beginning, kind of like exited. Will I finally get to feel ok now? But,I'm still tired, lethargic most of the time and now I also start to feel anxiety again. As I did when I was in the severe hyper state of the thyroiditis.

I have a hard time coming to rest, enough to sleep. Suddenly my mind can start to steer my thoughts into negative ones and then an aweful feeling of despair is rolling over me, I go hot all over my body and I have to get out of the bed. I don't sweat buckets, like I did when I was hyper, but it's like this wave of heat comes over me.

Is 88 mcg perhaps a too high starting dose? I've read people usually start at 25-50 mcg. And will I feel better once the meds is adjusted in my blood and these feelings are just because I'm still adjusting?

Or can it be that my thyroid has repaired itself and produce enough thyroxine on its own and I'm now acctually getting hyper due to the meds? Even though I'm seriously doubt that since the inflammation was pretty severe.

Thank you for reading.

[Red_Star]

I was in a panic state until I read that as well! Hope you aren't permanently hypo. :)

[Guppy70]

Thank you Red Star, that makes so much sense! That explanation acctually made me feel so much better! I can still look forward to feel better then and take these symptoms I'm having in stride.

So, the Levothyroxine can/will put the thyroid to sleep/lazy mode? So unless I have Graves or toxic nodules there's no reason I will go hyper.

I think I will be on meds for 1 year (from what I read about subacute thyroiditis) then go off all meds to see how my thyroid acts on its own.
According to a Mayo Clinic study about 15% of SAT patients end up permanently hypo and the worse the inflammation was the higher the chance for that. So I'm kind of counting on being low.

Thanks again for your reply.

[Red_Star]

88 mcg is a high amount to start with. I started on 50 mcg and was hyperthyroidism for a week then a month of worse hypothyroid symptoms.

Excerpt from Running On Empty by Robyn Koumourou....

"It is not uncommon to start thyroid hormone therapy and find that your symptoms become worse before they get better. When you begin taking thyroxine the areas in the brain that control thyroid hormone production sense the increase in T4 levels within the blood stream.  This feedback system will then cause the thyroid glands natural production of thyroid hormones to slow down.  

Less natural T4 and T3 will then be produced and released and blood levels may remain stagnant or even decrease temporarily.  Less free T3 hormone available to the body will slow down cellular metabolism. The symptoms of hypothyroidism may become worse until an increase in thyroxine is taken or an optimal dose is found.

On the other end of the scale, some people are particularly sensitive to T4 and find that their initial T4 dose produces hyperthyroid symptoms.  In these cases smaller starting doses are required with smaller and slower increases."