Just started Levothyroxine

[Zaley]

Hi :) I just started Levothyroxine 50 micrograms yesterday so I've had it twice now. I feel extremely tired...more than before. I've also felt cold off and on and kind of flushed. I was having flushing before but not feeling very cold. The med was called in for me when labs showed high tsh. She just said it was over 5, she didn't tell me the actual level. I wish I would have asked more questions. I follow up in 6 weeks. Are these normal side effects as my body adjusts to the med? Thanks for any advice

[Zaley]

Thank you for your responses and info! I appreciate the help!

[gimel]

The only way Levo could affect your asthma would be if you react to any of the inactive ingredients or dyes used in manufacturing Levo.  

"In addition to synthetic T-4, levythyroxine contains eight inactive ingredients plus color additives. Color additives vary depending on the dose being manufactured. The inactive ingredients include butylated hydroxyanisole, a food antioxidant, microcrystalline cellulose, sodium lauryl sulfate, sucrose and magnesium stearate. Magnesium stearate is a powder that can be added to other powders to make them flow more easily, which assists in the manufacture of levythyroxine."

Vitamin d should be about 55-60.  B12 should be in the very upper end of its range, and ferritin should be about 70 minimum.  Ferritin is a good test for iron because it seems to show a deficiency before tests for serum iron levels.  if you supplement with iron it is good to also take a form of magnesium other than magnesium oxide and also take some Vitamin C.  If you cannot tolerate iron supplements then you could get your doctor to give you iron injections.    

[Zaley]

Thanks for your advice. Do you think that Levo could affect my asthma? That's the main reason I want to stop it. I'm allergic to iv contrast dye which causes an asthma reaction instantly. I forgot to tell the endo that. I have no idea if the iodine in that is similar to Levo. I'm starting at the beginning and need to research all of this, I do have low vitamin D which I think was 22 when I had the last lab on that and was told to take vitamin D. My b12 was normal but in the past it was low and I've taken supplements. My iron saturation is low so at one point I was told to take iron which bothers my ibs symptoms. I have constipation already. I've thought about going to an internist/naturalist in my area and may end up doing that. I will post the results of my labs Monday when I talk to the nurse. I talked to her yesterday and she really wanted me to keep taking the Levo at least until she can see what the endo thinks about how it's affecting me. It makes sense how I would be extremely tired at first. That made me so anxious last night thinking I have an underlying heart or adrenal issue or that I'm allergic to it and having asthma issues for that reason. If the hashi's test shows I have that, it would explain a lot of things and how my life was turned upside down 2-3 years ago and how the Drs I've been too have labeled me as simply anxious. It's been so frustrating because I know something has been off with me and I haven't felt any doctor has really cared. Thanks again for your responses!

[gimel]

Meant to mention that hypo patients are frequently too low in the ranges for Vitamin d, B12 and ferritin.  So if not tested for those, you should request them.  If tested, please post results.

[gimel]

It is not unusual for a hypo patient to feel worse when starting on thyroid meds.  If you think about the serum thyroid hormone levels being the sum of both natural thyroid hormone and thyroid med, when starting on med the TSH will go down and the natural thyroid hormone production will likewise be reduced.  Often the result is no change in serum levels, or even a slight drop in levels until the dosage is increased enough that TSH is suppressed and serum levels are totally a function of thyroid med dosage.  

So I would not stop the Levo.  I would continue and make an appointment for followup testing in 4 weeks.  That gives the T4 med time to reach 90 % of final effect on serum levels.  Then when you go back for tests, you should request those I listed above.  You always want to test for both Free T4 and Free T3 every time you go in for tests.  If the doctor resists, then you should insist and don't take no for an answer.  If would also be good to test for the Hashi's antibodies.  Those tests are TPO ab and TG ab.  Your description of also having hyper symptoms indicates the possibility of a swing from hypo to hyper that, along with high TSH, is often associated with Hashi's.  If possible it would also be good to have an ultrasound of your thyroid gland to determine if nodules are present.  

Keep in mind that a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results.  You can get some good insight from this link written by a good thyroid doctor.  

http://www.hormonerestoration.com/Thyroid.html

So you need to also find out if the doctor is going to be willing to treat clinically as described.  If not then you will need to find a good thyroid doctor that will do so.

[Zaley]

Oh and as I'm laying here thinking, I forgot these other symptoms I've had for 2 yrs: joint pain, hoarseness in my voice that comes and goes, heart palpatations, racing heart and then I can remember about a yr ago a period when my heart beat was too slow for me. It seems like I go from having hyper to hypo symptoms. 3 yrs ago, I lost weight suddenly although I was a normal weight. I thought I had cancer or something cause it just fell off for no reason.

[Zaley]

Thanks for your reply. Other than feeling extremely tired I have had lots of symptoms over the past couple of years. I have gained 15 lbs I can't seem to lose although I have always been thin, have anxiety and depression that seemed to come out of no where, hot flushes, feel cold all the time, dry skin, pale, feel brain fog like I can't think straight, cycle is off some months with 2 periods, etc. I went to this endocrinologist 2 yrs ago after having a positive hypo test and when he did the extensive testing he didn't find anything. I decided to go back because I have had more issues and feel like my gyno and regular MD have just blown me off and don't care I'm walking around with some sort of hormone imbalance. The endocrinologist did do those extensive tests but like I said, when the nurse called to tell me she called in the Levo I didn't ask enough questions. They usually mail the results to you and I go back in 6 weeks. My sister has Hashimoto's but her levels are normal at this time and she doesn't take meds. I have asthma so I wonder if the Levo may have caused extreme fatigue and it affected my asthma because I had an asthma attack tonight. I'm allergic to a lot of things and various meds. Or maybe I have an adrenal issue. I did read you shouldn't take Levo if you have adrenal issues and I've been told before maybe I have adrenal fatigue. I've had a positive Ana for lupus in the past but when rechecked it was negative. My aunt has Addisons and Lupus. Anyway that's my history lol I wish I knew the exact lab results to share and try to understand myself. I think I will stop the Levo until I can see the dr again. Thanks for any feedback.

[gimel]

Other than being tired, what symptoms were you having before starting on the Levo?

I am somewhat surprised that the doctor was willing to start you on thyroid med, without even testing beyond TSH, for Free T4, Free T3, and the antibodies of Hashi's.  Those tests are TPO ab and TG ab.