Thyroid Disorders Community
Synthroid/Levothyroxine Side Effects
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Synthroid/Levothyroxine Side Effects

Has anyone had high blood pressure while taking Synthroid and Levothyroxine?

I am hypo and I was given .50 Levothyroxine and I started filling shaky and light headed, I had trouble breathing and felt pressure in my chest, stomach cramps, headaches, and high blood pressure so my doctor told me to stop taking them and referred me to an endo who put me on .50 Synthroid because he thought I was having reactions to the fillers in Levothyroxine so I've been taking Synthroid for 2 weeks and starting to have some of the same reactions, stomach cramps, headaches, fatigue, light headed, and high blood pressure. I've never had a blood pressure problem in my life, my endo said Synthroid and Levothyroxine can't cause high blood pressure but when I stop taking it my blood pressure goes back to normal. I want to hurry up and find something that will work for me because I don't like putting up with my thyroid symptoms. I hate feeling weak and tired all the time, stomach issues, scaly dry skin, my hands and my fingers swell.

My Results
10/26/11 my TSH was 6.9 and I was given Levothyroxine .50 and had almost every side effect of it and high blood pressure so I quit taking it and went back to the doctor on 12/06/11 and my TSH was 5.3, FT4 was 10.8, FT3 Uptake was 23, and FThyroxine Index was 2.5 so my doctor referred me to my endo and I went to see him on 1/30/12 so I wasn't taking any thyroid medication since November and my results on 1/30/12 was TSH 5.65, FT4 1.0, Thyroid Microsomal was >1000 (reference <35).
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649848_tn?1357751184
First of all, it appears that you might have been started on too high a dose.  It's always best to start at the lowest possible, to allow your body to adjust to the hormones it's been doing without, then work up very slowly. The smallest dose of synthroid is 25 mcg and many people split that in 1/2 for a beginning dose of 12.5.

The main side effects of levo or synthroid are those of hyperthyoidism, which results from over medication, unless you are sensitive to the fillers/binders.  

It takes between 4-6 weeks for a med change to take effect, so what you're feeling after only 2 weeks is most likely not the synthroid, unless you are especially sensitive to meds.

What are the ranges for the Free T4?  Also, what are the units?  Your level of 10.8 on 12/6/111, seems horribly high with a TSH of 5.3, compared to 1.0, with a similar TSH on 1/30/12.  That's a huge drop.

Your antibody test (thyroid microsomal; also known as Thyroid Peroxidase Antibodies (TPOab), indicates that you have Hashimoto's Thyroiditis, which is an autoimmune disease, in which the body sees the thyroid as foreign, so produces antibodies to destroy it.  This destruction takes place over years/decades and as it progresses, your thyroid will produce less and less hormones, so you will have to keep increasing your dosage of medication, until your thyroid no longer produces anything. .  

It's not unusual, in the early stages of Hashi's, to swing back and forth from hypo to hyper.  This may be what's happening to you.

Your doctor should also be testing for the active hormone, Free T3.
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Avatar_f_tn
Thank you so much for you comment, I really appreciate it and yes my endo had mentioned to me that I had Hashi's sorry I should have included that in my post. First, I have always been sensitive to medication such as pain medications always knock me out so my doctor gave me tramadol to take and said its just a little stronger than tylenol and my sister takes it and said she can work while taking it so I took it and passed out for 10 hrs lol I have just always been sensitive to medication. Second, I did start out with the less dose my endo recommended me to cut them in half so I started both of them at .25 and the Levothyroxine still had me so jittery and dizzy I was vomiting and he put me on Synthroid and told me to take .25 after 2 hrs of taking it I was falling asleep in my office so I called him immediately and told him I was fighting just to stay awake so he said I needed to go and take another half because the dosage wasn't enough so I took another half and within 30 minutes I was awake and able to finish my day at work. I agree with you on the back and forth from hypo to hyper because after I take the Synthroid I get alot of energy and some jitters but after work around 6 or 7 I start coming down where I get light headed and start feeling weak and exhausted and my husband has to help me to the bed also I thought thats what is causing me high blood pressure (hypo to hyper), my mom has a similar situation with hormones, such as her birth control, she can only take one specific type of birth control because other birth controls cause her high blood pressure and her doctor doesn't understand that so he keeps her on that brand and her pharmacy has to order it from Canada so maybe thats what happening with me, maybe its something to do with the hormones. I don't know I'm so confused but like I said once I quit taking the Synthroid my blood pressure is normal again. My normal blood pressure is 120/80 but at my endo appt on 1/30 it was 120/60 and that was weird to me because I've never had that as a reading. My blood pressure last night was 157/100 so I didn't take it this morning and just checked it at 11:15 and its going down its 138/86 so just not taking it my blood pressure is already going back to my normal.

Range you were asking about ( I went ahead and included all results listed in my post with the range and units), bare with me because I'm not educated on Thyroid results lol so I'm just going to type it as it is on my papers.

12/06/11 TSH was 5.3 range is H with 0.450- 4.500 uIU.mL, FT4 was 10.8 range is 4.5 - 12.0 ug/dL, FT3 Uptake was 23 range is L with 24 - 39% and FTIndex was 2.5 range is 1.2 - 4.9

1/30/12 TSH was 5.65 range is H with a 0.34 - 5.6 uIU/mL, FT4 was 1.0 range is 0.0 - 1.8 ng/dL, Thyroid Microsomal was >1000 range is H with <36 IU/mL

Thank you again for your help!

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649848_tn?1357751184
Not to worry about not being educated on thyroid results; we'll help you with that.  

Okay - they used different units for the 2 FT4 tests; the first in ug/dL and the second in ng/dL........ so that makes them actually about the same, when converted to the same units.

It takes 4-6 weeks for levo to build in your system, so how you feel today would depend on your medication from a week or more ago; therefore, if you are feeling effects of it so soon after taking a dose, you must be reacting to the binders/fillers in the pills.  We've seen other members stopping and starting their medication; they ultimately, end up creating a vicious circle that's very hard to get out of.

You might ask your doctor about trying Tirosint.  It's a relatively new brand of levo that was just put on the market in 2009.  It's a gelcap and its only ingredients, besides the levo, are water, glycerin, so there's no fillers/binders to react to, making it virtually hypoallergenic.  Tirosint is also absorbed much better than pill type medications, so you probably want to start on the lowest possible dose (13.5 mcg); since it's a gel cap, it can't be split like a pill.

You might also ask your doctor to look into adrenal issues.  Some people who can't tolerate thyroid med, turn out to have adrenal fatigue or insufficiency; in that case, the adrenal issue should be addressed before trying to actively treat the thyroid.
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Thank you for your advice and that makes since about the fillers/binders since I'm having reactions so soon after taking the pill. I'm going to call him tomorrow and let him know what has been going on the past 2 wks of me taking Synthroid and ask him about Tirosint. I'll post tomorrow what he says.
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Avatar_f_tn
My Endo just returned my call and told me to stop taking the Synthroid and we will discuss it at my next appt on 2/20/12. I called Abbott Laborotories before I called him and asked about high blood pressure while taking Synthroid and she confirmed that yes it has been reported as an adverse reaction.
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649848_tn?1357751184
Wow, you'll be a week without medication. Hope that's not too long.  

I'm assuming that adverse reaction would be to the fillers/binders, not the active ingredient, which is levo, right?

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Avatar_f_tn
yes it is levo, i'm not sure he just said we would discuss it next week when i come in so i just have to deal with it.
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Avatar_m_tn
My BP and TSH both were borderline for years. Now after I turned 52 I am on lifelong prescription meds for both. I am a skinny fitness freak but my biochemistry does not seem to care. Now my BP and TSH Re normal
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548668_tn?1394190822
I was unable to take 25mcg - on the second day I had all the symptoms you described.   I broke it in half, and took half a day for two weeks before I tried taking a whole one again.   It too me 5 weeks of taking half, a couple of days, then adding one, then being brave enough to take whole tablets two days in a row!!

I'm now, finally, taking one x 25mcg every day and am about to increase the dosage by another half on alternate days to build up further.

I'm sensitive to meds, and initially my doctor said to take one x 24mcg every alternate day, but I did better on half a tablet a day.  I'm amazed at how the body does manage to get used to it in small increases....  
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Avatar_f_tn
Thank you for your comment, did you get high blood pressure or more frequent urinating and back pains? The symptoms I listed above I could deal with but these here I couldn't ignore and my endo told me to quit taking it immediately and we would discuss it next week so maybe he's thinking something else is wrong? I have no idea I guess I will find out Monday when I go to the doctor.
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548668_tn?1394190822
My blood pressure was highish 150/85 when I was asking for medication (when my TSH hit 4.5).  It has lowered;  I'm really not sure though - I read where hypo can give you high BP, but then others have told me that there BP drops when they need more meds.  I was 121/85 5 weeks ago at the doctors - my TSH was 7.1 FT4 4.9 (he didn't take the FT3 but I talked him into if for yesterday's tests.  My BP is all over the place, although I'm seeming to get more lower reading now (yesterday 120/63).  I didn't dare take it when I felt terrible on the two evenings when I first took a 25mcg tablet.

I did feel dehydrated and was drinking more water; it did seem to go straight through me., but my saliva felt thick and my urine felt 'syrupy' (I also had a sinus infection at the time).  The locum I saw, said that it was probably due to the sinus, but to get my kidneys checked if it carried on.   It didn't carry on, but I was increasing the meds as fast as I could, and she'd also said (if I thought your were really going hypo I'd put you on 50mcg so build up to 25mcg as quick as you can.)

Unfortunately when I got to 25mcg per day, my doctor told me not to adjust higher, and I've had to wait for a blood test (yesterday) to prove that I need more.  My thyroid is a little sore, and I'm feeling the same spaceyness but unable to sleep.  I upped my dose this morning and want to get to 50mcg as soon as I can.

My doctor acknowledged that each adjustment up can be a little harsh;  I've got an appointment next week with the original endo who picked up the 'toxic nodule' so he can scan my thyroid and give me a second opinion on my meds.  (My GP wouldn't prescribe until my TSH was 6.8 and T4 10 (T3 4.5).

Its really hard to distinguish which symptoms are from hypo, and which are from the meds.  It seems to me that when I'm uncomfortably hypo, I seem to gulp air and get flatulence, my voice 'breaks',  I'm vaguely tired/heavy and alternate days feel as though my neck is swollen.

I haven't been constipated again since before I started at least some synthroid, but have had some strange bowel motions some days - and, early on it was a matter of hours after taking the synthroid that I seemed to 'evacuate'.

This time two weeks ago I felt great, but I think my hypo is now increasing faster than my meds are.   Others have talked about 'adrenal' problems with taking synthroid if you have adrenal insufficiency, which apparently can go hand in hand with being hypo.   I'll mention that to the endo, but, I know I can get to the right dose slowly - but hopefully fast enough.

A girl at work has had a terrible time - she started on 50mcg alternate days, had the same tummy flutters, flushed/temperature evenings, inability to sleep.  Once she started getting comfortable, they put her up to 50mcg daily.   (However, she is looking good now, and has managed it faster than me).

I've been quite anal about it - I write down next to the date whether I took 1 or 1/2, and write next to it how many tablets I took over the 7 days prior.  (So yesterday I took 1 with 7 in the week prior, today I took 1.5 which makes it 7.5 over the week prior).   I hoped this would help any doctor understand the small eponential increases, plus take into account the accumulation of the med into my system (about 5 days to leave your system) so there's a build up to your recommended dose with the constant accumulation, somewhere between  6-8 weeks......  In the last 5 weeks, I've gone from averaging 4 tablets a week to 7 a week (1 daily) over the last fortnight.  I'm sure I've done it too slowly now and hope I get prescribed the 50mcg tablets this week.

I simply could not imagine trying to take 50mcg to begin with.  On the second night of taking 25mcg I had a nasty headache, felt like I had a temperature, was shakey (shaky) and my stomach jittery.... but I still knew that I needed the meds.   Many here have tried other things with success.  In New Zealand we don't have too many alternatives, so I thought I'd just try to pump in what I could.   I'm astounded that a 25mcg a day has no side effects at all now for me, and will let you now how I go on my voyage up to 50mcg (which will be a quicker transition!).  

It's also worth noting that because the meds accummulate and stay in your system, an adjustment down (or stopping meds) will not be felt immediately.  

I celebrated when my hands aren't as dry as they were, and I've had no more sinus infections (I was given betacort to use daily; it seemed to stop my nasal passages from being so dry).  But almost the worst side effect for me would be forgetting what I was doing and feeling 'overwhelmed' at work when there was too much going on.   I've managed sleep with a half a zopiclone (or I wouldn't have managed work!).  

I was told there are no side effects (the fillers etc);  my doc says I'm 'sensitive' to meds, but acknowledges that the peak of the med can be a bit of a jolt.  Some here have likened it to being hyper, but it's was like a hyper dump to me, and lasted 2-4 hours about 12 hours after taking the 25mcg.  12.5 was fine (felt a little nauseas in the morning - that was a side effect that the locum acknowledged as the only possible side effect).

This is only my experience, but Barb has also advised that it sounds like 50mcg was too high a dose to start - and I saw on the specialist forum that monitored dose increases can be done fortnightly.   Then if you cut back too much, you end up where you were...but it's all so very slow moving!  

All the best for your visit;  being hypo affects the whole body, so I'm hoping for you that it's just the hypo giving you symptoms, and that the meds can get sorted for you.  We'll get there eventually!!
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548668_tn?1394190822
(I have the endo appt on the 21st Feb... we can compare notes!!)
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Avatar_f_tn
I agree its really hard to know if its the medicine or the hypo symptoms, and I would continue the medicine but my blood pressure was getting scary high my mom is a nurse and said people usually stroke out when the BP gets that high so I don't want to take it and cause something worse than what I have. There are more medicines my endo can give me so hopefully everything goes well on Monday and sure I don't mind comparing notes with you, I'll post on Monday night
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My endo gave me Tirosint to try and see if I can take it without my blood pressure going up, hopefully everything goes good, I'll keep you guy updated
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Avatar_f_tn
I tried the Tirosint 25mcg and within 30 minutes after taking the first pill my BP went up to 140/90 so its already happening again, is there anything you recommend for me to try now. my endo thinks its over dosing me causing hypertension because of my TSH he said i could either try brands until i find one that i can tolerate or wait til i get a little worse??? what i don't want to wait to get worse any advice you could give would be great
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649848_tn?1357751184
There could be a couple things going on.  25 mcg Tirosint may be too much to start with. You can't split Tirosint since it's a gel cap, but you can drop down to 13 mcg and see what that does.  As has been stated, it's not unusual for odd symptoms to appear, or for symptoms to worsen, when first starting a medication. You might even have to drop down to 13 mcg every other day, until you can tolerate it better.

The active ingredient in the medication (the levo) is identical to what your body would produce if it could, so there's really nothing to react to in Tirosint.  Also, as stated, it takes 4-6 weeks for the levo to build in your system.  

Since you've had reactions to fillers/binders, you could be having anxiety after taking the medication, which will raise your blood pressure.

Many people have to start on beta blockers when first taking thyroid med.  I've been on bp med for years before thyroid problems, but had to add a beta blocker to help control rapid heart rate and even higher bp.  I'm still on the beta blocker, but was able to cut the dosage in 1/2 after a while.  Some people can get off it altogether once thyroid levels come into balance.

You really need to get your doctor to test the FT3.  Trying to manage a thyroid condition, particularly Hashimoto's, based only on TSH is like trying to hunt with a blindfold on.  Both blood pressure and TSH can fluctuate for a variety of reasons.  With the TSH levels you've posted, I doubt seriously that you're overdosed.  

BTW - please check the FT4 reference range for the 1/30/12 sample.  I've never seen a range that started with 0.0; usually it's 0.7 or 0.8 - 1.7 or 1.8.

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Avatar_f_tn
I just checked my results again and the range for FT4 starts with 0.0, and when I took the Tirosint I had no anxiety about it because I had it in my head that the fillers/binders was what was causing me high blood pressure and I only checked my blood pressure 30 minutes after taking the first pill because my mom told me I needed to check it and keep notes on it so I listened to her and checked it and it was already getting high so she thinks its hypertension since I had normal BP before I took it and then 30 min after I took it it was high, do you think maybe I should try something natural like Armour or Naturethroid? I wouldn't mind continuing the Levo if I had something for BP but I don't and the last time I took the Levothyroxine for 3 wks my BP got near stroke out (my mom is a nurse and told me it was way too high) so I'm really scared and my endo thinks I may need to wait til I get worse to take medicine because of my TSH result. I asked him about the FT3 at my last visit and he said it was normal but I don't see that on my results so he may be going by my old results (12-6-11) for the FT3, I have no clue and I'm starting to lose hope, I'm so tired of being tired and exhausted and moody, my hands have been swollen and kind of feel numb for months now my muscles ache so bad I can hardly move sometimes and he wants me to wait til I get worse, just doesn't make sense to me :(
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649848_tn?1357751184
You don't have "feel" anxious to have anxiety.  I know that sounds crazy, but it's true. I learned that the hard way.

How high has your blood pressure really gotten? Granted, high blood pressure is not good, but mine has been really high at times since I do have hypertension, too, but I was no where near stroking out.

Your lab is using an outdated reference range for TSH; new range set by AACE nearly 10 yrs ago is 0.3--3.0, so at 5.65 your TSH is considerably over range; I don't see where your endo gets off telling you, you have to wait to take med until you get worse.  That doesn't even make sense.  If you have a hard time tolerating the med now, you'll still have a hard time tolerating it down the road, if you don't get on something and stay on long enough to get used to it.  You might try to drop back to the 13 mcg Tirosint, or go back to levo and quarter the pills, taking only a quarter/day until you tolerate it, then up to 1/2 a pill........ very small steps.

You can always try Armour or ERFA, etc, but the desiccated meds all have both T3 and T4 in them, and the extra T3 may only make matters worse.  

Have you had any testing done on your adrenals?  Some people with adrenal issues, have a hard time with thyroid med; adrenal issues should be dealt with before the thyroid.
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200220_tn?1361955154
My endo just started me on Tirosint as I am having severe stomach pains after I took the Synthroid.  She said if this doesn't work there is a white pill synthroid that doesn't have the dye in it that might work also.  I also am having trouble with my BP jumping around, mostly high lately.  I am going away for a couple of weeks but am going to address the BP and other issues, with a new family doctor that is both an MD and homeopath.  I have severe stomach pain when I eat or don't eat.  I have been diagnosed with severe gastritis and I am presently eating gluten free.   I have been on the Tirosint since Monday and so far everything is ok.  I did have a little pain but not like the synthroid.  I also started on 2 weeks of prilosec to give me a break from the constant pain.  
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My BP got up to 175/108 and my Dr told me to stop taking it and referred me to my endo for treatment and my endo wanted me to try levo again and try half so I did and it did the same thing and then he tried me on the Synthroid and I tried half on it to and I took it for 3 weeks and so on. My adrenal and cortisol results were normal I just got the results today, and I asked him if he thought I should try something natural just to see if I could take it without getting high blood pressure and he said we could try and see so he called in Armour 15 MG and I was going to start it tomorrow. I hope it doesn't make it worse since my endo said my T3 was normal.
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Avatar_f_tn
How high does you BP get up to? When I took the Levo and Synthroid I had stomach cramps, and my BP got high within the first week taking it but on the Tirosint it was high within 30 minutes so my endo said I should wait til I get worse so I could tolerate it and I thought that don't even sound right I agree with Barb135 about if I can't take it now I'm not going to be able to take it later but anyway I told him I didn't want to wait to get worse and asked if I should try something natural and he said I could try it so I'm going to start the Armour 15 MG tomorrow and just see what happens.
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Go to a good health food store and buy a thyroid supplement. For $11 I bought ThyroSense and it has helped me. The Armour may not be the answer either because I have no thyroid and take Armour thyroid and my body rejected it. I too have trouble with levothyroxin (levothyroxine) and synthroid. Same symptoms of heart problems and trouble breathing. There are also supplements for adrenal help.
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Avatar_m_tn
I was started on Levothyroxine 25 mcg when my TSH level was just slightly high.  I ended up having neck, jaw, and ear pain along with headaches.  I got re-tested and I had become hyperthyroid so I stopped taking my medication. I felt great while on no medication.   I couldn't get in to see my doctor for almost a month and by the time I did my TSH has gone up to 99.73 and a week later was 88.91.  I was started on Synthroid 50 mcg and three weeks in I am suffering from dizziness, ringing in my ears, and headaches.  I am so frustrated!  My doctor says that "most of my patients feel better when I put them on the medication, you are the complete opposite".  I just want to feel "normal" again.  
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Hey Barb... You sound incredibly educated in thyroid issues... Can I run a few things by you?  I'm not part of this forum, so I don't know if I will be able to find it again - so, I'm going to add my email address... ***@****.   Anyhow... I'm 45 and for the past few years I have been losing hair, gaining weight (which I haven't been able to lose - no matter what I do) constantly feel like I got hit by a bus - no energy... Blah blah blah - SO... I had myself tested for diabetes (neg) but the TSH value was 5.69... I don't know anything else... That is the only reference number my dr showed me... So, I was put on levothyroxine 25mcg for 3 months - it kicked my ***.  I was even more lethargic, gained 14 pounds, couldn't do anything... Ok... So my next lab TSH was 3.19... My doctor said that was within normal range and was going to leave me at that point.... I told her ABSOLUTELY NOT... So she upped my dose to 50mcg... Ok... So now we get to the point... I have begun taking it... And have experienced an increase in urination... That's about the only negative - so far and I am a week in.  I have decreased my caloric intake to 1200 or so calories (with a diet specified by my MD) and haven't really changed my liquid intake... What is your take on this?  And... I'm feeling better as well.  The only other health issues I have are ANAs.  The Md says that has nothing to do with it.     Another thing is... I am usually at my best when I am at the extreme end of things . Could my happy place be at the lower end of the TSH SPECTRUM?     Oh... I have so many other questions!!!!
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649848_tn?1357751184
In answer to your questions.... your TSH at 5.69 was definitely over range.  Even your TSH of 3.19 is over range, if you use the ranges that AACE recommended about 10 yrs ago, which is 0.3-3.0.  Your lab, hence your doctor is using an old range.

It takes 4-6 weeks for the synthroid/levo to reach full potential in your body and it's not unusual for symptoms to worsen or for new ones to appear once medication is started; that's why you gained weight and felt like a bus ran over you when you first started.  

I'm glad you didn't just let your doctor leave you with a TSH of 3.19; I'm also glad you're feeling better.  Since it can take up to 6 weeks before the med reaches full potential, you should continue to feel better as you go along.  

I don't think the more frequent urination would be due to the med; maybe you're drinking more, or eating foods with more water in them.. many fruits and veggies have a lot of water, which, by the way, does count as part of your fluid intake.

I don't have a warm, fuzzy feeling about your doctor, at this point.  How can she possibly think that a positive ANA has nothing to do with thyroid?  ANA indicates an autoimmune disease (doesn't have to be thyroid, but can be); have you been tested for Hashimoto's Thyroiditis, which, by the way, is the most prevalent cause of hypo in the developed world? Did she run thyroid antibodies?  Those would be Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAB).  If she hasn't she needs to.  You also need a thyroid ultrasound to determine whether or not you have nodules on your thyroid.

Also, apparently, she's only testing TSH, which is a pituitary hormone and does not correlate well with either symptoms or actual thyroid levels.  You need to be getting Free T3 and Free T4, which are the actual thyroid hormones, every time you get tested for TSH.  Insist on getting those tests and if she refuses, find another doctor ASAP.  

Yes, your "happy place" can be at the lower end of the TSH spectrum; my TSH lives at 0.01 - < 0.01... But TSH should not be your main concern.

We're willing to answer any questions; you have only to ask them.
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Avatar_m_tn
Hello. I am a little anxious about starting Levothyroxin (levothyroxine). My Dr. prescribed 50mcg to start. My TSH was 4.94 & from what I've read my lab  is using an outdated range of .35-4.94. Should I start with a lower dose of 25mcg or possibly even 12.5 ? Is it ok to split the pill in halves or quarters? I've also read to take it in the morning 1/2-1 Hr. before breakfast or in the evening because it will be better absorbed.   Which is better? My prescription only says to take it once daily. I am insulin dependent diabetic with hypertension. I also take Losartan 100/12.5 & Crestor 20mg. I am a little worried about palpitations & blood pressure. I normally like to drink coffee upon arising & this seems to up my BP even tho I use the 1/2 caffeine strength brand of coffee. I am due for another lab test in 6 weeks for TSH & Free Thyroxins. My first test was only for TSH.  
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649848_tn?1357751184
You're correct that your lab is using an outdated range - the recommended range is 0.3-3.0, but most labs have been very slow to change.

Typically, we recommend starting at a low dose.  There is no 12.5 mcg levo, but you could split the 50 mcg pill in half for a few days if that would make you feel better.  They're pretty small to split into quarters - you'd pretty much end up with powder and you wouldn't know what dosage you'd have.

The instructions for levothyroxine are to take first thing in the morning on an empty stomach with a full glass of water, then wait for 30 minutes to an hour before eating or drinking anything else.   It's not that hard to wait 30 minutes before having coffee, but I don't always wait that long.  It doesn't really matter that much if it's just coffee, as long as you're consistent.

I assume the Crestor is for high cholesterol?  Hypothyroidism also causes high cholesterol, so you might be able to get off the Crestor once your thyroid levels are in line.

Be sure to insist on Free T4 and Free T3 whenever you have a TSH test.  
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Avatar_m_tn
Thanks for your speedy response. My lab orders state "Free Thyroxins" Does that mean FreeT3 & FreeT4? My triglycerides are my main reason for the Crestor. Also, I take Fibercon to help with Diverticulitis. Will that interfere with the Levothyroxin (levothyroxine)? I must admit, I don't understand the way the Thyroid hormone level is tested.  If your level is over the 3.0 that means you are low on TSH? That's confusing to me. Do you think 50mcg is a good starting dose for me at my level of 4.94? I saw in an earlier post where you said 25mcg.  
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649848_tn?1357751184
You should not take the Fibercon at the same time as the levo, as it will interfere with the absorption of the levo.  Take it a few hours apart or take it at night, with the levo in the morning.  Vitamins, minerals and other supplements should not be taken within 4 hours of levothyroxine.

TSH is not a thyroid hormone.  It's a pituitary hormone that's trying to stimulate the thyroid to produce more thyroid hormones.  It's counter intuitive.  When thyroid hormones are low, TSH is higher in an effort to stimulate the thyroid to produce hormones and when thyroid hormones are higher, TSH is lower to indicate that there's plenty of thyroid hormones.  Your TSH is higher, so your pituitary says there's not enough thyroid hormone.

Free Thyroxins, most likely stands for Free T4.  Are you located in U.K, by any chance.

You're probably okay with the 50 mcg, since that's what your doctor prescribed for you.  Many doctors will start off with a dose of 25 mcg, but some believe 50 is fine.  It takes 4-6 weeks for the med to reach full potential in your blood.  If you find that you have symptoms of over medication, such as diarrhea, sudden weight loss, excessive sweating, etc, ask your doctor to retest and ask about reducing your dosage.

Be sure to ask about testing Free T3 as that's the hormone used by individual cells.
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Avatar_m_tn
Thank you so much for explaining all that to me. Now I understand things better. No I'm in the good old USA. I'm REALLY worried about hair loss too because I've already thinned to the point that I can't afford to loose any more or it's gonna be wig time. Would it come back if the meds caused me to loose more?  OH God I certainly hope not. I'm gonna ask my Dr. about the Free Thyroxins & make sure they get lab orders for the Free3 & Free4.
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649848_tn?1357751184
I'm happy to know that you're in the US, where you have a better chance of getting good thyroid care; however, it's  very distressful to know that there really are doctors in here that are ordering tests called "Free Thyroxins".  Kind of tells me your doctor might know a whole lot about thyroid care.  You definitely should check to make sure that includes both Free T4 and Free T3.

Hair loss is a symptom of hypothyroidism.  Typically, once you get started on medication, hair will grow back; however, it's not unusual for symptoms to worsen before they get better.  It's also important to note that the body takes care of the most important functions first, such as heart rate, body temperature, etc - and hair loss is not one those, so it could be a before the hair loss is reversed.  It's very possible it could stop, though.
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Avatar_m_tn
My Dr. is an Endocrinologist so he should know all about the thyroid. Ya know, I don't have any problem with the cold. Matter of fact I tend to get hot very easy. But then I also have Ichthyosis so I just don't cool down very quickly. And with the Ichthyosis my skin is so dry that I wouldn't hardly even be able to tell if my skin was dry because it's always dry. But I definitely did notice it got worse several years ago about the same time I started noticing hair thinning. And I've been blaming my energy loss on the diabetes. I absolutely cannot loose weight and when I was put on insulin I gained even more. My Endo was amazed that I never lost any weight when I was having an A1C of 12.5.  I'm confused on the Free Thyroxin comment. Is it a bad thing that he called it that? I just started going to my Endo in Dec. Before that my family Dr. was treating me. He had checked my Thyroid years ago & also went by the labs old range. So he did nothing about it. My Endo gave me the option of whether or not I wanted to start on meds. All the labs here seem to be outdated & the Dr.'s go by their ranges. It's been so long since the ranges were changed I can't help but wonder why the labs don't update their ranges? I haven't started the meds yet cause I have company & I'm waiting till they leave in case I don't feel quite right when I get on it. Like I said I'm anxious about things like palpitations, Hair loss, being even more tired, etc. I've read peoples horror stories & it worries me. Sometimes I'm not even sure I want to go on the meds. In your opinion is 4.94 TSH a good enough reason to take meds?
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649848_tn?1357751184
Just because a doctor is an endo doesn't mean s/he's a good thyroid doctor.  Many endos specialize in diabetes and know very little about treating thyroid conditions.

I'm sure they Ichthyosis has a lot to do with your dry skin and it would be difficult to tell what's caused from that and what's caused from thyroid, but if you noticed a definite difference at one time, that may have been when your thyroid levels began dropping.

Diabetes will definitely cause lack of energy.  I'm surprised that your endo would think you'd lose weight with an A1c of 12.5... not everyone loses weight with sky high blood sugar levels.

It's not really a "bad" thing that he used the term Free Thyroxin, but it's so seldom used, that it shows that he might not be as up to date as we'd like him to be.  And the fact that he didn't order a Free T3 test pretty much backs that up.

You're right that very few labs have made the switch to the new reference range.  I'm not sure why; I guess because it's easier for them not to.  They'd have to change all their calibration standards, etc and as long as no one complains a whole lot they have no incentive to change it.  Doctors only look at what's on the lab sheet and that's what they go by.

TSH is never a good reason to start a thyroid replacement med.  Your doctor should have tested Free T4 and Free T3 and should be basing your treatment on those, along with your symptoms, not TSH.  Another reason I'm suggesting he might not be a real good thyroid doctor.

When are you supposed to retest your blood?  If you wait too long to start the med, it won't reach full potential before it's time to test, if your doctor is having you test in 6 weeks, which is typical when just starting out, since it takes 4-6 weeks for the med to reach full potential in your blood.  You might try splitting the pills for a few days to make sure you tolerate it before you take the full 50 mcg if that would make you feel more comfortable.

Don't go by other people's horror stories.  Those aren't that common.  You  have to remember, the people who have good luck with their medications don't post on forums like this.  We only get the ones who have issues.  

It's not unusual to feel worse for a while after you start taking the med, before you feel better.  It takes your body time to get used to having the hormones it's been doing without and everything has to rebalance. This is normal.
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Avatar_m_tn
So, is the Free thyroxin test "not" a test for Free T3 & Free T4 ?
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649848_tn?1357751184
Free Thyroxine is a test for Free T4 only; it does not include Free T3.

The complete, technical term for T3 is triiodothyronine, which is shortened to T3, for obvious reasons... the lab order would have to indicate either Free triiodothyronine or Free T3 in order to include Free T3... you said the order states "Free Thyroxins"... I have no idea what the "s" on the end would be for.  If your doctor intends that to include Free T3, that's one more indication that he's not well up on thyroid testing/treatment, even if he is an endo.  
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649848_tn?1357751184
I guess you should be thankful he's willing to treat... many doctors won't treat until TSH is much higher and they won't even test FT4 or FT3 at all.  This means that symptoms are allowed to get much worse before they receive treatment.  

If I were you, I would, however, think about looking for a different doctor, if this one isn't testing Free T3, because there may come a time when you may need to add a T3 medication and neither of you will have a clue as to your levels.
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Avatar_m_tn
Well Barb I'm certainly not going to start any meds until I get more detailed info on further tests. Thanks to you. How is it that you are so knowledgeable on the thyroid?
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649848_tn?1357751184
Oh, I think you're okay starting meds, you just may not need to start on that high a dose - depending on your symptoms, which I've been remiss in not asking about.  You mentioned weight; what others?

I've been through this (bad doctor/inadequate testing/poor treatment) and have seen a lot of others go through the same thing, here on the forum.  I've been on the forum for 6 yrs and was helped here; I've continued to do a lot of research, along with others, in order to help myself and others get through it and back on the road to recovery.  It's not easy, especially, when you add other conditions and/or inadequate care to the mix.
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Avatar_m_tn
Hi Barb. I've had basically fatigue, hair thinning, worsening of my already dry skin, and the inability to loose weight. I sure can gain tho. My sister has Graves disease & my oldest daughter has Hasimotos so I guess it is a hereditary thing. Oh yeah, and a cousin also had thyroid problem. My endo is the only one in my area. We live  outside of  a small town. But, I'm gonna make sure he gets the correct testing done before I go on any meds. I appreciate your knowledge & help. I don't know much about thyroid. I love that I can connect to the internet & learn from others that have the same experience. I won't get my labs again until I've ben on meds for 6 weeks.
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649848_tn?1357751184
Autoimmune diseases run in families... but not all family members will get the same autoimmune disease.  Both Graves and Hashimoto's are autoimmune.  There's a good bet you have Hashimoto's.  Ask to be tested for it.

You don't necessarily need an endo to treat thyroid.  Even a knowledgeable primary care doctor can do it as long as they are willing to test/treat adequately.

Your symptoms all run the hypo gamut. Unfortunate that you can't get labs until you've been on med for 6 weeks; I'd sure like to see an FT3.  
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Avatar_m_tn
I'm going to email my endo & request a new set of lab orders to include the FT3 & FT4 before I even start any meds.  And then If I start any meds at a later date I will have it all rechecked in 6 weeks. Does that sound about right?
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Avatar_m_tn
I'll also request the test for Hashimotos.
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Avatar_m_tn
Ya know I said I had thinning hair on my scalp but I might add that I have lost all hair also on the rest of my body. Legs, armpits, nothing. I've been blaming everything On old age & diabetes.Thank God I had enough super thick hair on my head that the thinning over the last few years hasn't made me bald yet but I can't afford anymore thinning.
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Avatar_m_tn
Hi Barb. I contacted my Endo & I now have my lab orders for FT3 & FT4 which I am going to do before I even consider starting any meds. Should I fast or not before the blood draw? I've researched this on the internet & have gotten conflicting answers.
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649848_tn?1357751184
Hi fricky, how's it going?

Fasting is not required for thyroid blood work; however I often end up fasting for it anyway, because I'm having other blood work done that does require it.

Because TSH may be lower later in the day and after you've eaten, you may want to have the tests done while you're fasting.  Since you're not on thyroid medication yet, your FT3 and FT4 won't be affected, but once you get on medication, particularly, if you ever get on a T3 medication, you'll need to wait to take that after your blood draws or you'll get false highs.

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Avatar_m_tn
Thanks Barb. I'll keep you updated on my results when I get them.
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Avatar_m_tn
Hi Barb. How ya been? Well, I got my lab results and ranges. TSH 3.19 (.35-4.94)  FT4 0.8 (0.7-1.5)  FT3 2.7 (1.7-3.7)   My last TSH was 4.94 @ the same lab. I have not taken any meds. Doesn't look like I need them. So, do you think these ranges are very updated? I know the TSH has been changed.
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649848_tn?1357751184
We know the new range for TSH is 0.3-3.0 and your TSH is just over that.  Your FT4 is only at 13% of its range, so it's getting down to rock bottom.  Your FT3 isn't too bad yet, at 50% of its range.  It often take FT3 longer to come down, because the body is converting most of the available FT4, to keep going.

In my opinion, it does look like you need thyroid med.  You'd do well to start thyroid medication at 25 mcg and work up, depending on future labs and symptom alleviation.

You should get tested for thyroid antibodies to determine if you have Hashimoto's.

How is your diabetes control coming along?
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Avatar_m_tn
I won't see my endo again till Jan. I think. So, I should ask for a Thyroid antibody test at that time? That's when he will be ordering new labs for everything. What type of reactions should I watch out for when I start on thyroid meds? What exactly is Levothyroxin (levothyroxine)? Gee, I didn't think I even needed the meds. You broke it down into percentages. You are one smart chick.  I really appreciate your help. I am thyroid illiterate. We are constantly working on my diabetes. It's getting better all the time.  
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Avatar_m_tn
My Endo was just leaving it up to me as to whether or not I wanted to go on meds because it wasn't that bad, I guess.
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Avatar_m_tn
Hey Barb, you there?
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Avatar_m_tn
Hi Barb. As you know I am considering going on the Levothyroxine 25mg for starters. I was wondering if being on the meds will in any way affect my lab results in Jan. when I have the Thyroid Antibody test done?
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649848_tn?1357751184
Hi Fricky

Yes, I know you're considering going on Levo.  No, the med shouldn't affect your antibody count.  You either have antibodies or you don't.
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Avatar_m_tn
Thanks Barb. How long should I stay on the 25mg before I up the dosage to the 50mg  that was prescribed? Any side effects to watch out for?
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649848_tn?1357751184
Dosage increase would depend on symptom relief and blood test results.  Typically, when we start on thyroid medication, we stay at a dosage for 6 weeks, then retest and go from there.  When I was put on thyroid hormone replacement, I was started at 25 mcg for 2 weeks, then increased to 50 mcg for 2 weeks, then to 75 mcg for 2 weeks, then on to 100 mcg.  At my first retest, my TSH was rock bottom and my doctor freaked out and started dropping my med back down, even though symptom relief was a long way off.

If I were you, I'd probably stay on the 25 mcg for a couple weeks, then go up, if that's okay with your doctor.
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Avatar_m_tn
Thank you Miss Barb.
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649848_tn?1357751184
You're welcome.  Good luck and be sure to keep us posted on progress.
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