levothroxine terrible side effects after only one pill?

[maries23]

Hi, I went to my dr because of extreme fatigue and a soreness in my thyroid area especially when I try and talk.  My TSH was normal I think in the 2 range and my T4 was .9 just borderline low.  He thinks I have Hashimoto's.  Since my thyroid felt large (waiting on an ultrasound result) and I've been extremely fatigued, he decided to have me take 50 mcg of levothroxine in the morning.  I took this first dose this morning at 8 am and within 20 minutes my chest felt tight, like an elephant was stepping on my sternum.  I called my dr late afternoon and was told to skip tomorrow morning's dose and to try and take it before bed each night instead.  I don't see how this will change my symptoms.  Since the dr phone call, my symptoms have gotten worse with some pain off and on along with continual tightness and now I have this weird nausea feeling in my sternum not in the usually stomach area like you'd have with the flu.  I also feel jittery.  It's 1:40 am and I continue to feel like I'm getting worse.  I don't know if I can tolerate this.  I haven't been able to do anything today other than sleep during the afternoon and sit around all evening.  The odd thing with this was I had these same symptoms when I tried birth control and was never able to find any I could tolerate.  I'm worried what I'll do if I'll never be able to tolerate this med.  Just want some advice.  I really don't know whether to take this 2nd pill like the dr advised.  He wants me on it because he thought my thyroid felt enlarged and this would help bring it back to normal.  I'm worried about my ultrasound results too.  I still can't believe they told me it will be about a week to get those results.  
What should I do?  I thought about taking the pill maybe one more time and if it gets worse then not taking it on Sunday and calling on Monday but then again I don't know if I want to tolerate this med another second.   Would you take it one more time with these symptoms?  Do these symptoms sound like something that could possibly subside?
Thanks for any advice

[medicmommy]

If that happens again, check your pulse rate. A normal rate is around 60-90 beats per min. I wouldn't be surprised if yours is going much faster during these chest tightness episodes. If these episodes ever last, create pain that goes to your jaw, left arm, or back or are accompanied with a cold sweat, call 911 and tell them you think you are having heart problems. Sometimes the heart rate can go so fast it causes a heart attack. Excessive thyroid hormones can cause this as well as blood pressure that climbs too high resulting in a stroke. Not a good thing...~MM

[maries23]

Thank you all again for your helpful advice.  I'm waiting to hear back from my dr about my ultrasound and what his plan is for my med.  At the moment I'm not taking the med. until I hear back from him.
  
I thought I was doing better...which I am for the most part, but when I went out shopping today,  I really felt like I was a getting a little out of breathe and I had a little tightness again in my chest.  It subsided when I got back into the car and was able to sit.  I did not have anything of these symptoms until this med. I am very nervous to take another thyroid med. but yet I know I have no choice but to take something.  I just hope I hear about my ultrasound soon.  

Thanks again all
Hugs

[goolarra]

I'm glad you're feeling better.  I think it was wise of you to discontinue the meds until you can talk to your doctor tomorrow.

Your FT4 is quite low...you don't provide the range, but the FT4 range is usually about 0.8-1.8.  Yours, at 0.9, is too low in the range.  We often find that we have to be around midrange before all hypo symptoms are relieved.

Your doctor's approach could be considered a little bit "backwards".  However, Hashi's or not, the treatment for hypo is the same.  Since you have quite a few symptoms, he probably was trying to get you some relief.

Next time you have lab work, insist on FT3 as well as FT4.  FT3 is the test that correlates best with symptoms.  It will tell you if you are converting properly or if you need to add a direct source of T3 to your meds.

Also, your doctor doesn't have to "guess" about Hashi's.  He should test antibodies, TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies).  If either is elevated, it will confirm Hashi's.  You do, however, need to have both, since some of us are TPOab positive, some TGab positive and some both.

You should repeat labs 4-5 weeks after beginning meds or any change in meds to evaluate FT3 and FT4 levels and reevaluate symptoms.  Three months is too long until your dose has stabilized.

Best of luck...

[medicmommy]

I'm so glad you are feeling better. I've only had an allergic reaction to bees, but I do know what "that feeling" is. -I've actually had to use epi-pens twice (adrenalin shots that self-inject). Not a good thing.
Sometimes a person with a long-lasting allergic reaction needs to be on steroids (usually prednisone or solumedrol) for a few days to combat swelling and cellulitis, but it sounds like you are okay.
Hang in there. At least some thyroid meds don't have fillers and you shouldn't have any issues with taking them, but as others here have said, the meds should be started slow and low. -You can always work your way up to theraputic levels, and your body can adjust on the way. -Just throwing you in the deep end isn't fair or smart. (((HUGZ))) ~MM

[maries23]

Thanks to all of you for your comments.  I am finally feeling a little better.  My chest is so much better, only very mild but I started to feel a little hot to the face and have had a headache today but no rash and I'm not red.  I tried to call the dr about all of this but I guess he doesn't take calls over the weekend.  I was told to go to the ER if it was an emergency.  I decided to not take any more pills after this first one and I am going to call on Monday.
Stella my T4 test was free.  Of course being new to all of this I have no idea what the difference is.  He was making a guess about Hashimoto's.  It really made no sense to me why he wanted to start medicating me first without doing all the rest of the tests.  He wanted me to take this for 3 months and then he was going to test for all the tests you mentioned.  Seems quite backwards to me.  I feel kind of stuck at the moment until I get my ultrasound results back but after all of this and hearing what you all had to say, I plan on trying to find someone else.
Thanks again all

[goolarra]

I agree with both of the above posts.  

It sounds to me like you might also have a "general" intolerance to meds considering your experience with BC pills and all.

Either way, don't despair about being able to take thyroid meds.  Most allergic reactions to thyroid meds are not allergic reactions to the meds in the pills, but to the "fillers" or inactive ingredients.  Different manufacturers use different fillers, and different doses are usually "color coded" so they have different dyes, etc. as well.  Also, a relatively new product, Tirosint, has the same thyroid meds as the pills, but is in a gelcap so is hypoallergenic (no fillers except water).  Keep in mind that the medication in these pills is not really medication, but replacement of the hormones your body would be making if it could.

If you've been hypo for quite a while or if you are very sensitive to meds in general, you might have to start at a lower dose and work up slowly.  I had to start at 25 mcg and work up to 75 mcg over the course of a year.  Some people have to start even lower than that.  Your body is no longer used to having thyroid hormones available, and you have to give it time to accustom once again.

Find yourself a better doctor, and ask about trying one or both of these two approaches.  You'll find one that works.

[stella5349]

absolutely. Thanks MM for suggesting that. Take the benedryl.

What the heck way does this doctor practice good for his patients?  He is not giving you an asprin for Pete's Sake when taking thyroid meds.  Geesh!!

These drugs do not just leave the system if you miss a dose. Once started the effect of taking the pill can last up to 4 to 6 weeks if not longer. Its a hormone you idiot (doctor) not a vitamin... :(

I almost fell off my chair also when you said "He thinks its Hashimoto". He thinks?

hmmmm... where's the autoimmune labs indicating it? You don't rely on an ultra sound only either. A TPOab and TgAb test should be drawn to know this. Also he is basing everything on the TSH lab and God only knows if that T4 test was "total" or "free"

No Free T3 test either on direct thyroid cell in your body... Strike #3 - You're out!

If your doctor was guilt-free after telling you to just stop the Levo and assume he did his job and could sleep that night after saying that... "Run" .... Run as fast as you can away from that flunky and find someone who can really determine your best treatment. In my opinion, that one is a loser.

[medicmommy]

Hi.
Take 50 mg of benedryl NOW. It sounds like you are having an allergic reaction. Do not take another. If you become short of breath, start wheezing, feel like you are going to pass out, or anything starts swelling, call 911. Do you have a rash or are you turning red?
I'm also a newly diagnosed Hashi's patient and was just started on 25 mcg of synthroid (levothyroxine) today. I was told if I had any of the symptoms you just listed to do what I just said. My endo emphasized caution as to dosing too high to start with because not all Hashi's thyroids are equal as each patient's thyroid is in a different "state of demise" and each thyroid is still putting out different levels of natural hormones...
Good luck and feel better...~MM