Chest pain and dizziness with Levothyroxin?

[samia906]

Hi,
I have Hashimoto and I really want to know if having chest pain and dizziness is normal with 25mg of levothyroxin. I started on 50mg last week and the side effects were so unpleasant! chest pain, sore throat, feeling low, mild panic attacks, feeling dizzy, unable to concentrate, short of breath.I swear I was much better before the medication. I stopped it after 2 days. I went back to the doctor and she said there is no other cure to reduce my TSH of 10 even though my T3 and T4 are normal! I must go back on levo! I am what is called subclinical hypo. I have antibody antithyroglobulin which is attaking my thyroid (level is 440 and should be less than 110 normally!). I am now on the first day of half the dose and it is not much better. Apparently, the symptoms get worse before they get better? Is that true? anybody out there with similar symptoms and eventually got better? How long do these awful symptoms last?

Thanks Samia (32 years old)

[gimel]

It may be that it is not the levothyroxine itself, but a reaction to it caused by other problems.  Just for example, it is always a good idea to test and assure adequacy of cortisol before starting on thyroid med.  Another possibility is low ferritin.  It is important that ferritin not be toward the bottom of its range when starting on thyroid med.  If tested for either of those, please post results.

What symptoms did you have and what were your thyroid related test results that caused the doctor to initially diagnose you as hypothyroid?  Along with the TSH of .004, were you recently tested for the biologically active thyroid hormones, Free T4 and Free T3?  If so, please post results and reference ranges shown on the lab report.  

[sunduss]

I experienced similar symptoms about six weeks after I started on a 100 mcg dose of levothyroxine. Chest pain, heartburn, muscle aches, palpitations and dizziness. After two months my tsh had gone down to 0.004 and my doctor stopped my medication. I didn't take thyroxine for 3 months and felt much better, chest pain had vanished. But when I started again on levo, similar symptoms appeared. My sick of levothyroxine.  

[gimel]

Please post your thyroid related test results and reference ranges shown on the lab report from before you started on the levothyroxine,  

[Barb135]

This is an old thread and Samia906 is no longer active on the forum.  It's unlikely she will respond.

[Jeda01]

I have had the same symtoms as you. I have a goiter with nodules and have a lump feeling in my throat. I was started on 75mcg and have had sweats, bad pain in the back of my neck, headache, dizziness, tremors, I feel horrible.

[goolarra]

Both you FT3 and FT4 are low in their ranges.  As a rule of thumb, target for FT4 is midrange and FT3 is upper half of range.  That's where many of us have to be before hypo symptoms are relieved.

Were those results before you ever went on meds?

Are the symptoms you listed prior to meds or now that you're on meds?

Prior to meds, did you have any of the "traditional" hypo symptoms?  Fatigue and/or drowsiness?  Cold intolerance?  Weight gain?  Hair loss?  Constipation?  Etc.  You can google for a more complete list.

[samia906]

Hi Goolara

test results and range, what do you think?
TSH = 10,66 ( range 0,4 - 3,8)
Free T3 =3,0 (range 2,3-4,1)
Free T4 =0,89 (range 0,6 -1,3)
Thyroglobulin antibody 440 (range less than 115)

symptoms: regular cluster headaches with neck and upper shoulder pain, low mood swings, heavy and irregular periods, lumpish feeling occasionally in throat

[goolarra]

The medication takes six weeks to build in your system to its full potential, but your levels are rising during that time.  If you move slowly, you'll be able to tolerate the increases.  No one was more sensitive than me, and I managed to do it, but it took me over a year to go from 25 mcg to 75 mcg.

Hashi's is a degenerative disease.  As the antibodies attack thyroid tissue, you lose more thyroid function all the time.  Sometimes that can take years, or even decades, and sometimes it can go like gangbusters.  Since it takes so long for meds to build in your system, we often feel more hypo at first because we're not keeping up with the progression of the disease.  Also, our whole endocrine system has to readjust.

Your FT4 is very low in the range (assuming a range of 0.8-1.8...you should check your lab report and make sure that's very close to your lab's range.  FT3 is also low in the range.  The target for FT4 is midrange, and FT3 upper half to upper third of range.  Reference ranges vary lab to lab, so when you post results, you have to post ranges as well.  The best way is:

FT4 0.89 (0.8-1.8)...the test, the result, the range in parentheses

A heart arrhythmia is an irregular heartbeat.  It can be too fast of too slow or uneven.

If you read the dosing instructions for Synthroid, you'll see that if you are over 50, or you've been hypo for more than a few months, or you have a heart arrhythmia, starting dose should be 12.5-25 mcg.  Since you think you've been hypo for a couple of years, you'd be in that category.  Start low and take baby steps.  

GERD is acid reflux.  

[samia906]

Dear All,
Many thanks for your support and comments. I do admit that I am feeling pretty glum with the side effects of levothyroxin. I am now taking 25 grams for last 4 days. feeling rather strange with periods of low mood, sluggishness,chest pain, breathlessness, dry skin and lump feeling in throat . The doctor says the medication takes 6 weeks to get in the system and I should be taking 50 grams! no way! I find it strange that I am having the effects so quickly and not nice effects! It is so strange to have the side effects of being hypo when I am actually taking medication against it! I was diagnosed Hashimoto because I have been trying for a baby for the last year and no luck :=(((. apparently it has something to do with hashimoto??! It came up in a fertility test. Goolarra, in response to your questions Free T 3 was 3 and T4 was 0,89. TSH 10,66, thyroglobulin antibodies 440. What is heart arrhythmia by the way? yes, I think I had hashimoto for a while with many symptoms of hypo for about 2 years, it got worse with time  (PMT moodiness, heavy periods,regular neck and shoulder pain and headaches esp after periods, difficulty to lose weight). I am 32. Pattysha, what is GERD?

[Kaz1969]

Sorry to hear this. I had similar problems when first diagnosed. Now whenever I have a change in medication I have to increase very very slowly. I often have to break tablets in half or even quarters! I usually increase my meds over about 8 weeks. Starting with half doses then every other day.  Good luck

[Kaybaby1984]

I was also just recently diagnosed with hashimotos disease this came as no shock to me. My mother was also diagnosed only  6 years ago.I am lpn so this disease is nothing unknown to me. I have and still go through the same side affects you have mentioned. You must understand hashi's is nothing like hypothyroidism. You can have hashi's and hypothyroidism but hypothyroidism does not lead to hashimotos.We have many symptoms of both hyper and hypo as our bodies attempt to fight it out with our thyroid. As our thyroid is under attack we admit more hormones to fight. In turn you may feel your heart pounding, sweating, hotflashes and even difficulty sleeping or staying asleep at night. As your thyroid becomes over taken by antibodies and cells begin to be destroyed you will go into the hypo mood. Where you may feel tired, confused, muscle pain and weakness the symptoms may very by person but they can feel horrific in both states. So yes they will get worse way before they get better and depending on the amount of damage done it may be years before you feel better trust me. Mine has been severly destroyed as i have seen through an ultrasound. there is now recovering from destruction just medicating and moving forward.

[Pattyisha]

When I was first put on 75levo last april, I did experience a variety of unusual symptoms, chest pain being the most worrisome. It tapered off and went away when my levothyroxine was dropped to 50. I also had what we thought was GERD but nothing was found and it went away too. Best of luck to you!!

[MRS_MELMS]

I was put on 75mg levothyroxine last july. I've been experiencing chest pains, some dizziness,lots of anxiety attacks,and some fatigue. My anxiety gets do bad at times, that it literally exhausts me and I end up taking a nap for a few hours and wake up feeling better. Has anyone else felt these symptoms? I'm wondering if my dosage should be lowered because when I accidentally skip a day, I don't experience any of these feelings...it's like I'm normal again. It's been scaring me. I put a cool rag on the back of my neck and other does help relax me and calms me down. this feeling is scary

[goolarra]

Please post your actual FT3 and FT4 results and reference ranges (ranges vary lab to lab and have to come from your own lab report).

TGab that high is really not unusual.  We often see numbers in the thousands.  My TGab (just for the sake of perspective) on diagnosis was "greater-than 3,000" and my TPOab was 900-something.  

There is definitely an adjustment period getting used to meds.  Once you've been hypo for a while, your body is no longer used to having thyroid hormones available.  It's found other ways of compensating, and everything has to fall into it's new place.

You sound very uncomfortable.  If I were you, I'd ask my doctor about starting even lower...she could give you 25 mcg tablets that you could break in half.  While the symptoms are usually transitory, they can make you pretty miserable for a while.

How old are you?  Do you think you were hypo for quite a while?  Any history of a heart arrhythmia?