correct dosing?

[marijo44]

I was recently diagnosed with underactive thyroid. My T4 level was just below 11. My GP started me on 50 mcg of levothyroxine. I also take tramadol and fentanyl patch for chronic pain, and oramorph occasionally for breakthrough pain. Since I started levothyroxine, I went immediately from being cold all the time, to perspiring profusely. My blood pressure has shot up, and is around the 190/100 mark or thereabouts. I have horrible;le tinnitus, and my chest aches, and generally I feel weird. Is it possible my dose is too high for starters. Or should I give it a bit more time to settle. I have only been taking it for two weeks so far, but I absolutely hate the perspiring. I wake up several times in the night completely soaking, and I feel so tired, and my eyesight has also gone a bit blurry. Not good ,generally. I need to be careful, because I lost my large bowel and associated bits two years ago, and now have an ileostomy, so have to watch that I dont get dehydrated, and I think this has already happened to me a couple of times, when I have been completely out of it, and My husband thought I had been drinking....at 10.am....and mixing up my meds. This has caused us to fall out I must add. Any advice or words of wisdom would be very welcome.

[marijo44]

I think I made a mistake above.It was in fact the thyroid stimulating hormone that read at 10.7. I was getting confused!! So its more than twice the upper limit which here is 4.5. Its quite difficult to get my head around it.
Thanks again.

[marijo44]

Thank you for your reply. I ended up going to the Doc this morning as I felt awful. He has reduced my dose to 25 for a month, and then review with a blood test. I looked at the screen to try and work out what results meant. I should really have asked for a printout. Whatever one I can remember that read 10.7, I'm not sure now, but I know the normal range for that one is top level 4.5. Also he said that the antibodies test was positive. I asked what that meant, and he said that it indicated that I might develop thyroid problems in the future. I did not quite understand that remark, as I thought I already had this problem, I certainly have many of the physical symptons, and surely that is why I have started thyroxine.
This forum is very good and informative. Thanks to all who contribute.

[Super_sally888]

Hi,

Do you know what your TSH levels were?  They should also test FT4 (not t4) and you need to post the reference range as well, becuase different labs have different values.

It is really difficult to know what a correct dose would be for you, and it varies for everyone.

However, based on what you're saying you may need to start on a much lower dose, and then titrate it up gradually over a period of months.

An appropriate starting dose, given your symptoms, could possibly be 25 mcg (but do please work with your doctor).  This could be every day, or even every second day.  Then test in 4 - 6 weeks for TSH, FT3 and FT4 (ideally).  Based on the results of these tests, you would then make a further small adjustment in meds, if necessary.  Keep testing every 4 - 6 weeks until your levels are stable and you're feeling good.

After that testing can become less frequent.  Every 4 - 6 months would be appropriate, but more frequently if you have symptoms.

Hope this helps.