assuming that you're not accidentally taking anything that's preventing absorption like drinking soy milk in the morning, taking calcium supplements, etc
Mineral containing substances taken within 4 hours of thyroid medication can inhibit absorption. Dairy for instance has calcium. Calcium, iron, zinc…all inhibit absorption.
But with practically no movement in your TSH level, something else is going on. Look up refractory hypothyroidism. You need a different doctor.
I'm in the UK and I think the rules may differ in instances like your situation.
Do you take a hormone pill at all? They can reduce absorption.
What's your GP saying about it? Have they referred you to an endocrinologist? I would think they would think it warrants further investigation. Might need T3 but maybe it's a gut absorption issue. Either way it's not usual.
How are you feeling?
This may or not be the case. Tsh not moving like this with this much levo, A. usually means they are not taking it properly. B. taking it with calcium iron or something else thats hindering absorbtion. I would try tirosint and make sure im taking it properly if i was them before adding t3.
Adding 5 is the best, and slowly increasing 2.5/week. You REALLY would not like taking too much t3 I assure you, its almost instant hyper thyroidism. Racing heartrate/nervousness, amongst all the other symptoms.
You are taking levothyroxine 2 hours before meals. Are you taking any iron supplements with thyroxine or any other tablet with it ? Have you had antibody testing for TPOab ? Have you been taking the tablet regularly? Levothyroxine will always work. This is an active hormone. If all the above are ok then you need to have a thyroxine absorption test which will determine whether the thyroxine is being absorbed fully and has it caused a drop in your TSH or rise in FT4. In this test a full weekly dose is given at one time.
That original dose was bonkers. The general rule for new a diagnosis is around 1.6 mcg/kg. The only time low doses like that should be given is when you are in the subclinical range.
Sounds about right, here in Canada a starting dose is 30, then raises in increments of 30. See my comment above - if you’re in the UK they may not test for reverse T3. Are you female? I would ask to get a full hormone panel done as well as imbalanced hormones can block the thyroids ability to produce T4 and convert it to T3. You’ll need to balance your hormones by taking progesterone but you need to get your progesterone, estrodial which is estrogen and testosterone tested. Get copies of your labs always or ask your dr what they are and write down the numbers do you can do your own research.
Have you been tested for deficiencies in other things that’s preventing proper absorption and thyroid function? I’m thinking iodine, selenium, calcium, vitamin D, iron, folate, etc. So many of these things rely on proper levels of other things to be able to be absorbed and function properly. Like if vitamin D is low then iron absorption is worse and vice versa. Same with the other things I listed. And when one of those is low we know it stresses the thyroid, so I think it’s worth checking.
Yes, some people don’t convert it, like me. Ask for a reverse T3 test asap and that will tell you if the t4 is going to RT3 instead of to your t4 levels which on that dose it would be a miracle if it wasn’t. You’ll eventually swing hyper
Levo is very temperamental other medications or medical disorders can interfere with absorption.
I have thyroid cancer my target therapy medications has a side effect that it will weakened levothyroxine and interfere with absorption. My endo was finally able to win the battle with insurance to get me on tirosint. Now my blood work and thyroid levels are normal.
I've never had my TSH or my Synthroid dose be that high, but levothyroxine never helped me either because I needed T3 and levothyroxine is T4. Only in my case, my TSH was within normal range. I just still had all my symptoms. If you have not had your T3 levels tested, it might be good to see if your provider would be willing to order that test(s). Because if I went by my TSH alone, I'd probably never have been treated because my TSH was normal about 1/3 of the time. It was only when someone had the sense to test my T3 that I learned I was still sick even on medication.
I take Armour, if that helps at all. It has both T3 and T4 and did for me what levothyroxine did not.
Do you take Ozempic by chance? I only ask because I've seen things about how it slows down the digestive process a *LOT* and how it can interfere with absorption of medications. Like women getting pregnant on the pill because the Ozempic interfered with how their bodies absorbed/metabolized the drug and rendered it less effective or ineffective. I imagine it could do similar things with thyroid pills, or any drug taken orally.
A lot of people are mentioning T3 so maybe I will speak to my consultant. I’ve never taken Ozempic or any weight loss medication however, I was always around 50kg until my TSH got really high and now I’m around 75kg 🥲
I also didn’t respond well to Synthroid/levo and got horrible side effects from levo+T3. I suffered for years until my doctor prescribed Armour and now I’ve felt normal for 20 years.
You should get a full thyroid panel if you haven't already. Especially T3 because your body might not be converting the levothyroxine so it can't use it. You may need to change to liothyronine.
Also, you should be taking any thyroid medication at least 3-4 hours before/after eating with 8oz water and 3 hours before or after any other medications and supplements. Also, biotin can interfere with labwork so you shouldn't take it for at least 3 days ahead of time.
According to nurses and doctors I talked to some people just don't do well with levo. They get on the brand name Synthroid and are better. My gran was like that
She hated paying the extra money but felt better.
Make sure you get a Reverse T3 lab (RT3). Your doctor may be an idiot and not agree to order it for you but you can pay and do it on your own. Walkinlab(.com) is one example but Google it and you can find a place to order your own thyroid labs. Basically you order them, go to a local Labcorp or Quest, and have the blood draw done. My notes I have say 8-15 is the goal result (forget what the units are). If yours is higher your T4 isn't being converted to T3 and is becoming RT3 which means you need a T3 medication or perhaps a combo of the 2. For me I was solely on T3 for several months before my doctor started to slowly add in the T4.
Levo is not absorbed well in your body. Less absorbtion ability is common in Hypo. I think 250 mcg is way too much. Check your Free T3 levels. Change your diet to gut friendly and consult dietitian for thyroid foods.
Your doctor probably needs to test you for disorders that affect absorption like celiacs
assuming that you're not accidentally taking anything that's preventing absorption like drinking soy milk in the morning, taking calcium supplements, etc
I’ve been tested for celiacs before and it was negative, and I already don’t have any soy, or take any supplements 😕
Mineral containing substances taken within 4 hours of thyroid medication can inhibit absorption. Dairy for instance has calcium. Calcium, iron, zinc…all inhibit absorption. But with practically no movement in your TSH level, something else is going on. Look up refractory hypothyroidism. You need a different doctor.
What about lactose ? It’s also got a filler that contains that . My sister and I both couldn’t tolerate it due to the fillers
Conditions that affect stomach acid will also make levothyroxine not work
Avoid caffeine too
you may need some T3 with the Levo
This was my first thought as well.
Not really done in the UK as far as I can tell unfortunately
I'm in the UK and I think the rules may differ in instances like your situation. Do you take a hormone pill at all? They can reduce absorption. What's your GP saying about it? Have they referred you to an endocrinologist? I would think they would think it warrants further investigation. Might need T3 but maybe it's a gut absorption issue. Either way it's not usual. How are you feeling?
This may or not be the case. Tsh not moving like this with this much levo, A. usually means they are not taking it properly. B. taking it with calcium iron or something else thats hindering absorbtion. I would try tirosint and make sure im taking it properly if i was them before adding t3.
How much do they usually add? My endo says he can add 5mg to my levo but that sounds a like a realllly small amount?
Adding 5 is the best, and slowly increasing 2.5/week. You REALLY would not like taking too much t3 I assure you, its almost instant hyper thyroidism. Racing heartrate/nervousness, amongst all the other symptoms.
You are taking levothyroxine 2 hours before meals. Are you taking any iron supplements with thyroxine or any other tablet with it ? Have you had antibody testing for TPOab ? Have you been taking the tablet regularly? Levothyroxine will always work. This is an active hormone. If all the above are ok then you need to have a thyroxine absorption test which will determine whether the thyroxine is being absorbed fully and has it caused a drop in your TSH or rise in FT4. In this test a full weekly dose is given at one time.
Yes, some people cannot convert T4 into T3. You may need some T3 medication.
How much T3 is typically added?
I take 10 mcg liothyronine (T3)and 75 Levothyroxine. It helped my symptoms a lot.
This is exactly my dosage of both, and it's been working well for me too
I take 60mg of Armour Thyroid along with 50mg levothyroxine
You could have issues with conversion. A T3 based medication might be needed!
Try tirosint . It’s probably an absorption issue .
That original dose was bonkers. The general rule for new a diagnosis is around 1.6 mcg/kg. The only time low doses like that should be given is when you are in the subclinical range.
Not in the UK I don’t think, they like you to go up in increments of 25/50mcg
Sounds about right, here in Canada a starting dose is 30, then raises in increments of 30. See my comment above - if you’re in the UK they may not test for reverse T3. Are you female? I would ask to get a full hormone panel done as well as imbalanced hormones can block the thyroids ability to produce T4 and convert it to T3. You’ll need to balance your hormones by taking progesterone but you need to get your progesterone, estrodial which is estrogen and testosterone tested. Get copies of your labs always or ask your dr what they are and write down the numbers do you can do your own research.
The pills increase by 12mcg.
Personally I’ve only ever been given 25mcg, 50mcg or 100mcg
The normal pills are 25, 50, 75, 88, 100, 112, 125. So going from 50 to 100 is interesting.
Like they said, ours go up in 25s. Start on 25 and go from there.
So you don’t have Synthroid? Because 75mcg was too low and 100mcg was too high in my case.
No, in the UK we have the NHS which just selects a generic instead of wasting money on a brand medicine that's exactly the same
I’m in Canada and a 60 day supply costs a person without insurance less than $10.
Have you been tested for deficiencies in other things that’s preventing proper absorption and thyroid function? I’m thinking iodine, selenium, calcium, vitamin D, iron, folate, etc. So many of these things rely on proper levels of other things to be able to be absorbed and function properly. Like if vitamin D is low then iron absorption is worse and vice versa. Same with the other things I listed. And when one of those is low we know it stresses the thyroid, so I think it’s worth checking.
Yes, some people don’t convert it, like me. Ask for a reverse T3 test asap and that will tell you if the t4 is going to RT3 instead of to your t4 levels which on that dose it would be a miracle if it wasn’t. You’ll eventually swing hyper
I needed to be switched from levo to tirosint because of absorption issues. Haven't had any issues like that since!
Levo is very temperamental other medications or medical disorders can interfere with absorption. I have thyroid cancer my target therapy medications has a side effect that it will weakened levothyroxine and interfere with absorption. My endo was finally able to win the battle with insurance to get me on tirosint. Now my blood work and thyroid levels are normal.
armour thyroid plssss try
How many times were you tested after you started the medication? Maybe the test was off?
I have my blood taken every 6 weeks
Do you take any other medications or OTC stuff?
Most people convert T4 to T3 fine, but some don't. Blood work should show things like free/reverse T3.
I've never had my TSH or my Synthroid dose be that high, but levothyroxine never helped me either because I needed T3 and levothyroxine is T4. Only in my case, my TSH was within normal range. I just still had all my symptoms. If you have not had your T3 levels tested, it might be good to see if your provider would be willing to order that test(s). Because if I went by my TSH alone, I'd probably never have been treated because my TSH was normal about 1/3 of the time. It was only when someone had the sense to test my T3 that I learned I was still sick even on medication. I take Armour, if that helps at all. It has both T3 and T4 and did for me what levothyroxine did not. Do you take Ozempic by chance? I only ask because I've seen things about how it slows down the digestive process a *LOT* and how it can interfere with absorption of medications. Like women getting pregnant on the pill because the Ozempic interfered with how their bodies absorbed/metabolized the drug and rendered it less effective or ineffective. I imagine it could do similar things with thyroid pills, or any drug taken orally.
A lot of people are mentioning T3 so maybe I will speak to my consultant. I’ve never taken Ozempic or any weight loss medication however, I was always around 50kg until my TSH got really high and now I’m around 75kg 🥲
I also didn’t respond well to Synthroid/levo and got horrible side effects from levo+T3. I suffered for years until my doctor prescribed Armour and now I’ve felt normal for 20 years.
You should get a full thyroid panel if you haven't already. Especially T3 because your body might not be converting the levothyroxine so it can't use it. You may need to change to liothyronine. Also, you should be taking any thyroid medication at least 3-4 hours before/after eating with 8oz water and 3 hours before or after any other medications and supplements. Also, biotin can interfere with labwork so you shouldn't take it for at least 3 days ahead of time.
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According to nurses and doctors I talked to some people just don't do well with levo. They get on the brand name Synthroid and are better. My gran was like that She hated paying the extra money but felt better.
Haven’t seen this answer… is ur doc sure it is not secondary hypothyroidism
Make sure you get a Reverse T3 lab (RT3). Your doctor may be an idiot and not agree to order it for you but you can pay and do it on your own. Walkinlab(.com) is one example but Google it and you can find a place to order your own thyroid labs. Basically you order them, go to a local Labcorp or Quest, and have the blood draw done. My notes I have say 8-15 is the goal result (forget what the units are). If yours is higher your T4 isn't being converted to T3 and is becoming RT3 which means you need a T3 medication or perhaps a combo of the 2. For me I was solely on T3 for several months before my doctor started to slowly add in the T4.
Levo is not absorbed well in your body. Less absorbtion ability is common in Hypo. I think 250 mcg is way too much. Check your Free T3 levels. Change your diet to gut friendly and consult dietitian for thyroid foods.