I am a newby too - hiya! I would think that the doctor might want to know about these symptoms. From the reading I have done, I seem to read stories about people being put on the lowest dosage available first. I think you already "have a feeling" that the dosage may be too much for you....

Hello...it's good to have a place to gather information and find support.

I just received a message from my doctor(I can't speak) stating I do have Hashimoto's Thyroiditis. I told him I was concerned with some of the symtoms/reactions I am having. Hopefully, he'll have some recommendations.

WOW! I bet it feels good to finally know exactly what you are dealing with!

Hey ShoeFreak, (I, too, am a shoe freak)
Welcome to the hashimoto's club! Sorry you have it, but glad you found us. There's alot of smart folks here.

Here's my take on what you asked, K?

"I'm worried as I'm supposed to be at 50 mcg for 8 days and then increase to 100 mcg. The way I'm feeling now, I can't imagine increasing the dose! Is this normal? Does it improve? "

This is called titration (moving up in dosage or starting meds for the first time) and it is not for the faint of heart. it's hell. But, it's a hell that you can only walk through. It DOES get better, but it can take several weeks. I'm thinking that your symptoms are because you're HYPO/Hashi's and not because of the meds - here's why - synthroid (and I'm assuming it's synthroid, levothyroxine,etc from the dosage you listed) takes about 4-6 weeks to get into your system, which means you won't "feel" it for about that long.

So, in 4-6 weeks you should know what the 50 mcg is doing to you. However, since the doc is bumping it up to 100, you'll have to wait an addition 4-6 weeks after you start the 100 to know what -that- dosage is actually doing to you, ya know?

I think I know where he's coming from, he's increasing it because your TSH is so very high - which means your extremely HYPO, but slow and steady is my motto.

You can always try it, and then see where you are once you get there (4-6 weeks from taking the 100). If you need to back off, you can back down to the 75 if ya need to, but I wouldn't do anything like that until you get your next set of labs (that should contain a Free T3 and a Free T4 test), K? Why? Because, you, dear lady, are extremely HYPO!

Let's look at the tests you provided:

Free T4
Range: 0.700 -1.800
Result: 0.900
Percent of range: 18.18%

*most* people feel well with a Free T4 of 75%-100% of range (or slightly over for a few people). Yours is sitting in the basement at 18% of range. That means you have almost no Free T4. I think your doc was right to start you off at 50mcg. Your symptoms are not coming from the meds - they're coming from lack of Free T4.

Free T3
Range 1.700 -3.700
Result: 2.500
Percent of range: 40.00%
*Most* people feel well with a Free T3 of 75-100% of range. Yours is 40 percent of range. That will most likely get better when your Free T4 level comes up, which is why your doc started you out on T4 only meds (if I'm assuming correctly that you're on synthroid/levothyroxine)

Here's more on Hypo and Anxiety/Weakness/Shaking:
http://tiredthyroid.com/feeling-hyper-when-hypo.html

http://www.dailystrength.org/groups/thyroid-resources/discussions/messages/17753905

http://www.dailystrength.org/c/Hypothyroidism/forum/18006043-hypo-and-muscle-weakness



http://hypothyroidmom.com/300-hypothyroidism-symptoms-yes-really/

I suggest you tuck this away for future reference when you're feeling a bit better
Good newbie info:
http://www.dailystrength.org/groups/thyroid-resources/discussions/messages/17754063

MButterfly...Thank you for the wealth of information; I really appreciate your response. It's a bit overwhelming dealing with another health issue, but I'm determined to be optimistic about the complex journey that lies ahead.

My doctor did email me back, and he wants me to take 50 mcg of Levo EOD for a week, and then return to 50 every day. I'm hoping easing into it will take care of the throbbing head, dizziness, nausea, and stomach pains that started when I began taking Levo 2 days ago. Do you know if weight/size impacts how well Levo is tolerated?

I'll definitely check out the links, and I also ordered several books from Amazon that should arrive tomorrow. Yes, I own a Nook, but prefer the nostalgia of turning pages, smelling the newness, etc.

Thanks again...Shoefreak(Glad you love shoes, too!)

Here's the recommended dosing for synthroid

http://reference.medscape.com/drug/synthroid-levoxyl-levothyroxine-342732

As you can see 50 is a good starting dosage. some people start with 25, but you are EXTREMELY hypo.

Your symptoms are coming from hypothyroidism, not the meds. It takes a full four-six weeks for them to get into your system.

If I were your shoes, I'd take 50 EVERY day. Skipping days freaked me out - because six weeks later BOOM one day I felt ok, the next i felt like crap.

"I'm hoping easing into it will take care of the throbbing head, dizziness, nausea, and stomach pains that started when I began taking Levo 2 days ago."

All those symptoms are HYPO related.

In RARE instances, some people are allergic to the intert ingredients. I'd give it a full six weeks before I decided to ditch.

MB did her usual job of covering all the bases.

I can appreciate her suggestion of trying to knuckle down and take the 50mcg daily.

However, if you really want to start off with a lower dose, I suggest splitting your 50mcg tabs and take 1/2 each day.

While many of us can successfully alternate doses (as in, I alternate 125mcg and 137mcg), a 50mcg difference in day-to-day intake is waaayyyy too much.

That can put a person on a bigger roller coaster ride than titration already means.

Another consideration is your adrenal function. If you read the patient leaflet that accompanies your prescription, you'll see that adrenal function is to be confirmed before starting treatment.

Many doctors don't do this (mine didn't) and those with untreated adrenal issues will have an even harder time adjusting to thyroid meds.

Believe you me, titrating thyroid meds is no picnic but, it is soooo worth it in the end.

MButterfly,

"Your symptoms are coming from hypothyroidism, not the meds. It takes a full four-six weeks for them to get into your system."

I'm a bit confused by this as the throbbing head, stomach pains were new symptoms once I began Levo, and the nausea/dizziness/weakness were more pronounced than previously. I had headaches prior to Levo, but nothing like the throbbing(it felt as though my head my explode)!

I decided to take CD's advice and I took 25 mcg this morning instead of zero as my doc suggested. I don't want to be on a bigger roller coaster than I'm already on.

My leaflet didn't say anything about adrenal testing prior to taking, and my doc didn't do the testing. I will mention this to him.

Thanks again...ShoeFreak

ShoeFreak

When we start thyroid meds, it's VERY common for old symptoms to worsen and/or new ones to develop. Unfortunately, this can continue until our levels are optimized.

It's not the meds per se that are doing this but, instead, your body's response to the introduction of new amounts of thyroid hormone.

To help others understand just what's happening with our bodies and how we respond to thyroid hormone, I use a sponge analogy.

Before I do that, you may know that thyroid hormone fuels every single cell in our body. No system can function properly without adequate amounts and that's why hypothyroidism can manifest in countless symptoms related to different body systems.

OK...here's my sponge analogy:

A hypothyroid body is like a dried-up sponge....certainly not performing at its best as a fully saturated sponge would represent.

The different-sized holes in the sponge represent the different body systems that need thyroid hormone... in different amounts....that change from day to day.....all for proper function.

When we first start taking thyroid meds, the body is thrown into flux.

Some of the hormone might go to the biggest holes but, more likely than not, the new amounts of hormone aren't enough to fill the holes. This means old symptoms will continue

However, as the body might try to fill one of the bigger holes, one or more other holes might become even more dried out.

That's when we experience new symptoms.

All of the holes need to be completely saturated with thyroid hormone for us to function properly.

Since each body system needs a different amount of hormone....and that needed amount can change from day-to-day, it's important to keep getting dose adjustments until our sponges are fully saturated.

Our dose ultimately needs to be adequate enough to keep the sponge fully saturated while the holes are having hormone taken out of them.

This process can take 10-18 months. (it took 15 months for me).

Hypothyroidism treatment isn't for the fainthearted but, once we get to the "other side" (optimal levels), it is soooo worth it.

Please know that it's entirely possible to achieve freedom from thyroid symptoms (I did) but it takes time and perseverance.

I think your doctor Rx'd 50mg with instructions to go up to 100mcg because he recognizes just how hypo you are.

You see, the longer we take an inadequate dose, the greater our chance of developing symptoms and the greater the possible number and duration of symptoms.

You are paying the price now for a possibly shorter journey towards optimal levels.

However, not everyone adjusts to new doses the same as others do and they need to titrate more slowly.

No matter what, everyone benefits from regular dose increases during titration. Otherwise, the agony is prolonged.

Hope this makes sense. I will gladly clarify things - please ask.

CD...Your analogy is perfect! I realize this isn't going to be an easy journey. I do feel better today in that the 25 mcg has made the new symptoms not as pronounced. Thank you for suggesting taking half rather than skipping today.

"I'm a bit confused by this as the throbbing head, stomach pains were new symptoms once I began Levo, and the nausea/dizziness/weakness were more pronounced than previously. I had headaches prior to Levo, but nothing like the throbbing(it felt as though my head my explode)! "

With thyroid disease symptoms aren't always as "clear cut" as they seem to be which is why it's so important to keep a symptom journal complete with rx dosages and dates. :)
Here's what happens with thyroid hormones (again if it's not clear, please ask questions) :
Your thyroid levels have tanked (you can see that by your labs, right?) What you're feeling RIGHT NOW is the thyroid hormone (T4) you had in your body FOUR TO SIX WEEKS ago. It takes that long for T4 to get into or out of our systems (see CD's sponge analogy).

So, your new symptoms may be from a complete lack of thyroid hormones that are just now causing your cells to scream at you because they lack thyroid hormones. They're just now feeling the lack of thyroid hormones from 4-6 weeks ago. Make sense?

Here's why I mention it: When I first started with thyroid meds - my thyroid was tanking just like yours (my labs resembled yours as well). When I started taking synthroid - I blamed all my new symptoms on the synthroid - why? Because I thought it worked like taking an asprin - as in: take the med=gets into system immediately and causes symptoms. It doesn't, and I didn't know that. So, what did this genius do? I asked for a decrease in meds. That made me sicker. Why? Because my thyroid hormone levels continued to tank. The synthroid wasn't to blame (which I didn't know then) it was the hypothyroidism. I simply don't want to see you make the same mistake.

I know it can be confusing, but just remember that synthroid doesn't work like an asprin, it takes 4-6 weeks to get into your system.

I understand. I truly do. I've been where you are, and it's not pretty.

Cd, per usual, did a brilliant job of explaining things! She is the guru who helped me get some semblance of my life back. So, listen to her. :) The key word she used is: PROCESS.

PS I don't know where you live but lots of bugs are going around as well - and the recent arctict blast - all contribute to sever headaches/nausea.

I'm a sensitive creature and I've been down for 3 days due to the rapid weather change/severe headache/nausea.

I was diagnosed seven years ago with hypothyroidism with multiple symptoms and a TSH of 7.2. I also think I had hypo for several years prior to diagnosis. I have been a member of this site for several years. I am also very sensitive to medications. I was unable to tolerate even 25 mcg when I was first diagnosed. I started on 12.5mcg and even that brought side effects. I persevered and was able to take 25 mcg after several weeks. I believe that it takes a while for a body to adjust to medication. Medication is one part of your treatment but it's also important to take a holistic approach-good nutrition, sleep habits, exercise like walking, rest when you need to, stress reduction are also very important and will help. Because I cannot tolerate the medication dose I would need to keep my lab numbers optimal, I accept that my labs will never be as optimal. But I opt for balance over labs. It will take you time to feel decent again. I have never felt quite like I used to but I am not as young as I used to be either. However, I am able to live a normal life. I think I have a different point of view from others on this site as I try to manage my lifestyle more than labs and medication adjustment after 7 years. But I send you lots of encouragement as you manage this new health condition.

Hey JoanK - Nice to "see" you. Great post!

You're absolutely right when you say: "Medication is one part of your treatment but it's also important to take a holistic approach-good nutrition, sleep habits, exercise like walking, rest when you need to, stress reduction are also very important and will help. "

It's essential to do ALL those things. I'm also VERY sensitive to meds (not just thyroid meds). I had to ramp up slowly. I started at 25 mcg but I felt like someone had given me crack for a while (I've never had crack, for the record, but I'm assuming that must be what it feels like - lol). I've white knuckled it through a few titrations, but I don't recommend that for everyone. And, there's been a few times I couldn't do it and had to back off the dosage for various reasons (mainly the feeling like I'm on crack reason).

If you're doing what works for you - then please feel free to share what that is - as much or as little as you feel comfortable with. It's not a one-size fits all type of disease. At least, not in my experience.

JoanK22...Thank you for your reply. I do like to think I have a few good things going for me in that I do exercise; although it has to be low impact because of my disk issues. It can be a challenge with the dizziness and difficulty getting air/shortness of breath, but I do what I can. I also try to eat somewhat healthy, and buy/grow organic when I can. I don't follow a gluten free diet, but I don't consume a lot of grains, anyway. I also don't eat much meat, and instead of 3 big meals a day, I have 5-7 small meals/snacks. I may try go grain/gluten free for a week or two just to see if it has an impact on how I feel.

Do you supplement with herbs/vitamins?