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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17548
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Levothyroxine 25 mgm. I feel the dosage is too strong, my

Customer Question

levothyroxine 25 mgm. I feel the dosage is too strong, my heart flutters on occasion and my head feels very heavy and I find it difficult to concentrate at times. My TSH Nov 2014 was 4.8. after taking 25 mcg my TSH May 2015 was 5.86. I do feel some better but find it difficult with the side effects of levothyroxine such as heaviness in my head, trouble concentrating at times, heat intolerance, I live in Florida which doesn't help. I may have other problems that I am not aware of altho all my blood work was normal except for an elevated cholesterol. I realize my age may have something to do with it. If i could just clear my head. I have had this feeling for years.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.
Which of these symtoms were present before starting on the levothyroxine?
Were you having any heart fluttering before starting on the levothyroxine?
Customer: replied 1 year ago.
I have been taking levothyroxine for years because of fatigue and difficulty with concentration which cleared several years, now my problem seems to be with me again
I have never had any heart problems and have EKG and stress test within the last 3 years
Customer: replied 1 year ago.
Did you receive my answer?
Expert:  Dr. D. Love replied 1 year ago.
What strength were you taking in Nov 2014 when the TSH was 4.8?
What was the highest that your TSH was before treatment?
Customer: replied 1 year ago.
I reduced the dose and was taking 6 mcg as I felt it was the levothyroxine . I guess that was why I was feeling tired. I realize the dosage was too low so the Dr. increased it to 50 mcg which I could not tolerate so I am now on 25 mcg and I am still having problems. Is there any kind of a diet I should follow, I eat well and take vitamin d and fish oil.
Expert:  Dr. D. Love replied 1 year ago.
Thank you for the additional information.
It is sometime difficult to decide whether to treat when the TSH is only mildly elevated. There is clear evidence that people do better when there is treatment of a TSH greater than 10.0. But when the TSH is mildly elevated but not as high as 10.0, the usual decision of whether to treat would be based on symptoms.
Since the decision of whether to treat is based on symptoms, development of symptoms as side effects to the levothyroxine will also suggest that treatment should be stopped or the dose decreased. If the 25 mcg dose is causing side effects and the 6 mcg dose is not sufficient, then it would be appropriate to use a dose of 12.5 mcg per day. This is a small dose, but if the key here is to balance the benefit in relief of symptoms and avoidance of side effects.
If I can provide any further information, please let me know.
Customer: replied 1 year ago.
Thank you, ***** ***** try taking 12.5 mcg and see what happens. Is it still necessary to take this medication an hour before eating in the morning or can I take it after breakfast?
Expert:  Dr. D. Love replied 1 year ago.
It is best to take it on an empty stomach, and is generally recommended to be taken about 30 minutes to an hour before breakfast. But if it is not convenient to take it before eating in the morning, it would be fine to take it later in the day, about 30 minutes to an hour before lunch or supper. It is also better to be taking it about the same time each day.
Customer: replied 1 year ago.
Thank you, ***** ***** give it a try.
Expert:  Dr. D. Love replied 1 year ago.
You are very welcome.

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