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[KaraShannon]

Another question today, 2 in one day 

Anyone taking levothyroxine, if you miss a day, do you feel pretty rough the next day and also have a bit of an upset stomach?

I think the way I'm feeling today is due to missing a dose yesterday due to it not being available, but wondering what other's experience is. 

Thanks 

[SundayGirl]

The half-life of levothyroxine is quite long, about 6 or 7 days if I'm remembering correctly so missing one dose shouldn't make much of a difference.

Having said that, I've been on 100mcg for years but am currently trialling 75mcg instead of the 100 for one day per week instead. Took my first 75 on Saturday morning and Sunday and Monday felt a bit jittery and tummy flipping anxiety type feelings. Also had the thing where it feels like your heart stops and then gives one almighty thump then settles - had that a lot before my hypo diagnosis.

So, although the science says it shouldn't make a difference, it may well do. I'll find out next weekend if it was a one off or not.

[Wrensong]

As SundayGirl says, the half-life of Thyroxine is meant to be about a week, so in theory we shouldn't get any significant upset, but I do find my body reacts to dose changes, up or down, usually with disrupted heart rhythm for a few days.  So wouldn't be surprised if you are registering the missed dose.
Wx

[KaraShannon]

Thanks Sundaygirl and Wrensong

yes half the problem I find if there's a missed dose going to be on the cards due to some blip at the pharmacy or surgery is I'm told it won't make a difference.  I know the science says it doesn't but interesting that you both seem to get effects.  I always do, but not had the upset stomach before upon taking the next dose of thyroxine.  That said another medicene was messed up the other day, so it's probably the combination. 

I was fine about an hour after posting anyway, a lot better now.  I'm interested that you both mention heart rhythm, my heart definitely skips beats if a dose is missed.  Again I've been in the doctor's years ago asking for a slight increase in meds and being told that too much thyroxine does this, not too little.  But one doctor agreed I might need a slight increase and the heart skips went away.  Not saying the doctor's are wrong, an induced hyperthyroidism from over medicating would do it too, but there are some things that occur that the general science does not report or make clear. 

Another interesting thing was that my heart skips settled on HRT as well plus it gave me some energy, so it seems it worked alongside the thyroxine to assist me. 

Anyway, thanks for the replies   

[Wrensong]

Hello KaraShannon, glad to know you were feeling better a little while after posting.  Yes, there seems to be a misconception among medics who are not endocrinologists that it's only being overmedicated that causes heart disturbance.  But there's frustratingly a widespread lack of appreciation about the complexity of thyroid disease among medics who are not Endocrinologists.  I can categorically say after nearly 30 years on thyroid replacement that changes of dose whether up or down do affect my heart rhythm for a few days & we don't have to do much reading around on hypothyroidism to discover this is definitely a thing.

Another interesting thing was that my heart skips settled on HRT as well plus it gave me some energy, so it seems it worked alongside the thyroxine to assist me.

I was plagued by very scary ectopics throughout peri & for several years into postmenopause & these didn't resolve until I started HRT & had a change of thyroid meds (reintroduced T3) within a few weeks, so not sure which finally sorted the palpitations, maybe a combination of the two.  But as with any changes in thyroid dose, changes in HRT also bring back the heart rhythm disruption temporarily for me.  Tends to last about 2 weeks. 

Anyway, your original query was about digestion possibly being affected & as we all know thyroid medication governs our metabolism with systemic effects, the whole body can be affected by any changes.  I certainly find the rate of throughput is reliant on optimising my meds.
Wx

[KaraShannon]

Thanks Wrensong

It highlights the importance of doing our own research on this condition.  My doctor said mine was hashimotos, so it's autoimmune. 

I've noticed that increasing my selenium intake (not too much or it's toxic apparently) and eating foods with lots of 'minerals' in like salt etc actually helps me (as long as natural, not things like crisps, but fish etc, and cut out as much gluten as possible!).  I'm sure at times I get that condition (hyponatremia or something?) where I'm too low in salt.  Lots to look into and try to improve on. 

[Wrensong]

Yes, I have Hashimoto's too but also had partial thyroidectomy many years ago & I'm a v poor converter of Thyroxine so have to take T3 as well.  I find I have to be careful with selenium & magnesium.  I avoid wheat on gastroenterologist advice, but I'm no longer completely GF.  Do you stick to the same brand of Thyroxine for absorption consistency?

[KaraShannon]

I've always been on levothyroxine, for 23 years.  I hear about the T3 thing and that levo gives poor conversion to T3, but it's been so convenient, especially here where my current GP surgery don't agree with use of T3.

Another thing to find time to look into, but I generally feel well on levothyroxine, probably more so since starting hrt, but I've got mild prolapse symptoms at certain times of the month and wonder if everything is being done that can be.  I sometimes wonder if the hrt did that, who knows, but it made me feel better in many other ways, heart skips well reduced.

[Wrensong]

If you are well enough on Thyroxine, T3 is a complication you can do without, believe me!

Have you seen a women's physio/gynae/colorectal surgeon (depending on type) for advice on the prolapse?

[KaraShannon]

Thanks Wrensong, I will if need be, I'm trying to get the HRT right first as it's only happening at certain times of the month and I think it might be when oestrogen low and progesterone high..

Also I need to reintroduce some sort of vaginal oestrogen but I'm avoiding because of other life stresses and it's been known to give me migraine, so waiting for the right moment to start at a gentler level and see if helps first.

[Wrensong]

The muscle relaxant effect of progesterone can exacerbate any laxity & there's the double whammy that if it also slows your gut function any consequent bloating increases pressure on the pelvic floor.  I think you're right that vaginal oestrogen could be helpful when you're in a position to try again.

[KaraShannon]

Thanks Wrensong.

The weird thing is I have a lot more energy when I have the progesterone and oestrogen combined.  I read that progesterone supports the thyroid.  At the moment I've got ringing in the ears and migrainey, not enough to be a problem but enough to notice and while talking to someone on the phone today I couldn't wait to get off because of my head ache (and unfortunately it was work so it was an hour long).  I'm either about to change to combined tonight, or on Sunday, not sure, that's another thing I've got to work out before I can put my feet up tonight, lol.  Been a long day.

[Wrensong]

Yes, progesterone does seem to rev the thyroid & I think that's part of the problem I had with it.  It certainly made me way too hot & wired to sleep.  There's an interesting study here, albeit small, that found it increases FT4 levels.

https://www.aapec.org/images/BibliotecaVirtual/1.4.3.clin_endocrinol_2013_79_2_282-87.pdf

I've got a long migraine history & tinnitus & I know just what you mean about feeling migrainey some days.  I do often get that sense on HRT, but thankfully not full blown migraine with intense headache.  Touch wood, that seems to have stopped with final period.

[VioletAquarius]

I've forgot to take my levothyroxine a few times but I don't get any problems when I do forget.