midwest1

I'm not certain what exactly "low colonic motility" is, but I suspect that's a fancy-dancy phrase that means constipation... And most of us here know that's part and parcel of classic hypoT. And did you know that many thyroid experts consider fibro and CFS to be the muscular and sleep manifestations of the lack of enough thyroid hormone? In other words, at least some of your conditions might just be plain ol' hypoT, which will improve when you finally get as much T hormones as you need.

The fact you have lupus and Raynaud's indicates you probably have the autoimmune version of hypoT, too. Not that it will change your treatment, but it might be a matter of interest to you.

It's probably rare for a body that has been deprived of thyroid hormone for months or years not to react intensely when those hormones are suddenly in increased supply. Doctors just don't tell you it happens, but it does. I reacted so strongly and unfavorably to Synthroid that my then-doctor ran $2000 worth of unnecessary tests looking for an explanation for the symptoms the Synthroid caused. His ignorance about thyroid treatment prevented him from realizing this reaction happens.

As GH said, you might be having an allergic reaction to the inert ingredients in the pill. Hypos have allergic reactions many times more often than the general population, and so reactions to hypo meds are common as well. Allergic reactions usually manifest themselves as rashes and itching... that sort of thing. Another issue might be the apprehension about taking the med in the first place... a sort of mini panic attack.

T-4 is absorbed very slowly. It is unlikely you'd feel panicky or nervous from just one dose. I won't say it can't happen, though, since everyone is unique in their reaction to the med. My suggestion would be to cut the dose in half, taking only 25 mcgs for two weeks, then increase to the full 50. But if you still have a reaction to that minute a dose, it might be due to weak adrenal function. All of the hypo meds prescribing information includes a statement that adrenal function ought to be tested before meds are begun. I think very, very few doctors follow that advice; but if adrenals are low, the added stress of more thyroid hormone sends them into a tizzy, increasing your stress level.

If all else fails, ditch the T4-only med and ask for Armour thyroid. It's gentler on the system for most people, and just plain works better.