Total thyroidectomy, over-medication and managing it; and does anyone else experience vertigo/migraine as 'hyper' symptom?

I have just joined this community and I would like to ask some questions. But first a little background. I am 62 and had a total thyroidectomy over 11 years ago for a goitre that was giving problems with eating and breathing. As far as I know it functioned OK as previous blood tests were always ‘within range’. I was prescribed 100 mcg thyroxine and survived satisfactorily on this (except for one minor blip when it was reduced and then increased again) until last year.

After my annual blood tests last year my GP indicated I should reduce my dosage due to over-medication (FT4 =24.3; TSH <0.05). During the course of this year my thyroxine dosage has varied between 75mcg daily and 100/75mcg on alternative days. On 75 mcg it went too low, though ‘within range’ (FT4=16.1 and TSH=3.64) and my GP put me on to the higher dose. However, 100/75mcg alternatively appears to be too much. Blood tests have been ‘within range’ the two most recent ones being FT4=18; TSH=0.8 and FT4=17.1; TSH=1.3; this last one was in August. However, in September I noticed a recurrence of hyperthyroid symptoms I have reduced my dose back to 75 mcg.

I appreciate this is a long post and I thank you if you have read this far. Now here are my questions.

1. Is it possible for sudden changes in thyroxine levels to happen e.g. ok one month and next month over or under?

2. Is it OK to adjust thyroxine dosage according to symptoms and how one feels without a blood test? By the time I get an appointment and wait on results it can be 3 to 4 weeks.

3. Has anyone with hyper-thyroid illness (either through malfunctioning thyroid or like me over-medication) experienced migraine wih vertigo as an associated symptom?

Any insights on this would be appreciated.

Thanks again.

Liz

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  • Are you sure you are overmedicated?I have had a TTand I am hypo with migrains and vertigo when my TSH is not supressed. Your last T4 is infact quite low. Most people feel best when it is towards the upper end. It would be good if you could get the ranges and also a FT3 done to see what your active hormone is like.

    Roslin

  • Dear Roslin, many thanks for replying.

    The ranges used by our lab are FT4 10-25 and TSH 0.2-5. Browsing other posts I realise I should have given these. (Historically, I have felt ok with FT4 about 19/20 and TSH between 1.2 and 1.5. I have never had tests for FT3 - maybe I should ask, though GP says TSH is all they look at.)

    As you say my last FT4 seemed low/OK. However, about a month after that test I started having what are normally hyper symptoms i.e. intolerance of heat; excessive sweating, especially overnight; palpitations; more frequent bowel movements and diarrhoea; and raised blood pressure (especially systolic). Plus the vertigo and migraines. These were the symptoms I had last year when the GP said I needed to reduce thyroxine. That is why was asking if there can be such changes over a short period of time, like an accumulation which suddenly spikes!

    I asked about the migraine/vertigo because last year when I reduced the thyroxine, the migraines diminished but the GP said this was coincidence as it may be associated with hypo-thyroid but not hyper.

    Thanks again, Liz

  • Hi First thyroid bloods and most others are back in 2 days, ask the receptionist for a print out with ranges. Make sure you also have a Free T3 test, very important. Bloods always vital as sometimes, hypo has the same symptoms as hyper. going over and under is not unusual with Hashi or Graves., specially Graves.Thyroid often gets worse with age.Migraine and vertigo is not a diagnosis, may need a proper one.The vertigo may be Menieres, which is autoimmune. These can be cause by Atrial fibrillation ( A, F) not too serious but you need to know and treat if so, Initially diagnosis is pulse, heart rate, manually for 2 weeks, 3 times a day, especially when having symptoms. If it swings, take the readings to the GP and ask for a home monitor 24 hour or better 7 days, If positive a Cardio and endo are required. A normal ECG will show nothing, the monitor takes ECG non stop fur the duration it is fitted.

    This is just in case,as Af is common and thyroid can bring on an early onset, frequently not diagnosed.

    Best wishes,

    Jackie

  • Many thanks, Jackie. You have given me a lot to think about. I did have a diagnosis of migraine from a neurologist and an ENT specialist ruled out Meniere's or anything else in ear as source of problem. I'll arrange for more blood tests and ask for FT3.

  • Hi, I'm hyper and suffer from migraines, I think it's very common in hyper's. Re the vertigo I would make sure you have your B12 tested.

    Hampster

  • Hi Hampster. Thanks. I didn't realise B12 was an issue before coming on to the Thyroid UK website and this forum. Something else to get checked! Liz

  • Hi No one, I saw seemed to know that the vertigo/. menieres were related to my fast AF,, I just discovered it, later a cadio agreed, In fact I get severe dizziness, before I arrest, it is well known by cardiologists. The only test is how I described ,that is the accepted medical way as intermittent to start with ,so not easy to "catch" any other way. Just worth making sure., if the H.R no problem , you do not need to go any further

    Best wishes,

    Jackie

  • Hi Jackie. Thanks - so many things to think of. I'll follow up on this. Regards, Liz

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