Overmedicated? Doesn't feel like it!

My GP has up to now been really good, doing lots of blood tests and actually listening to me, so I'm a bit disappointed at the latest development. She rang me with my latest blood results, and said everything was OK and remarked that I may even be a little over-medicated! I certainly don't feel it. Some symptoms have improved but I still have problems with my hair, skin, sleep, libido and have dreadful mood swings. My antibodies are still very high (though they have decreased from the original 1600-hopefully because of my gluten free diet) and she said she's surprised that my thyroid is not functioning worse than it is, but still seemed happy enough and said she'd see me again in 6 months.

I'm on 100mcg of Levo, which I take at approx 4am-would this be OK if the blood test was taken at approx 12.30?

The results are as follows:


TSH *0.33 mU/L 0.4-4

free T4 17.8 pmol/L 9.25

free T3 3.7 pmol/L 2.8 - 7.5

Thyroid AB screen 1170.0 IU/ml 0.01-34

I'd be very grateful for some opinions on this...because I'm stumped! Thanks a lot.

14 Replies

  • I wouldnt say you were over medicated at all, your T4 is mid range and your T3 is low in the range, for you to be over medicated your T3 would be high. I think I would politely point that out to your GP

  • Pretty similar to mine and I am also on 100mcg and feel very Ok !

  • If you were correctly dosed with levo i would want to see your Free T4 at around 20

    and your free t3 around 6

    So in my book your not on enough meds

    Trust you did not take them for at least 24 hrs before the test

  • I took my levo at approx 4am then had the blood taken approx 12.30. I didn't know she was going to take bloods or would have waited...next time, definitely! I have always felt that I needed more T3 but my GP can't seem to work out if it's available or not in our area. She had to specifically request for it to be tested so I think not somehow!

    I really don't feel overmedicated at all. I joined Slimming World in January and have more or less given up as my weight loss in slow to non existent and it was a waste of money paying a fiver a week when I wasn't losing.

  • I agree you could well benefit from t3

    if you avoid your meds for at least 24 hours next time and complain loudly about a host of symptoms maybe she will up your dosage

    i trust that your ferritin and folate levels are above halfway in their ranges because low ferritin especially can make it very difficult for your body to convert levo /t4 into the t3 your cells are screaming for

  • I'm asuming they are OK as when I was diagnosed last year it was found that my iron levels were actually too high and I couldn't donate blood till they'd come down a bit. I'm going to do as you say and complain a bit more next time. My GP is normally quite amenable so hopefully I'll get somewhere. I really have no idea how she thought I was overmedicated! Have you any thoughts about my antibodies? I know they are still massively high but I'm quite chuffed that they've reduced a bit :-)

  • In all probability because your TSH is low because she is ignorant of the workings of the pituarity feedback system plus you could well have secondary/central hypothyroid in which case tsh will always be low because of pituarity failure

    Do ask about ferritin and folate though because your heamaglobin may well have been high but your ferritin could be at rock bottom

  • OK thanks, I'll definitely ask next time. I'm not due to go back for 6 months but if nothing improves she will be seeing me earlier I think!

  • GPs only think seriously when patients go back for the 3rd time so yes make a nuiscance of yourself

    she cant prove you do not have a whole bunch of symptoms

  • I do have a whole bunch of symptoms so I won't be lying! Last time I complained about my horrendous mood swings but said I didn't want anti depressants so she's arranging "talking therapy" for me which is going to include cognitive behavioural therapy, so she's not all bad :-)

  • sorry but that will not solve the problem which would be easily addressed by better level or kind of thyroid meds

  • You're right of course. Hopefully it will help until the glorious day comes though!

  • I believe you should have missed your 4 a.m. dose before your blood test and taken it afterwards. Next time have your blood test at the earliest time as that's when your TSH is highest.

    Why doctors adjust meds due to the TSH level I don't know. It should actually be on how 'you feel'. They just don't understand metabolism.

    A link and excerpt:-

    What our study shows is that the TSH level is not an accurate gauge of a patient’s metabolic rate. This finding is consistent with what we regularly see when we do metabolic evaluations for patients. We often find that a hypothyroid patient on T4-replacement—with an "in range" TSH level—has a metabolic rate that’s abnormally low. Often, the patient’s metabolic rate is severely low, sometimes as much as 50% below normal.

    For this all-to-common undertreated patient—who suffers from chronic hypothyroid symptoms—the TSH level is simply not an accurate gauge; that is, the TSH level fails to correctly tells us what thyroid hormone dosage will give her a normal metabolic rate.

    Typically, when the patient increases her dosage high enough to raise her metabolic rate to normal, she then has a "suppressed" TSH level. The endocrinology specialty, of course, will argue, or at least imply, that her suppressed level shows that her metabolic rate is too high. But this is proven false by our actual measurements of the patient’s metabolic rate.


    Our measurements of patients’ metabolic rates, then, are objective evidence that TSH levels do not correspond to patients' metabolic rates. If the goal of thyroid hormone therapy is to provide a patient with a normal metabolic rate, the TSH level is for all practical purposes useless.


    Links within may not work.

    You can email louise.warvill@thyroiduk.org for a copy of the Pulse Online article by Dr Toft, to give to your GP, and highlight question 6 which says that some need a suppressed TSH and maybe the addition of T3. (ignore the para after this as it is rubbish and Thyroiduk has already written to complain to him).

  • Thanks very much for that Shaws. Do you mean to get an early as possible appointment and take me Levo after? I will be very interested in the results!

    I will get the article by Dr Toft but as I'm not due to see her for 6 months I think I will take the cowards way out and send her a letter with a copy and let her ruminate on it so I don't have to try and persuade her face to face. She is really nice but I always feel awkward when I have to try and tell GPs their job!

    Can I ask what you make of my antibodies reducing? I'm rather chuffed but perhaps it doesn't really mean anything as they're still really high?

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