I hope someone will get back to me on this one. The anxiety I'm going through is a nightmare.
I do believe I have over medicated as I am having palpitations, anxiety like you would never believe, cannot sleep, lost appetite, rapid weight loss over the last three weeks, headaches and tinnitus.
My last blood test from August last year showed that my T3 was low:
T3 3.8 (4.0 - 6.8)
This didn't mean much to me until someone here pointed this out to me.
In December last year I increased my levo by half a 25mcg as I was still experiencing symptoms of under medication. After the increase my skin improved and so did my hair, etc.
Three weeks ago I began having anxiety attacks, headaches, etc. and I noticed my eyelashes were falling out. My dr had blood test done and the results were my T4 jumped from 18.6 to 25.3 (12.0 - 22.0) and my TSH dropped from 1.8 to 0.55 (0.27 - 4.20). I now realise these are symptoms of too much medication.
I somehow find it strange that half a 25mcg could account for this but also note that during that time I changed my diet drastically cutting out gluten increasing good foods and also including supplements and began taking my levo at 4 a.m. Maybe absorption had changed.
What do I do to stop these horrible feelings? Can I stop the medication for one or two nights and then lower my medication? How do I go about this? I'm feeling awful.
My Dr has arranged for an endo appointment but I cannot wait until then. Please can someone help here. Thank you.
Written by
mischa
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Mischa, your FT4 is slightly over range and your TSH is low, but within range. Those results don't scream overmedication to me but it is possible that they aren't quite right for you. Being gluten free may have improved your absorption, it does for some people. Skip 2 or 3 days doses and cut back to the dose you were on prior to increasing by 12.5mcg to see whether the anxiety improves after a few days. The higher dose will wash out within 8 days and skipping a few doses will hurry it along.
Thank you for getting back to me so quickly. Its the waking up every morning with anxiety sitting in your stomach that's so awful. And it doesn't go away. Over the next couple of days I will leave out the doses and restart at a lower dose. Once again thank you.
As a matter of interest can you explain to me exactly what pooling is. I've heard of it but am not sure how it happens and would my symptoms occur as a result of pooling?
Mischa, I'm not at all knowledgeable about pooling. I think it means the T4 hangs around rather than converting to T3 but I don't know how FT4 and FT3 look when pooling occurs.
I had a buildup of T4 which may or may not be the same thing. It made me very ill but FT3 was also below range so won't have helped. Having stopped T4 for 3 months and T3 for 2 weeks all symptoms cleared within days but resumed within hours of starting T4 again so it certainly wasn't a build up or pooling then and adding T3 calmed the adverse symptoms.
I will be seeing an endo but am waiting for the appointment. They normally take the T3 test alongside the other tests before they see you. I am very interested in knowing what the T3 shows because I too think it could be a problem with conversion. If this is the case then I am going to have to think about adding T3 to the T4 I already take but I also strongly believe I'm going to have a tough time getting it on prescription. Anyway let's see what happens.
Stop taking T4 for a while. But I wouldn't do it without seeing your blood test results first.
In the meantime, start thinking : if I'm not convert, why aren't I converting?
First step : check your vits and mins - vit D, vit B12, folate, ferritin, iron. These all need to be mid-range for you to use the T4 you're taking. Vit B12 needs to be even higher - at least 600, preferably more. Low levels of nutrients could also be causing symptoms.
Thanks for getting back Greygoose. My D levels are 131 (25 - 120) so thats high. Ferritin is 123 (13 - 150). I take iron, Vit C, biotin, zinc, Evening Primrose Oil, Magnesium, Selenium, B complex, Fish Oils and a good quality multi vit. My diet is gluten free. I make vegetable juices everyday, eat protein and I don't eat junk. I don't know what my B12 levels are.
I must be converting some because most if not all of my hypo symptoms that I had initially have gone. These latest symptoms are new. Puzzling.
Okkkkkk... Tinnitus could be low magnesium. Most people are low in magnesium, and being hypo puts you at a further disadvantage.
Anxiety, could be low cortisol. Have you ever had a cortisol test? That could also be why you aren't converting very well - I know you're converting some, or you'd be dead! lol But with a high FT4 like that... I take it you're not taking something like 200 mcg levo. Also, your TSH is not as low as it would be if you were converting well. If you see what I mean.
So, next step, see if you can get some sort of cortisol test. The best, of course, is 24 hour saliva, but that would have to be private. I think you might get a 8 am blood test on the NSH - if you can find a doctor that knows what it is!
Contrary to the concept of pooling, I think given the changes she has implemented in her diet and supplements, she's probably using the thyroxine better than before.
4 days off and resuming at previous dose should help.
Back in 2012 I increased from 112 to 137. Everything was going along charmingly well. I did a lot of work at home (physical stuff) that had been a sore to the eyes for years.............then BOOM! Same symptoms as what mischa is reporting. It took from end of October to first week of January at the higher level and I was into hyper zone. I just stopped taking everything for 4 days and then resumed at alternate days dosing.
mischa, trying to get T3 is such a long miserable road (unless you are extremely lucky) and self medicating requires a lot of self confidence only achieved by gaining more knowledge, and being completely desperate.
I would definately play with Levothyroxine dosages. Given you have changed your diet, supplements and meds timing, it is just too much of a coincidence to be ignored that you suddenly appear to absorb so much better.
You may well have just found the answer to making your meds work for you.
If this is the case all you need to do is reduce. Don't be afraid to experiment going up or down 25mg.
mischa, I experienced many positive changes happening when I went totally gluten free.
I just think you should take one step at a time. If reducing meds combined with your new healthy life style isn't cutting it in 6 month time, then is the time to look at alternatives, i.e. the addition of T3.
Hormones take a while to settle down and Levothyroxine takes many days to really totally enter or leave your system.
Have you had any Vit D, Vit B12, folate, ferritin blood tests done recently? If you are deficient in any of these if can affect how your thyroid meds work.
Also have you been tested for thyroid antibodies - TPOAb and TgAb?
A lot of hypothyroid people have these antibodies causing a disease called Hashimotos thyroiditis. Hashimotos can be made worse by anxiety or upset which in turn may increase the attack on your thyroid sending your hormone balance into turmoil.
You have done well to initiate a healthy life style and hopefully will see many positive changes.
Yes, I have had Vit D tested and it is over range: 131 (25 - 120). I was supplementing but have now cut back. Ferritin 123 (13 - 150) appears good. I haven't had B12 or Folate tested.
I have Hashimotos thyroiditis. In May last year my TPO results were 315 down from 383. I suspect when I see the end this time I will get another test for this.
I hear what you say about anxiety or upset and yes, I have been very anxious over the last four weeks and was like it when I had the last lab tests done last month. I was wondering if this may account for the high T4 levels. I don't know. At the same time I was eating healthily and exercising (walking everyday). I have lost a lot of weight and I read that this also could affect T4 levels taking you into over medication. I'm working on the anxiety but I do find it difficult as it can be overwhelming and this is new to me. I haven't experienced this level of anxiety and insomnia before.
I will stick to what I'm doing and work on relaxation.
thanks for the info - it is valuable and your support.
Well done. If it is of any comfort I too have been suffering huge anxiety attacks. This is totally new to me and I just know how well a calm approach has helped. I bought headphones for night time & play either self guided meditation or relaxation music. The key is to also play it in happy good situations (like sunbathing in the garden as I am now lol) and then transferring those feel good feelings to the bedroom. 3 weeks ago I was dreading bedtime but am managing to sleep much better now.
Cutting out gluten did that for me too. I also got my ferritin up and vit d, b 12 within range and I guess I started converting better because my Tsh dropped to 0.05. I was also experiencing a thudding heart at night but no increased anxiety or restlessness. I've dropped down to 112mcg rather than 125mcg. The thudding heart has gone ( I only noticed it at night) and I have put on a bit of weight which I don't like!
Thank you for the information. Very interesting read. I have just said to janiebell I will have my B12 checked. This appears to be an essential one. It's so comforting to hear from others.
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