Skip a dose or two?

I just want to skip a dose or two of levothyroxine to see how I'll feel. I read somewhere that after over-medication that it could be helpful to skip a dose or two. My doctor just told me to keep taking lower dose. Will it hurt to skip a dose to see if I can get some relief? Will this mess up my labs I have in two weeks?

[Clutter]

Mary, It would have helped speed up wash out of the higher dose if you'd done it 2 weeks ago when dose was reduced. The higher level will have washed out a week ago so there's really no value in doing it now.

If you want to try it go ahead, it's not dangerous, skipping a couple of doses now is unlikely to mess up blood tests 2 weeks away.

[Heloise]

There are many steps after T4 is taken to make any difference. Some feel that you do not need to take a daily dose since it goes through this process.

Thyroxine (T4) is a prohormone and is relatively inactive. It has to be converted to T3 by the body. An enzyme removes one of the iodine atoms to accomplish this. As much as 80% of T4 is converted to T3. T3 is three to five times more potent than T4. So the efficient conversion of T4 to T3 is critical, and levels of circulating “free” T3 are essential to well being.

[Hidden]

mary212,

You only increased 25mcg of Levo for five weeks and then reduced straight back to original dose over two weeks ago. I feel the main effects of that extra 25mcg Levo should have left your body by now.

It is unusual for a TSH of 9.0 to reduce to 0.06 on just a 25mcg Levo increase. Again I suggest Hashimotos and ask whether you are really over medicated? Thyroid issues are complicated and hypo can often present as hyper symptoms.

Skipping doses usually wouldn't be felt too much by a person with a stabilised hormone level, but it might greatly relieve someone with an excess of thyroxine. However without blood tests you may make yourself feel worse.

As I have previously suggested you need to get thyroid tests T4, T3, TSH, TPOAb and TGAb to assess what exactly is going on.

You can ask your doctor if he is cooperative but otherwise there is private testing, details given in link below

thyroiduk.org.uk/tuk/testin...

mary212, thyroid hormones inbalances can be really horrid and scary but remember once you are stabilised again, you will feel better.

Flower007

[Hidden in reply to Hidden]

I am going to try stopping a couple doses as I feel I am over-medicated. I know what under-medicated feels like and this isn't it. The insomnia and weight loss and lack of appetite are too much.

[Hidden in reply to Hidden]

I never thought a hormone imbalance could make you feel so awful. I had no idea this could be such a long, drawn out suffering. I should have known something was wrong with my dose much sooner. Other dose increases didn't make me sick. I always felt normal and better after a dose increase. So my Dr says it took me a month to get the way I am now, so it could take that long to be better. I can't picture doing this for that long.

[Hidden in reply to Hidden]

Hang in there mary212.

A lot of us have been there too and know how you feel.

Time will heal.

Sending Sympathies and hugs,flower007

[JillOliver]

Hi Maryd212,

I've just done exactly that, well last weekend. Been over medicated for a long time and when I came back off my holiday I just felt completely toxic! Also came back to my latest blood test results, that I had done the week before I went on holiday and again they showed I was over medicated, so I thought that's it, I'm going to have a few days off the levo altogether, which I did last weekend, didn't take any at all Last Sat and Sun. I felt tired and slept more, but I had just come back from a hectic walk everywhere holiday, so not sure if it was that or the no levo. Anyway I started taking it again at a reduced dose last Monday and have stayed on that reduced dose now for a whole week. I did feel tired, but now I feel amazing to be honest, hardly any aches and pains, which I had plenty of on the higher dose and I also feel a lot less bloated and just less toxic! Be prepared to feel the tiredness though, but try and ride it out. I see the doc on Tues this week, so I'll see what she thinks.

Good luck!

JillO

[Hidden in reply to JillOliver]

So you went in for bloodwork 2 times and were over-medicated both times. How far apart were the tests? How much was the decrease? I can't sleep on my own without medication so perhaps skipping would help me sleep on my own.

[JillOliver]

Well my blood tests were a whole year apart, but last year my free t4 was higher than this year, but I was adamant that I was ok and in if anything under medicated, due to how crap I was feeling a lot of the time, so I refused to lower it, but like I said I felt completely toxic a few weeks ago and just thought right I've tried everything else, all these supplements etc and I am going to have a couple days off the levo now, I wanted a whole week really, but chickened out after the two days...and yeah I feel a bit tired, but I'll see how I go. I was hovering between 200mcg and 175mcg and am now on 150mcg, but I did have to lower my levo anyway, as I am also giving t3 a go alongside the t4

JillO

[Hidden in reply to JillOliver]

You must handle the excess medicine a lot better than me because I can't imagine a year of over-medication. What exactly were your symptoms when you decided to decrease? I know you felt toxic, but in what way? I'm glad you're feeling better than before.

[Heloise in reply to Hidden]

Maybe the information in this paper would help.

mythyroid.com/optimalthyroi...

[Heloise in reply to JillOliver]

mythyroid.com/optimalthyroi...

Maybe this article will help.

[SassyAF in reply to JillOliver]

Jilloliver I am also on 200 mcg levo and have been told to decrease to 175mcg. Can I ask how much t3 you are taking please x

[JillOliver]

Well I have been over medicated before a few years ago now and I couldn't sleep, lost loads of weight, but felt great! Of course the sleepless nights couldn't go on, so I did have to lower it, but this time I just felt bloated, dull headache lurking in the background, aches and pains and holding onto weight! Seemed to be sleeping ok though...well, a bit restless in the night, but I can get some sleep.

[Hidden]

You didn't have anxiety? I'm sorry if I'm being intrusive. I just like to know what others go through. I don't like taking sleep meds, so I have got to get some relief. Let me know if you continue to feel better on your decreased dose. I like to know if I have something to look forward to.

[JillOliver in reply to Hidden]

Well funny you should say that, because I did start to have what I think we're mini panic attacks, just an overwhelming feeling of I'm either going to be sick or pass out or both! Most bizarre! And they were only fleeting, so would last for seconds and not all the time. Not had any recently though and looking back now, I used to feel quite nauseous a lot of the time...

[Hidden in reply to JillOliver]

I have had to ask my husband to stay home with me at times because I am scared to be home alone. The stomach issues like nausea are what's most troubling now. I'm losing weight and am afraid I will get too thin as I am a small person. My Dr says nausea and vomiting are normal for being over-medicated, but it makes me miserable. I don't want to go through it any longer and that's why I want to stop the levothyroxine for a few days to see if it will help. Why would my Dr want me to keep taking something I have an excess of to the point of making me ill?

[JillOliver]

Yeah, I'm quite surprised that your doctor wants you to stay as over medicated, as most would prefer to see us under! And you shouldn't be suffering this much!

[Hidden in reply to JillOliver]

Well, I'm not in the UK, but I like the this forum. Maybe doctors here just want to do everything "by the book", but that's not helping me. It makes no sense to me. I would think the Dr would suggest a few days off meds.

[JillOliver]

I hope the doc sorts you out and sooner rather than later, it's not nice feeling the way you are!

[Caprice123]

My doctor told me that thyroxine, T4, has a half life of 6-7 days, which means that the drug takes this amount of time to get rid of half of the drug in your body. Thyroxine converts very slowly into T3. I am elderly, so I take T3 along with the T4, which helps with the conversion process.

[mummyG]

Mmm... As I'm trying to lose some weight and feel better .. I got some t3 from my holls 3 weeks ago in Corfu... After reading loads about t4 n t3 and converting and toxic and over medication .. I have been on 100 Levo and added 6 mi of T3 but felt not much so I tried adding 6 1pm too. But I felt my heart beating in the night and was wide awake

So... I'm now going to try 50 mic of Levo and 12 of T3

What do you all think of that ??

It's soooooo confusing and as I'm feeling really really mentally on the edge about my weight I will try anything

Thanks xxx

[Hidden in reply to mummyG]

I don't take T3, but all I can say is do not over-medicate on T4. You will get sick. When I was optimal in T4 it took a few months to lose weight I had gained from being hypo. Someone else will have to answer T3 questions.

[MrsRaven]

I am trying the same thing. My new GP noted with apparent horror that my TSH is 5.5, but i am on 100 levothyroxine, so being overmedicated. I have T3 in my blood, but its fair to say she didnt suggest cutting down, and she ordered resting cortisol bloods and has referred me to the endo. I have a big problem with weight gain, exhaustion mental and physical, fluid retention, constipation and in fact everything that suggests I have low thyroid, including carpal tunnel and extreme irritation amounting sometimes to savage anger. i struggle to get through a day. At one time the T4 was treating me successfully at this dosage level but not now.

[humanbean in reply to MrsRaven]

If you are on levothyroxine, then you must have been diagnosed with hypothyroidism. As a general rule of thumb (there are loads of exceptions), if TSH is high then you are hypothyroid, and if TSH is low you are hyperthyroid.

If you are taking 100mcg levothyroxine and your TSH is 5.5 then you are under-medicated and need an increase in your meds.

A healthy person will have a TSH around 0.5 - 1.5, a hyperthyroid person will have a TSH below about 0.05 (not sure about this exactly), and a hypothyroid person will have a TSH over about 5 (according to the medical profession, but symptoms start for many people with a TSH over 2).

The idea of treatment given by doctors is to get TSH to the same level as a healthy person. Doctors only pay attention to TSH which is actually a pituitary hormone, not a thyroid hormone. Patients however, often don't do well being monitored by TSH and need to know levels of FT3 and FT4.

But it is quite clear in your case that you are under-medicated, so there should be no argument from your doctor. Your TSH is too high. You need more levo. No wonder you feel ill!

Oh, your comment about having T3 in your blood, I find strange. Everyone needs T3 in their blood, it is the active thyroid hormone that gives us energy and warmth. Most hypothyroid people don't have nearly enough of it!

[MrsRaven]

She said that my ferritin levels are normal, she didnt specify what level. Or how much T3. I got the impression that she didnt really know what she was on about. She ordered resting cortisol tests, and obviously some info has been sent to the endocrinologist, whom I am seeing in October, because I received the copy of a letter today, from the endo to my GP, saying I now have subclincal hyperparathyroidism. apparently I am having a "short Synthen test" to test cortisol reserve. Its gone right over my head.

[JillOliver]

Hi Mary,

Sorry for late reply!

I take it you have your latest blood test now? I left off the levo for either 2 or 3 days and then started on a lower dose of levo, so went from 200mcg, had my 2 or 3 days break and started on 150mcg levo. Yes I felt real tired for a few days, but I put up with it and started taking 12.5mcg T3 and that seemed to perk me up almost straight away. Still on that combo at the mo and have an apt. to see an endo in Oct.

JillO