Anyone on 200+ mcg T4 only with successful managing of symptoms

[YulianaRossenova]

Anyone to share their experience?

[Clutter]

YulianaRossenova,

I was over replaced on 200mcg to suppress TSH. FT4 was >35 and FT3 7.0 which was slightly over range. I felt desperately ill.

[YulianaRossenova in reply to Clutter]

Oh, Clutter, even with such a good FT3?!?

[Clutter in reply to YulianaRossenova]

YulianaRossenova,

I think it was the high FT4 which was a problem because I've had FT3 8.4 without feeling over medicated and unwell. I don't tolerate Levothyroxine on its own so that may be something to do with it too.

What is your TSH, FT4 and FT3 on 150mcg?

[YulianaRossenova in reply to Clutter]

TSH 0.04, FT4 25.3 (12-24); FT3 was 6 for a short time and I felt great, no skipped beats, no fatigue, I cleaned the whole house, cooked, played with my kids.

And I began to feel great on the second day of that dose (150mcg), the skipped beats disappeared, my mood improved, I really process T4 quickly, don't know why.

But that good feeling lasted only for 5-6 days, less than a week. Now I am hypo again - fatigue, skipped beats, achy bones and muscles...

Now I will try to get my doctor write a prescription for SR T3. That is my last hope. Since I process T4 and T3 so quickly I hope I will benefit from some SR T3.

[Clutter in reply to YulianaRossenova]

YuliannaRossenova,

Have you tried 175mcg? Some people do need FT4 over range to have decent FT3. Just because high FT4 didn't suit me doesn't mean it will be the same for you.

Read Treatment Options in thyroiduk.org.uk/tuk/about_...

[YulianaRossenova in reply to Clutter]

"Have you tried 175mcg?"

Yes, kind of.

When the beneficial effects of the 150-mcg T4 dose waned on the 5-6th day, I took 200 mcg on the 7th day. Then on the 8th day I felt much better again, no fatigue, only 5-6 skipped beats per day and returned to my previous dose of 150 mcg on the 8th day.

Was taking that for 5 days again until I became more hypothyroid, then on the 6th day I took 200 mcg again and felt better the next day.

This regime worked perfectly well till 2-3 days ago, now I don't feel well on 6X 150 mcg and 1X200 mcg anymore.

I am afraid to raise higher because of a rT3 build-up.

As you can see, I really process T4 very swiftly.

Previously I waited for 6 weeks on 75 mcg T4 to feel the full benefits of the dose and almost died. Actually at the end of the 6-week wait, I felt severely hypothyroid.

Wonder if I feel hypo now because of a rT3 build-up (however I have been on that T4 dose (150 mcg) for 2 weeks, not months, not years) or because I am not fully replacing my thyroid own production yet and 6X150+1 dayX200 only slows my thyroid function down further.

Thank you for the link!

[Clutter in reply to YulianaRossenova]

YulianaRossenova,

It's all a bit suck it and see. Perhaps try 175mcg for six weeks and see how you feel?

If you think you have a rT3 build up it is probably best to have a rT3 test to check.

[YulianaRossenova in reply to Clutter]

Should I go on T3 only to clear rT3? I don't feel good on T3 only.

I will try some SRT3. Hope so.

[Clutter in reply to YulianaRossenova]

YuianaRossenova,

It would be better to have a blood test to check rT3 level rather than simply assuming it is high.

If you don't feel well on T3 only there's no point in going on it. You could try adding a little T3 to Levothyroxine.

[YulianaRossenova in reply to Clutter]

I tried adding a small amount of T3, less than 3/4 a tablet of 25 mcg, split into 2 doses, I have built up to that dose in 10 days. It made me more hypo.

Fear of rT3 build-up stops me from increasing my T4 dose. If my rT3 is fine now, who can guarantee it won't go high if I raise my T4.

[Clutter in reply to YulianaRossenova]

YulianaRossenova,

There are no guarantees, it's all experimentation to find our right dose or combination of medications. If rT3 does go high you will need to reduce T4 dose for a while.

18.75mcg isn't a small dose in combination with 150mcg T4. 6.25mcg is a small dose. Perhaps try that.

[YulianaRossenova in reply to Clutter]

I was taking about 15 mcg T3, and getting more hypo. Now I am taking about 6.25 (1/4 of a tablet) a day. Although I don't think I will benefit from that dose since 15 mcg made me even more hypo.

[Clutter in reply to YulianaRossenova]

YulianaRossenova,

How long are you waiting before changing dose? If you are chopping and changing dose every couple of days I don't think it is helpful.

[YulianaRossenova in reply to Clutter]

7 days for T3, I increase by about 4 mcg (less than 1/4 of a tablet) every week.

So far my T3 dose has not had a positive effect. Only deepening of hypo symptoms.

Apparently it cannot raise my FT3 levels.

T4 dose cannot either.

My GP thinks I am a rare case and something terribly wrong has happened with my HPA axis. She says TSH should be around 2 and my levels should mimic the levels of a healthy thyroid.

She is on 50 mcg T4 and doing great. I am beginning to think I am broken all over.

[Clutter in reply to YulianaRossenova]

YuliannaRossenova,

I think 7 days is too quick. It can take up to 6-8 weeks for a dose to metabolise and work on symptoms whether it is T4 or T3.

I can only suggest you stick with a dose for 6-8 weeks and then have a blood test to see how TSH and thyroid levels have responded before making other dose and medication adjustments.

[YulianaRossenova in reply to Clutter]

But I stayed on T4 doses (apparently low for my needs) for 6+ weeks in the past and it was terrible. They rendered me even more hypo.

I don't know why that is.

[Clutter in reply to YulianaRossenova]

YulianaRossenova,

It takes time for a new dose to be metabolised before symptoms are relieved. I don't think you are helping yourself by making rapid dose adjustments.

[YulianaRossenova in reply to Clutter]

I know, Clutter, but I feel so bad, as if I am dying.

And then again why do I feel T4 effects immediately.

[Keelah98 in reply to Clutter]

What symptoms did you have when you were over medicated. Where you extremely fatigue. How long does that take to go away if you did have the fatigue

[YulianaRossenova in reply to Keelah98]

I have never been over medicated on T4. Even on 200 mcg my heart rate is 60-70.

I have felt over-stimulation on T3 though - increased heart rate - 90-100, and sometimes more pronounced heart rate, I am just aware of my heart beating, although my pulse is 70ish. (this is not a hypo symptom, it is a sign that I am slightly over-stimulated. I know that for some it may be a symptom of under-medication though.)

[Clutter in reply to Keelah98]

Keelah98,

Typical symptoms of over medication are fatigue, racing heart, breathlessness, sweating, diarrhoea, anxiety, irritation, moist palms, fatigue, weight loss or even weight gain. Symptoms should improve when you stop being over medicated.

Many of the symptoms I had were due to intolerance to Levothyroxine, not just over medication.

[Keelah98 in reply to Clutter]

How did you know you had an intolerance to levothyroxine. I have been on brand name levoxyl. My dose was changed Dec. 19, 17. I was so anxious couldn't calm down, I had to get clonazepam to help, I was crying daily, fatigue horrible, I went from 200mcg, 175, i have been on 150 for about 5 weeks. My Endo had me stop them for 3 days last week. Ask her today if I can stay off them for 5 days but that might be to long. This morning was the first day I woke up without having panic/anxiety. Does the fatigue take a couple weeks to go away after the over medication has resolved?

[Clutter in reply to Keelah98]

Keelah98,

It can take several weeks for thyroid levels to drop after dose is reduced and if fatigue is due to over medication it should start to improve then.

I was recovering on Liothyronine (T3) but was switched to Levothyroxine and felt dreadful. I thought it was due to over medication but symptoms got worse even after dose was reduced. I'm now prescribed T3 along with Levothyroxine and that seems to calm the adverse effects I had on Levothyroxine only.

[Hidden]

I was doing ok on 200mcg to a degree. Physically I looked overactive, very slim, body temp was good and hair not like straw but I was chronically constipated and no appetite. I stopped converting T4 efficiently and was put on T3T4 combo. Now I have a good enough appetite and have put on a little weight.

[YulianaRossenova in reply to Hidden]

Thank you!