Feelin awful after dosage increase!is it normal?? - Thyroid UK

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Feelin awful after dosage increase!is it normal??

Agnes79 profile image
11 Replies

HI I have recently increased my dosage by 25 mg levo .currently on 30t3 and 150 levo and feeling achy, headache, heavy eyelids,dry skin, feeling cold...is it normal to feel like crap after a dosage increase?? How long to wait for things to settle??

thanks for any advice

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Agnes79
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Clutter profile image
Clutter

Agnes79,

Some people do have adverse symptoms when dose is increased. Symptoms will usually improve in 7-10 days. If you can ride it out go back to your previous dose and wait until symptoms improve and then try a gentler increase 125/150mcg alternate days for a couple of weeks before increasing to 150mcg daily.

greygoose profile image
greygoose

Why did you increase the levo? Because it was low in range? It's bound to be low in range when you take 30 mcg T3 - practically non-existant, I would have thought. And for a reason. You don't need it. T4 is a storage hormone, that needs to be converted to T3. If you're taking your T3 'ready made', you don't need as much T4. And, trying to increase the level, could just lead to the production of rT3, as a way of getting rid of the excess T4. Too much unconverted T4 can cause problems. I'd go back down by 25 mcg, if I were you. :)

Agnes79 profile image
Agnes79 in reply togreygoose

thank you so much! I SHALL do that then...go back to the lower those. I THOUGHT that by increasing levo I will increase t3 as I have been achy for quite a few months.....even though my levels have been good......

greygoose profile image
greygoose in reply toAgnes79

Well, you already take a substantial amount of T4, and that doesn't seem to have raised the T3 if you still have symptoms. So, my guess is, you don't convert very well. If you don't convert very well, you'd have to take an awful lot of T4 to raise the T3, and that just isn't a good idea. Far better to try and raise you T3 by a small amount - 1/4 tablet, say. And, maybe reduce your T4 even more, because are taking rather a high dose of T4 for someone on 30 mcg T3. It could very well be that you just don't need all that T4.

Agnes79 profile image
Agnes79 in reply togreygoose

thank you! I think I agree...every time I increased levo....was on 112 now 150....hasn't made a difference.....so I will go back to 112 levo and see what happens.....maybe I am producing Rt3...from all that t4!!! Cause on this 150 levo I feel worse and with bad headache....could rt3 cause that???

greygoose profile image
greygoose in reply toAgnes79

rT3, in and of itself, doesn't make you feel anything, doesn't cause symptoms. It's just that it could, temporarily, block the T3 receptors so that the T3 can't get into the cell, and you stay hypo, despite good levels in your blood. But, if the T4 is reduced, the rT3 will eventually go - converted into T2. So, just try lowering the T4 slowly - not more than 25 mcg every 6 weeks, and see how you feel.

mythreecats profile image
mythreecats in reply togreygoose

Hello greygoose....just been reading some stuff and saw this post and your reply to it. Maybe because of time delay you wont see this.

Im trying to prepare for a new doctors appoinment and "try" to explain that i felt very very ill when going up to 100 levo from 75. I noticed i felt adverse effects going from 75 to 100. Although i never felt wonderful, they subsided to a lesser degree. Maybe in keeping with clutters advice above. However, i became more and more ill on 100 of levo. I have gone back to 75 on advice from here and trying to see if addressing ferritin eg will help.

However(and you seem quite knowledgable on things), is it possible that there was unconverted T4 in my body making rT3 causing me to be even more undermedicated because the T3 was blocked going into my cells? That being the case if I don't start converting better im going to be stuck at a dose which doesent do the job really ....as raising is pointless. I need to be quite clear and concise and not confuse my doctor . Do you think this is a fair enough thing to try and explain to her? Do doctors ever do tests for rT3? ........results below.

After 9 weeks at 100...tsh 0.1 (.27-4.2) fT4 16.6 (12-22) fT3 4.3 (3.1-6.8.)

The results were mostly the same after the end of 3 months at 50..tsh then 2.7...... showing to me that tsh isen,t what should be looked at so much, as im proof that getting to 0.6 did nothing for me.

thanks

greygoose profile image
greygoose in reply tomythreecats

I doubt you had enough T4 in your system to over-produce rT3. You were just under-medicated. Both your Frees were under mid-range. You should have continued increasing to 125 mcg, see what that did for you, rather than reducing.

Besides, having high rT3 would not affect your ability to increase your dose. It sounds more like low nutrients, or high/low cortisol.

mythreecats profile image
mythreecats in reply togreygoose

thanks greygoose.....really? its just that i felt so poisioned more and more each week i took the 100....i did'nt even feel as bad as that on 75....and i was also very aware of my heart pounding on 100.....others here have mentioned cortisol. Do you think the best way forward for me is to stay on 75 Levo until i check cortisol etc and address these....then if I still feel tired etc start going up. I want to have a plan of action to suggest to her so to get her on board in helping me

greygoose profile image
greygoose in reply tomythreecats

Well, you could get a 24 hour saliva cortisol test, but I doubt your doctor would know anything about it.

You could try easing into the 100 mcg by taking 75 one day, and 100 the next, until you feel ok on it. Then go up to 100 every day. But, you still need to get your nutrients optimal.

mythreecats profile image
mythreecats in reply togreygoose

Thanks greygoose:)

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