Over medicated?

[Shamrock16]

hello, I'm wondering if I am over-medicated. I have Hashimoto's and have been on 100mcg levothyroxine since end march 2017 - an increased dose from 75mcg as my TSH had gone up to 2.75. I had another blood test two week ago and my results are as follows:TSH 0.27 (0.27-4.2)

T4 20.2 (10.8-25.5)

But I have loose bowel movements, feel nauseous on and off, and have had a sore head for the past 4 weeks.

A bit of additional background, I had been feeling well on 75mcg but had a nasty dose of sinusitis in January and my antibodies obvsiouly came out for an attack - fatigue and goitre returned. Endo increased my dose to 100mcg.

I have also gone strictly gluten free since end march 2017. So I wonder if I just had a blip in January due to sinusitis and/or my antibodies are reducing due to gluten free diet so my thyroid is under less of an attack?!

I'm thinking of trying cutting down to 75mcg / 100 Mcg on alternate days. How does that sound, any advice?

[greygoose]

Difficult to say, without the FT3. But, your FT4 isn't over-range by a long chalk. The TSH is irrelevant.

I don't think that sinusitis would trigger an antibody attack. And, in any case, after an antibody attack, the blood levels of the Frees rise temporarily, so you would probably have felt better, not worse. I think, given your symptoms, that you still have some sort of virus.

[SlowDragon Administrator]

Isabella Wentz (her website The Thyroid Pharmacist) talks about affects of going gluten free and how as the gut starts to repair we may begin to improve our vitamins & change how much thyroxine we uptake.

What are your vitamin D, folate, B12 and ferritin levels like? If they are too low you may be struggling to use your thyroxine. Can you ask GP to test them? Or have you got any results to post?

[Saggyuk in reply to SlowDragon]

Yes, have you noticed any improvements in your stomach? After a few months gluten free, I had to reduce my thyroid meds by a third and was a little up and down for a while. Although not clear immediately, I knew when I was hyper after a while and reduced a little which made me feel better so keep a closer eye on your blood test results if you're not sure

[Katepots]

I'd say meds are probably ok on the results that you have anyway. Do you still eat dairy?

The casein in cows milk looks like gluten and the thyroid to the body (molecular mimmickry) so if you eat and it gets into your bloodstream it will cause the same effects as gluten. T cells will be sent to attack and also attack your thyroid.

I eat goats butter, goats and sheeps cheese and have almond milk and Oatly cream as substitutes which seems to work well. May be worth giving it a shot.

[Shamrock16]

Thanks all so much for your comments and suggestions!! This is such a minefield. I'm worried about going to my gp with symptoms in case they reduce my dose and never let me increase it again if symptoms return...feel like I had to fight hard to get to this point and now it has backfired.

@greygoose why do the frees rise after an antibody attack? Learning more about this all the time, but I thought that if your immune system was fighting a virus or infection that it would also rise up the thyroid antibodies so a secondary effect of virus/infection would be more of an attack on my thyroid at the same time as my body fights the infection? I agree that my results don't appear to suggest overmedication but my two symptoms are common overmedication symptoms and the timing seems to fit...I'm confused by that, my body seems to be telling me something different that they blood test results say.

@slowdragon yes I wondered if my gut was healing and I was managing to absorb my thyroxine more effectively. My vitamin levels are all at optimal levels, I have worked with a brilliant naturopath to get everything to where it should be so again that could be helping me to absorb my medication more effectively so perhaps a smaller dose would suit me.

Saggyuk i haven't noticed any improvements since going gluten free unfortunately, I didn't have any digestive issues or symptoms but now i do have daily very loose bowel movements 😳 ?!?! That's why I wondered if maybe my gut was healing and I was absorbing thyroxine better therefore maybe needed less medication - interesting to hear this was your experience, what dose are you on now and what did you reduce from?

@Katepots yes still eating dairy and have done my whole life, I never had any digestive issues until I started messing with my diet, worried about making another change. Planning to get an antibody blood test after three months off the gluten to see if it's made any difference...wonder if that is long enough to tell?

[Saggyuk in reply to Shamrock16]

Your tsh and T4 does look okay but we're all different. When I was over medicated, I did get loose bowels and feel nausea and didn't actually suppress my tsh. I did feel worse after taking my thyroid meds but I was on T3 only and these work a little different to T4 as clear from your system faster and get into your system faster making it a little more obvious whereas levo/T4 hangs around quite a while so would feel hyper longer I imagine and not so reactive.

It's probably worth trying the 75/100 on alternate days to see if it improves a little but might take a while to see with levo or decrease back to 75 and see as long as you're willing to retest yourself after 6-8 weeks, it's not hugely expensive and you can get some better more extensive tests that the GPs don't normally do - you don't have to tell your doc you're trying different doses as long as you do it properly and sensibly.

Sometimes gluten free can take a few months to feel any improvements as can take a while for immune reactions to dampen so worth sticking to it for a little longer. You might not have a problem with it and can go back to eating it if nothing changes at all but at least give it enough time to know you've ruled it out properly so you don't have to question it again later

I was on 60mcg T3 which is considered maximum dose for T3 as more potent than T4 and I went down to 40mcg after GF so dropped a third. I have since swapped this for 30mcg T3 and 25mcg T4. I have no thyroid function so that's all I get.

Definately get your vit levels tested, many of us are deficient in these