Possibly overmedicated?

[Kes8]

Diagnosed in January with Subclinical hypothyroidism TSH not much over range with lower levels T4 and T3.

Also coeliac, type 1 diabetic (26 years) and low ferritin, Vit-D deficiency and low B12.

All deficiencies have been/are being treated by both supplements and diet.

My question is as in May my levothyroxine was doubled in dose at the same time as addressing nutrient deficiencies' could this have resulted in being overmedicated now?

To add for the past week I have new symptoms:

Elevated pulse and resting pulse averaging between 95 and 105 bpm,

blood pressure has been towards the upper end of parameters but not high,

anxiety, nervousness, shaky hands and feeling jittery......bloody miserable,

even though I feel very tired I have had difficulty falling asleep and sleeping,

increased thirst although blood glucose levels have not been elevated,

lightheaded with one dizzy spell,

feeling increasingly hot especially at night,

increased gut motility with continuous hunger pains.

And none of my original hypothyroid symptoms.

Many thanks.

[greygoose]

Impossible to say without knowing what your dose is, and seeing your blood test, with ranges.

Have you had your antibodies tested?

[Kes8 in reply to greygoose]

Thank you for responding.

Yes, TPO - 65.5 & 64.4 <34 (Dec 16 & May 17)

TgAB - 425.6 & 183 < 115 (Dec 16 & May 17)

TSH - range 0.27-4.20

Dec-16 1.13

Jan-17 5.14

April-17 3.3

May-17 2.65

Free T4 range 12-22

Dec-16 12.29

Jan-17 12.8

April-17 13.6

May-17 14.59

Free T3 range 3.1-6.8

Dec-16 4.11

Jan-17 3.7

April-17 3.9

May- 3.69

Starter dose of 50mcg now on 100mcg levothyroxine.

[greygoose in reply to Kes8]

Well, your doctor isn't terribly clued up if he increased your dose by 50 mcg in one go. It should only be by 25 mcg every six weeks. But, at no point to you show results that suggest over-medication - quite the opposite! Your FT3 - the most important number, is consistantly under mid-range, whereas most people need it up the top of the range to feel well. I doubt that the extra 50 mcg has sent you over the top of the range.

And, you haven't had a retest since May? That is very bad. You should be retested six weeks after the increase. So, I would suggest that you get retested as soon as possible. Could very well be that you are still under-medicated, and need an increase.

Did your doctor tell you that you have Hashimoto's Thyroiditis - he might have called it Autoimmune Thyroiditis? You have high antibodies, so that means that your immune system is attacking your thyroid.

There is no cure for Hashi's, but you do need to keep your TSH suppressed. What happens is that when you have an attack on your gland, the dying cells dump all their store of hormone, into the blood, so that your levels can suddenly jump up very high. Doctors just don't seem to understand how this works! And instantly slash your dose saying that you have 'gone hyper' - which is a physical impossibility, but hey, why would a doctor know that?!? But, you haven't 'gone hyper' at all, it's just a temporary rise in levels due to a Hashi's 'hyper' swing. The levels will go down by themselves, eventually, and then you will be hypo again. So, the last thing you need is a reduction in your dose. You just need to stop taking the levo for a few days until you start to feel hypo again.

In order to reduce these hypo/hyper swings, it's best to have a suppressed TSH - the less gland activity there is, the less antibody activity.

You can also try reducing the levels by adopting a 100% gluten-free diet, which might also reduce symptoms. And you can take selenium - which will also help with conversion. Although, at the moment, you don't seem to be having much problem with conversion.

I would also suggest you get your vit D, vit B12, folate and ferritin tested. Hypos often have low levels of nutrients, but they need to be optimal for your body to be able to use thyroid hormone.

[Kes8 in reply to greygoose]

Thank you yes was told about Autoimmune thyroiditis - but given no details of how hormone levels could fluctuate. I thought diabetes was tricky but frankly a walk in the park compared to the thyroid!

When you say:-

"What happens is that when you have an attack on your gland, the dying cells dump all their store of hormone, into the blood, so that your levels can suddenly jump up very high."

Makes total sense to me and fits my particular story/journey/diagnosis as hypothyroid symptoms were preceded last year by symptoms very much mirroring the symptoms I have now - sudden high heart rate, sweating, dizziness nearly resulted in collapse.

On totally gluten free diet and have felt better not great but better until last few weeks. Will stop levo until feeling hypo again.

Will also have all nutrient levels re-checked and push forward TFTs too.

Many thanks for your help - hope you have an amazing day!

[greygoose in reply to Kes8]

You're welcome. But, I don't think I would stop the levo before getting tested, if I were you. It will skew the results, and you won't know where you are!

[SlowDragon Administrator]

Definitely don't stop Levo, get blood test asap, then review when you get results.

When was dose increased? After May blood test

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after.