What happens if you forget to take your levothyroxine for a week or so?

[mocidoci]

Just that. I had forgotten to re-order my prescription (brain fog) and went without for a bit. Three weeks before that I had been told to reduce my dosage from 175mcg back to 150 mcg as I had been over medicated at last test.

So, reduced for three weeks. Forgot for about two weeks if I'm honest. Then back on 150 mcg for a week and had a test. The results are:

TSH 15.8mU/L (0.27-4.2)

T4 13.3pmol/L (12-22)

The GP wants to speak to me and I will tell him what happened and ask to leave on the present dose and retest again in 6 weeks. Though I haven't gone up so much in so short a time.

I have been extremely cold, even with extra layers and the heating on, and have difficulty getting out of bed in the mornings - more so than usual. I also have pins and needles in hands, arm, legs, feet and face, but thought that was due to my (possible) arthritis as my shoulders and neck are flaring up.

Thanks for reading.

[Clutter]

Mocidoci,

Well you can see and feel what happened. Your FT4 dropped low without Levothyroxine so your TSH shot up and you now feel crappy. It will have taken 7-10 days for Levothyroxine to be absorbed after you resumed taking 150mcg and will take up to six weeks, possibly longer for symptoms to resolve. Ask your GP to recheck thyroid levels when you've been taking 150mcg for 6-8 weeks.

If you run out in future your pharmacist will probably 'lend you' some Levothyroxine until you can get your prescription.

[SlowDragon Ambassador]

Why not use a weekly pill dispenser and keep by your bed. Make sure when fill up each sunday night to check you have enough for at least a weeks worth for the next sunday night.

Not taking Levo is very likely to have caused low B12, and possibly, low vitamin D, folate and ferritin. You were lucky it did not cause worse symptoms. Some are extremely ill if dose was missed for week or so.

Low B12 causes pins and needles. It should improve as you get back on steady dose.

The fact you continue to have brain fog despite "adequate" medication, suggests you still have unresolved issues.

Once you have been on 150mcg for 6 weeks ask for repeat blood test for TSH< FT4, FT3, folate, ferritin, Vitamin D and B12

All thyroid tests do as early in morning as possible, fasting and don't take Levo in 24hours prior to test. Delay and take straight after

TSH should be around or below one, FT4 towards top of range and FT3 at least half way in range

[Nanaedake in reply to SlowDragon]

Be careful about taking levothyroxine out of blister pack to store as it's prone to deteriorating with heat, light, moisture.

[Jazzw in reply to Nanaedake]

Although that would still be better than not taking any at all.

[Nanaedake in reply to Jazzw]

Well, I find stability is critical for me. If I think I'm taking a certain amount of hormone and I'm not, due to indeterminate factors, then its very difficult to correct the deficiency as you don't know how much more you need to take!

If you're not taking any medication at all, at least you know exactly what's happened and it should match blood test results.

My method is to eliminate everything that can cause any variation in order to maintain stability and stay well. I'll be working full time into old age to make up for years of thyroid ill health so no opportunity to be out of kilter and take time out.

[Jazzw in reply to Nanaedake]

Sorry Nanaedake - I was joking and honestly didn’t mean to sound dismissive in any way.

I think the brown bottles must be to protect from the light. Although I always hate it when someone chooses to put my pills in a bottle and not give me a blister pack - makes it even harder to remember when I’ve taken one if I don’t have the empty blister to remind me!

[Nanaedake in reply to Jazzw]

Haha, ok, I'll just lighten up then...

[Fruitandnutcase in reply to Jazzw]

I use a days of the week pill holder which isn’t all that large and I snip the blister packs into individual pills while still in their blister so that way I have one in each day but they are still wrapped up.

I take three pills every day and sometimes other odds and ends so you can fit a lot into those things. I keep it on the dining table and that way I remember to take all my pills every day.

No way would I ever have missed my thyroid meds when I was on block and replace.

[SlowDragon Ambassador in reply to Nanaedake]

My 25mcg are in bottles, not blister packs 🙁

[Nanaedake in reply to SlowDragon]

Are the bottles brown to protect from light?? I've never seen levo in bottles but I've only seen UK generic levo.

[Fruitandnutcase in reply to Nanaedake]

One of the tablets I take for blood pressure used to be dispensed in brown bottle but now comes in a bubble pack. I always figured someone somewhere was making money out of the blister pack arrangement. Told you I was cynical!

[mocidoci]

The issue is not forgetting to take them - I have them by the bed and take at night. The issue is forgetting to re-order as I only remember late at night! But I have just put a reminder for each month on my phone, so hopefully this won't happen again. (I do take a B12 spray in the morning along with cod liver oil, so B12 is not the issue)

I just find it strange how quickly it affected me - not 6-8 weeks but within 1 week I began to really feel the cold, and the on came the fatigue, pins and needles, and joint pain. Which makes me think - do I actually have some form of arthritis/connective tissue disease (still waiting for a diagnosis) or it a by-product of my thyroid being out of whack?

As an aside, I had an ultra sound of my thyroid in Oct as my neck was swollen on the right side but the radiographer said the thyroid was shriveled, probably as a result of being on levothyroxine for the last seven years. Anyone know what exactly this means for me in the long term. Do i no longer have Hasimoto's?

[mocidoci in reply to mocidoci]

And thanks for all the replies.

[silverfox7]

Those of you only getting a brown bottle save up the empties so you can have 4 spare and label them 1-4 so you can put a weeks supply in each but on week 3 put a reminder on to reorder and then on 4 a have you done it yet. Sounds basically weird but anything to help the sequence has to be good.