Thyroid UK
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Reduce dose slightly?

Hi,

After a bit of advice....

A blood test a while back came back with a tsh of 10.7 (0.38-5.33) and T4 8.6 (7.00-16.00) my Levothyroxine was raised from 125mcg to 150mcg.

This pushed my T4 over range and my results were tsh 0.006 and T4 16.5 (Same ranges).

Suffering from symptoms of over medication I have been working with my doctor to try and get my dose right. So far I’ve reduced to 137.5mcg and most recently 132mcg. Still feeling symptoms of over medication though. Last results on 132mcg were tsh 0.007 T4 13.1 and T3 5.2 (3.8-6.00).

Should I try a slight reduction to 128.5mcg a day?

14 Replies
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healthunlocked.com/thyroidu...

In the above link are the responses you had before. You are only over-medicated when the FT3 is over range. In range last time but not tested this time.

How are your levels of B12 - Folate - Ferritin - VitD ??

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My ft3 is not and has never been over range however I’ve been feeling overheated and have insomnia which my doctor said were done to over medication. I felt better when my tsh was around 2 but am struggling to get it back there.

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How are your levels of B12 - Folate - Ferritin - VitD ? - apologies if they have been posted and I have missed them :-)

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Ferritin is ok at 111 (10-210) I take ferrous glauconate daily. Folate 10.0 (3.1-19) and B12 453 (150-900).

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I would give B12 a nudge upwards - no VitD result ?

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Marz,

That's not true. FT3 is a lot more stable than FT4 and doesn't fluctuate as much. I was overmedicated with FT4 >30 (range 9-19) and FT3 at top of range. I felt terrible with FT4 over range but a couple of years later had FT3 quite a lot over range and felt fine.

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SarahLouise,

Have thyroid peroxidase and thyroglobulin antibodies been tested? It's usually autoimmune thyroiditis (Hashimoto's) which causes fluctuations in thyroid levels.

You won't feel anything with TSH 0.007 or TSH 2.0. It is the T4 and T3 levels which will make you feel over or undermedicated. T4 and T3 are both in range so you are not biochemically overmedicated. You could skip Levothyroxine for 2-3 days to let some Levothyroxine wash out and resume 125mcg. Retest after 6 weeks and if T4 and T3 are dropping too much and TSH rising too much increase dose to 125mcg/150mcg and retest 6 weeks later.

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Thanks Clutter, when I went back to my original dose of 125mcg my tsh went back up and T4 down to 8.6 (7.00-16.00) and I had hypo symptoms. I felt the best when my T4 was around 10.5 and was just wondering if reducing slightly from 132mcg to 128.5mcg would bring my T4 from 13 to around 10?

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SaraLouise1980,

No one can say with certainty whether it will or not. I doubt such a small reduction will reduce T4 by 3 points which is why I made the suggestion above. You will have to try it and see.

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I just thought that on 125mcg my T4 was 8.6 and on 132mcg my T4 is 13 (7.0-16.00) I guess I thought maybe trying the 128.5 would give me sonewhere in the middle.

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Sarahlouise1980,

Yes, I saw that but it doesn't mean T4 will drop that low if you try 125mcg again. Try 128.5mcg. I don't think it will be sufficient but I might be wrong.

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Sorry, do you mean you don’t think reducing to 128.5mcg would be enough of a drop to reduce T4 levels? 🙂

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Sarahlouise1980,

I very much doubt a 3.5mcg dose reduction will make the slightest difference.

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Essential to test vitamin D

If you have high thyroid antibodies this is Hashimoto's

Many/most find strictly gluten free diet helps

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