Too much NDT perhaps?

During the last year I've struggled to raise my NDT dose because i seemed to create adverse symptoms. However after about a year of taking various supplements for adrenal issues, I did get brave a couple of weeks ago and increased the dose by a small amount. Two to three weeks in, I seem to be tolerating it OK. This morning I thought I'd add in just a tiny chip more. Morning dose taken at 7am.

Around 10am I went upstairs to get showered but when I got to the top (wasn't rushing) my heart rate just rose and I felt a bit dizzy. I asked my husband to get me a glass of cold water as I used to have Atrial Fibrillation many years ago (mostly prior to Hypo diagnosis) and this was one of the stock remedies for bringing heart rate back to sinus rhythm. Heart rate came down over the course of 10 to 15 minutes, but had to go to the toilet twice during that time (bowel movements, quite loose) and have been again in the last half hour. Also felt rather odd, jittery but not anxious type jittery.

So I'm wondering if that little extra chip this morning put the dose just over the balance where I should be perhaps.

Here's a general summary of meds, diet etc:-

Erfa dose prior to this morning

7am 3/4 grain

4pm 3/4 grain

Been taking various supplements over the last year, but current cocktail is:

11am

Magnesium glycinate 120mg

Ashwagandha 340mg

Vitamin C x 1200mg

Selenium 200mcg

Zinc 10mg

10pm

Magnesium glycinate 120mg

Ashwagandha 340mg

I also have to take Aspirin 75mg soluble which I take around 7pm

At bedtime also have to take a statin tablet 40mg Atorvastatin.

The last two above were introduced after the cardiac 'event' I had last October along with another blood thinner which I was allowed to discontinue in January. This was not deemed to be a heart attack, could have been a plaque rupture, no definitive reason. Had an angiogram while I was in hospital at that time and arteries showed clear (thankfully)

I was in a pretty stressful job as an Administrator in a small local nursing home and had to have 9 weeks off because of the above episode, went back in December but after a further stressful month even on part time hours, I decided to resign and left there at the beginning of February.

Currently enjoying a break from work but searching daily to find a new more suitable job.

Over the last year I've also been very carefully changing my diet to lose weight and it's been very successful without being at all extreme. I've lost a total of 2.5 stone, about another 1.5 stone to go to get to my personal target weight (also not extreme)

I have Coeliac Disease and have been diagnosed over 40 years, so already gluten free,including oats which I cannot tolerate, even those now labelled gluten free.

I haven't smoked for over 30 years and haven't drunk alcohol in about 9 years.

I quite all refined sugar some months ago as part of my new food regime and fruit also kept to a minimum as I had raised blood glucose level last April and the year before. I did an HbA1C test a couple of weeks ago via Medichecks and delighted to see the result was right in the middle of the range.

I don't really exercise but since the event of last year have started a walking programme of my own. There is a farm shop in the village where I live which is a mile, so I walk there and back briskly a few days of each week, sometimes every day, depending on the weather.

So should I perhaps back off the Erfa dose a little bit today and go back to where I was tomorrow?

All the symptoms I have today seem to fit in with a bit of an overdose of NDT I think

Last blood results done in January: -

TSH 00.46 (00.27 – 4.20

)

Free Thyroxine(T4)13.50 (12.00 – 22.00)

Total Thyroxine91.10 (59.00 – 154.00

)

Free T35.16 (3.10 – 6.80

)

Reverse T320 (10.00 – 24.00

)

Reverse T3 Ratio16.8 (15.01 – 75.00

)

TG Antibodies<10 (0.00 – 115.00

) These were much higher last year

TPA Antibodies44.3 (0.00 – 34.00) These were much higher last year

TActive B12191.40 (25.10 – 165.00)

Folate (Serum)15.88 (2.91 – 50.00)

25 OH Vitamin D98 (50.00 – 200.00)

CRP Marker3.8 (0.00 – 5.00)

Ferritin157 (13.00 – 150.00) Not sure why this is over, not taking supplement

Appreciative of any hints, tips etc

Georgina

Bedfordshire

[silverfox7]

I would certainly stick with the dose you are comfortable with though there looks to be room for raising them. Hopefully someone will spot something else that needs tweaking. Have you stared a new lot of medication?

[Hidden in reply to silverfox7]

Hi silverfox7

Thanks for responding.

I left off my afternoon dose of Erfa yesterday and symptoms seem to diminish though felt very wary wondering what the cause could be.

Woken early this morning feeling quite anxious. I do have some very low dose diazepam which I use very occasionally for such situations so I took one. It works within 20 to 30 minutes so calm is back.

Then the dilemma of whether to leave off the Erfa another 24 hours. But I believe t3 has a half life about 6 to 7 hours so the excess should be out of my system from yesterday so have now taken my previous tolerated dose.

I thought leaving Erfa off another 24 hours could be worse.

[silverfox7 in reply to Hidden]

Think that's about right. Hopefully someone will reply as to where to go next. Not sure about your Vits levels etc so hoping you get advice on those

[Hidden in reply to silverfox7]

Well I thought yesterday things were beginning to improve and I just went back to my normal pre-increase dose of NDT. Though I did feel a bit 'jittery' in the morning.

So this morning I took my normal dose at 7am and felt reasonable when I first got up, but now feeling jittery again. Wondering whether to leave off all NDT perhaps for 24 hours again to see if there is still just too much running around in my system. Wonder if anyone has any pearls of wisdom?

[silverfox7]

I remember when I first started off and missed my sweet spot I was told to leave ? Days and then given a figure to work from but I'm not sure I could 'guess' about that. I missed my sweet spot because I was instructed to increase in hall grains up to 2 and then increase in quarters but I wasn't improving but I found my seeet spot was 1.75 so missed it by default really so from my personal experience I would start on the lower dose sooner. So if you feel you still have a way to go drop down and hold and see if that helps. In theory you may feel later that you do need to raise to be on your former good level.

Just had a thought. I've read if you have been taking NDT for a while you do get a residue of 1-3 doses in your body but have no personal experience of that.

[Hidden]

Thanks Silverfox7.

I had a rocky time when I started on NDT in October 16 as I felt the consultant who prescribed perhaps may not have given me the best advice. Though it ties in with some websites I've read. He said stop Levo one day start NDT the next on 1 grain a day, no advice on dosing times. So I did exactly that but I'd been given half grain tablets, so I did split the dose. But at around day 4 I felt very unwell. I was never sure whether it was too much NDT because of still having Levo in my system, but I read here and there and stopped it all for a good day, then started on just half a grain a day for 2 weeks or so, then very gradually worked up, but it took me many months to get as far as nearly 1.5 grains which is where I stayed.

Your 'days' comment came out with a ? beside it, so not sure how many days you meant