Thyroid UK

Help! I was overmedicated, need advise stat!

I'm 41, TPO negative, been on NDT / NDT+T4 for 17 years. Used to be a Skinner patient. Now i do it myself.

I swapped from 2.125gr + 25mcg T4 in early November to 1.5gr+ 50mcg T4. It was mathematically neater and rounder and easier to deal with, and I hoped to get the T4 on the NHS eventually.

I've apparently spent the last few months overdoing it on 1.5grains + 50mcg T4. I was also taking 10,000iu of Vit D every OTHER day as a supp since December. I have had a rash on my face since Christmas and couldnt figure it out.

Suddenly on 19 March i had gone to the walkin to get something for the rash on my face and they gave me tetracycline - and I had foamy pee which scared me to death. I quit the vit D on the spot.

I did assume i was a bit undermedicated because I was so cold and my bladder/kidneys were twanging and I was going to the loo so often, so i bumped up to 1.75gr + 50mcg T4, and I thought i'd injured kidneys with the vitamin D since the ends of my fingernails had new red tips on them (Terry's nails????), and my anxiety has been so bad since the last week in march......

Turns out I have had a UTI potentially for a while and I'm on cephalexin now. Diagnosed on Saturday at the walk-in, given the right med yesterday. My blood pressure was quite high (for me) 144/90 at the walk-in, my heart banging, my head hurting, and peeing off so much of my body weight that even my stomach skin was dehydrated.

I skipped PM thyroid meds Saturday, took nothing Sunday and don't know how to proceed from here. I'm looking for any advice. The anxiety and insomnia are wrecking me, i've been up trembling since 2am.

Obviously no vitamin d ever again, but what about thyroid? What have I done?

Times like this I miss Dr Skinner so very much.

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You need to get your thyroid and vitamin D levels checked. Self medicating without checking where your levels are is asking for trouble.

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On 2.125gr + 25mcg T4 tests were:

TSH 0.06 [0.4 - 4.9]

FT3 3 [2.6 - 5.7]

FT4 9.7 [9 - 19]

This is why i changed things around in the first place to include more T4 and less T3 back in November.

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Did you test 6 weeks after dose change? What about vitamin D levels?

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I didn't test either, no. I had too much on, didn't get into the GPs. It's only been a few months since the change.

I'm guessing it didn't suit me, my reaction has been bizarre in the least. The trembling inside me in the last 4 or so days has been terrible.

I don't know when to resume thyroid meds, how long to let this "overstimulation" wash out - i won't be touching vitamin D.

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You're ft3 is VERY low still, why did you think you needed to reduce NDT? Was that two 125grain NDT you were on and you reduced to one 1.5grain? When on t3/NDT it is usual for TSH to be supressed and ft4 to be low.

On those bloods above I would have suggested an increase in NDT not decrease (just a patient and my own opinion 🙂)

As for vitamin d, get tested... You seem to be assuming you have taken too much vit d but really best to test, not guess 😉

Have you had

Ferritin, folate, b12 tested? If so what's the results if not get tested 🙂

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At the same time those thyroid tests were done, Ferritin was 10 (range 15+) and Fe was 4.4 (range started at 8 iirc), so i was diagnosed severely iron deficient and given 252 iron pills, 3 pills a day which I couldn't take the way they gave me because it interfered with my NDT which i take twice a day. I took 1 iron pill at bedtime until i used them all up, and I continue to take an iron supplement (iron biglycinate 20mg) at bedtime.

I'm assuming it was too much vitamin D because of the red marks that appeared on my nails. There are white bands that are growing out, too. Maybe I'm wrong, I don't know why the red marks at the ends of my nails but obviously my kidneys were struggling with high blood pressure / stress for some reason or they wouldn't have appeared.

My surgery reopens tomorrow.

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Red marks can be heart or splinter hemorrhages, not just kidneys. Low iron could contribute to heart problems. White bands on nails can be zinc deficiency. It takes months for things to show up in your nails (the length of time it takes the nail to grow to that point), so it will be down to deficiencies etc that started a long time ago.

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I'd say you needed more T3 as you expect free t4 to be low when taking T3, but most people find that free T3 needs to be at least in the top third of the range (>4.6). I'd be more likely to put foamy pee down to nasty antibiotics than Vit D, but you shouldn't supplement vit D or A without checking levels first as excess isn't urinated out .

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Dr Skinner is sorely missed by his patients and staff. He was such a sensible and sympathetic doctor.

When we take NDT, (which contains all of the thyroid hormones) the blood tests we have were introduced along with levothyroxine, (T4) alone so if we take T3,T4, T2,T1 (NDT) results wont correlate. I am not medically qualified but believe that we have to rely on how 'we feel' on particular doses to judge. These are a couple of links:-

web.archive.org/web/2010103...

web.archive.org/web/2010112...

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I cried for weeks when we lost him. His patience and level head was so reassuring. I really wish I had him to talk to now.

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I saw Dr S too as did my daughter who was told she didn't have a thyroid problem. It was well worth the journey to Birmingham. Did you know that his staff have been working over the past three years to collate all of the scientific results/evidence and were looking to publish.

healthunlocked.com/thyroidu...

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I did. I live in Birmingham, it was easy to pop over to Moseley for a chat. He saw me through the births of both of my children too. I used to visit when I was pregnant too, even though my "care" was transferred to endocrinology for that time, just to say hello. I'd just seen him in April the year he died, and bought a copy of his book... his secretary said to me "you know, he won't be around forever" -- i never thought to take it seriously.

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Most of his patients/staff believe it was because he had to appear before the GMC several times due to 'complaints' made to them about his 'treatment' and it certainly was not his patients. The stress he suffered must have been absolutely enormous and one 'fan' did a calculation and the odds were about 4 million to 1. I also doubt the GMC ever had 10,000 testimonial letters from his grateful patients.

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I know that to be true. The GMC gave him hell for so long. Unjustified, unwarranted, and just awful.

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I wasa patient and saw him I think 3 weeks before his death. My GP had recently reported him and I'd refused permission to be named. Wasn't sure what to do but once out there I couldn't retract. He complaint was that he had never written to her andci said hecalways told me he would do plus it was demanded that he did. I requested a copy of my notes after his death and found a copy of a letter he has sent ( there were more) and I felt it all my fault as I must have not given him the. Orrect address but then I found her reply! It was a good job she had retired by then as another letter of complaint would have been going to the GMC!

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It may be an idea for you to get tested via thyroid UK, medichecks or blue horizon, they both do tests for less than £100 you can do at home by finger prick.

TSH

Ft3

Ft4

Both Antibodies

B12

Folate

Ferritin

And vitamin d

thyroiduk.org/tuk/testing/p...

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Hi Leoniedelt -I miss Dr S tooo....may he rest in peace.

Given your actual thyroid levels in those results prior to the change Id be surprised if the change in dose would send you hyperthyroid.

My understanding is Internal trembilng is more associated with adrenals. Your ft3 was mid range and your ft4 was bottom of range on your old dose.

Its a shame you didnt check after changing your dose but if you lowered your ndt but increased yout ft4 then maybe whats happened is your ft3 has sunk lower but your ft4 level should have increased. It all depends on how good you are at converting ft4 to ft3. Of course this is guess work as we dont know. You need to get your bloods checked. And getting your vit D checked is really important. I wouldnt take any more vit D until you know the result.

You really cant go on your blood pressure as that may well have been affected by the infection that youd had for sometime. UTIs make you pee more as the body tries to flush it out. You need to drink loads of fluid. I mean loads. Your headache is probably from dehydration. I felt soooo ill when I had one & my thyroid levels were stable.

On the odd occasions Ive over cooked myself & temporarily stopped thyroid meds Ive felt better within 48hrs. I then ususlly resumed my otiginal dose prior to altering it.

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Thank you for this reply. Yes it is unfortunate that I didn't get in to the GPs to check how I was doing on the other dose. Anxiety makes me pee too. I feel so quivery inside, internal shivering. It's so peculiar. Yes i have been peeing so much, it's frightening.

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I think the picture is confused by the UTI so its best not to rely on symptoms as much for your thyroid. As you are fighting an infection I really wouldnt stop your thyroid meds for roo long as your body needs the meds to help it fight. Why dont you try resuming your old dose of thyroid meds. Get your blood tested and go from there. Your low iron levels wont have helped matters & could also cause thumping heart and fatigue.

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I think you're talking sense, THANK YOU. Thank you so much.

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No worries -hope it helps. Your right I wouldve been on the phone to Dr S & he would have joked with me with his dry sense of humour reassuring me whilst telling me what to do. Bless him. I actually do find my self thinking what would he say when Im not sure what to do & can almost hear his dry warm humerous voice reassuring me. I was very lucky to be treated by him for so many years....& am sure he would be horrified but not surprised to see how the treatment for hypothyroidism on the nhs has degenerated further....lol.

Hope that UTI goes soon.....

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Exactly this. And he would talk to me for as long as I needed. I have never had the heart to take his number out of my mobile phonecontacts list - how sad is that? I will re-read his book tonight, hear his voice, and take some comfort in it. Thank you for reminding me what I would've done, it helps quell anxiety and get my head sorted out.

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I lent my GP my copy of his book. She returned it with a note saying 10 years old so out of date! I didn't realised until I got my notes that he had asked her to give me T3 or NDT and she never told me that or acted on it.

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Oh my siverfox - thats awful. She never even discussed it with you! Wow very poor. I was shocked when I got a copy of my notes to see that my TSH was sky high before I saw Dr S but my GP had not thought to act on it despite by then being formerly diagnosed hypothyroid by them & on treatment. At the time I could barely walk & thought I would loose my job. Truly shocking. And it was Dr S who turned this around. Dont like to think where Id be now without his help.

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Very true! If only the so called experts had listened to him.

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