The heatwave and medication

[MMAndrea52]

Hi all. Just wondering should I lower my levythroxine dose in this heat? Iv no thyroid

[Hypopotamus]

I don't know if there is a definitive answer. If you can vary the dose by a small amount it may be worth trying. But then again, any change that produces may not come into effect until the hot weather has gone.

[4Alexandra in reply to Hypopotamus]

I also have no thyroid and was advised to lower my thyroxine during the summer months June to September but I live in Crete so the high temperatures are constant.

[MMAndrea52 in reply to 4Alexandra]

Hi Alex. Thanks for that. Can I ask who told you to lower in summer months? Was it a dr or endo?

[4Alexandra in reply to 4Alexandra]

Since my first reply I have had an appointment with my endroconologist, who comes twice a month from Athens to Crete. He was for many years in Canada and I have great faith I him. I asked him about lowering during the summer months, as a previous Endo had prescribed but he disagrees saying it is better to keep your medication constant. Coping with high temperatures for months here becomes a way of life, routines change and you do everything slower and drink gallons of water. Alcohol at night will make you hotter, so early evening is best.

[MMAndrea52 in reply to Hypopotamus]

Hi hypo. Thanks for that. Iv not reduced as yet. I am very hot, but who isn’t atm haha

[Hennerton]

I find I need to lower mine a little. I take both T4 and T3, so I reduce the T3 by 5mcg. It is easy to increase because effects are very quick. Unfortunately my correct dose seems to be balanced on a pin head so I spend a lot of time wondering what to do next....the result of having no thyroid, I suppose.

[Caesard in reply to Hennerton]

What's your 5mcg in %? I am, for example, working with 10% adjustments on both T4 and T3 (it's a combo pill)

[Hennerton in reply to Caesard]

I dropped from 10mcg to 5mcg which is one dose a day instead of two. But I tend to just see how I feel, as I react very quickly to everything. If the weather becomes more normal for UK I shall go back to 2 doses per day. Fortunately, my GP leaves me to do as I think best...

[Caesard in reply to Hennerton]

That's a bit drastic, halving an already small dose of T3. If I may ask, you, as a post TT, how much T4 you are adding besides the 10/5 T3 to keep symptoms under control?

Myself, an 38 YO 85kg male, use 137.5 T4 and 27.5 T3 and I feel reasonably good, but, more important, consistently good.

[Hennerton in reply to Caesard]

You will laugh at my tiny dose but I am tall and weigh very light - 47 kilos and take 75 Levo, plus the 10 or 5 T3. As I said above, I react very quickly to everything, including all those nice, safe alternative therapies like Reiki, Acupuncture, chiropractors, etc, which I have learnt the hard way, leave me prostrate for days.

[Caesard in reply to Hennerton]

Not laughing, I'm well beyond that point in my maturity level After all this ordeal nothing surprises me anymore and nothing is too less important to take seriously; also my cynicism level is at all time high

I've actually tried acupuncture myself, but was never able to assess it's effect, I have been dramatically changing several thing in parallel.

[MMAndrea52 in reply to Hennerton]

Hi Hennerton. Thanks for that. And i can so relate to you. I had my TT Nov 17 and it’s been a crazy roller coaster of a time, as you say balancing my dose on a pin head and wondering what to do next. And being very grateful if I have an up day Take care 😊

[Hennerton in reply to MMAndrea52]

Are you also very thin like me? I have always attributed the insane difficulty in balancing doses to my low weight.

[suggi in reply to Hennerton]

Hennerton - Finally I have found someone without a thyroid who is thin . I was thin to begin with and lost quite a bit of weight with severe Graves disease and then had RAI to kill off the thyroid (double dose). That was Sept 2016 and then went hypo fast - TSH 75 on Levo. I am now "in range" - low end for all but lowered dose as I read the elderly should have a TSH around 5 or so. I only gained back half of what I lost and can not seem to get back to where I was no matter what I eat. I have even gone off the grid eating stuff bad for your health but supposedly fattening - bakery goods, cookies, chocolate, etc. NO WEIGHT GAIN, just starts up my IBS. I am no longer tall as I have severe scoliosis which has made me shrink and I hate to see what my next bone density test shows but that is another story as I went off Evista when threatened with a stroke in the elderly. I had been on it for years with no problem. They want me on Prolia but no thanks, I have enough problems trying to straigten out my hypo and still feeling under.

If you know how to gain weight please let me know. Endo just says I am alone and every other hypo patient she has is trying to lose weight. Big help. Thanks

[Hennerton in reply to suggi]

Hi Suggi,

Very pleased to meet another thin Graves’ patient. It also took a long time for different GPs to diagnose me. I kept returning to the surgery and seeing a new doc each time, who all suggested something else as the cause for my constant aching. Finally one with a brain saw the blindingly obvious, a skinny, shaking wreck, I had TT in 2006 and am basically still trying to become the person I was before it all happened. I guess it isn’t going to be resolved now and I cannot blame lack of T3, as I use and love it but it does not make me 100% well all the time. That elusive balancing act on a pin head again...

[MMAndrea52 in reply to Hennerton]

Yes I too am quite thin for someone post TT. I weighed 8st 8lb pre op and now weigh 8st 10lb in the morning up to 8st 13lb at night. I am not complaining, but I too am desperately trying to find my balance and well state again. I find I need more levythroxine to givf me the feel good factor, however that gives me terrible fluctuations of anxiety. At the moment I am just terribly fatigued. And doctors and professionals look at me like, what’s wrong with you. I usually forgot and or I’m too tired too explain, last time I went to see the Hormone guy. Of general medicines. I was ushered out out the room whilst trying to explain my plight, to no avail. She said oh you can tell mr Howell on your next visit. I’m not being funny but what kind of after care is that???!!! This is my life and they don’t give a shit. But I keep going and trying to look after myself, good diet etc. I am resigning myself to the idea that life post TT will never be the same. But every day I’m grateful for lots of wonderful things in my life. U know things could be much worse. I am grateful 🙏🏽

[Hashi-Monster]

I’ve dropped my NDT by 1/2 grain as I was overheating

[MMAndrea52 in reply to Hashi-Monster]

Thanks for that and take care 😊

[jgelliss]

When I become heat intolerant I know I have to lower my T4 . The same works for me in the winter when I feel cold intolerant I raise my T4 a bit and it makes a difference . I lower my T4 in May and raise my T4 in September . I raise and lower my T4 by 12.5mcg T4 approximately .

[Caesard in reply to jgelliss]

Same here, but it doesn't set in instantly, I used to slowl down around december and eventually crash end of jan or feb if replacement dose is not adjusted for the cold season.

[MMAndrea52 in reply to jgelliss]

Thanks for that. Oh I couldn’t bare it if I had to start doing all that. It’s been bad enough trying to find a good dose for me to be balanced. Take care 😊

[Caesard in reply to MMAndrea52]

Well, after the post TT rollercoaster nothing is too much to get me to a stable situation. Actually I consider me getting out of this one of the hardest thing I've ever overcome in my life.

[Hennerton in reply to Caesard]

I am so relieved that you say that as I also think it is the hardest thing I have had to deal with so far in my life (more grim moments to come, no doubt!) and just as I think I am fine, it all goes wrong again.

Yet frequently members talk about knowing people who have had TT and have been absolutely fine on just T4. Maybe my perception of absolutely fine is different to theirs?

[Caesard in reply to Hennerton]

No, it's true, some do just fine on T4 only. Not our case it seems....

And yes, I also have this feeling that it's not over with this. I'm afraid but I also know I'm well equipped for whatever it is to come. Accelerates maturity, I think. Average male usually don't get that...:)))

[JOLLYDOLLY]

Never ever heard of lowering my medication due to the heat and I have been taking it all my life. Sounds weird to me as it is a hormone we need to take regardless of the weather.

[Caesard in reply to JOLLYDOLLY]

Might be true, cold season changes metabolic response and should demand more available hormone. If already thin on it, might happen to feel the gap.

[Kell-E in reply to Caesard]

In the winter I end up going to bed much earlier. I am also much more physically active in the summer. I wonder how these things affect the need for thyroid hormone?

[Caesard in reply to Kell-E]

Should affect it as well! Increased physical activity demands more "fuel" but probably at a slightly different metabolic mode than a cold season. Honestly? That's an assumption....though it's clear that seasonality affects metabolic rate and manifestation

[Kell-E in reply to Caesard]

Does it affect metabolic rate due to the cold temps or the darkness?

[Caesard in reply to Kell-E]

I would think both. The temperature it's clear and has a clearer, studied path/mechanism, I've seen articles and studies. But i would suppose that circadian rhythms and consequently metabolic behaviours are affected by both temperature and differences of active hours/daylight.

Again, this is my personal supposition.

[MMAndrea52 in reply to JOLLYDOLLY]

Hiii jolly dolly. Well u certainly made me feel jolly and give me hope that I really don’t need to bother. Thank u and take care 😊

[JOLLYDOLLY in reply to MMAndrea52]

Ha ha! I aim to please MMandrea52 lol

I am in my golden years lol and never heard of lowering medication because of the weather. I have been on medication since I was five weeks old. All I know is that when my medication was lowered because of incompetence by a GP, it changed my life completely and to my detriment. Alas, I am now back on the original dose and some T3 but the damage was done.

I personally would not recommend, weatherwise or for any other reason, to lower or increase your medication, unless blood tests dictate that you should.

If you feel good on your current dose, enjoy the sunshine whilst it is with us and take care

PS I think if anything, it has made me a little cynical ha ha!

[Caesard]

Nobody (qualified medical staff) spoked to me about seasonality of hormone replacement. I am also post TT on T4/T3 combo and for 3 consecutive years I have experienced a crash of some sort during jan-march period. This last year I have sort it out, by increasing a mere 10% of the substitution hormones (both of them) I've felt some decrease of wellbeing during Feb but got over it just fine, no hard landings

So yes, seasonality must be factored in, at least in my case.

[MMAndrea52 in reply to Caesard]

Hi thanks for that. I have also titred my dose ever so slightly if iv felt I needed too. Take care 😊

[Wildbird]

If you have no thyroid, your body will need the levothyroxine in order to function. It is said that the body requires less thyroxine in the summer months, though I have not seen any research that proves this to be true. I guess it may be something to discuss with your Dr if you think that you need less. I have never reduced my dose in the summer months as I don’t feel overheated.

[JOLLYDOLLY in reply to Wildbird]

I am like you Wildbird, not seen any research either.

I was born with a non working partial gland and I have never heard of it before. I used to get hot and bothered in the summer, but I just thought it was a genetic thing. I just feel cold all the time now lol. Surprising what we hear and learn.

[MMAndrea52 in reply to Wildbird]

Thanks wild bird. Hmm interesting, I have really been overheated but who hasn’t so hard to tell. I might just try break a quarter tablet off tomorrow. You take care now 😊

[Wildbird in reply to MMAndrea52]

Well I was thinking last night that when we have a thyroid, it can adjust our hormones according to the temperature 🤒. When we don’t have a thyroid or it’s stopped working, we have to rely on external thyroxine and our bodies probably can’t make the temperature adjustment in the same way. Go with your instincts, it’s not often that we have such a run of good weather 🌞

[MissFG]

Interesting reading this post!

Tbh I feel so much better in heat and warmer summer months does everyone else? But wouldn’t decrease my T3 but think I’m more or less optimal so don’t like to mess with my dose

[Caesard in reply to MissFG]

Yes, I can confirm. Summer brings me more vitality and joy

If you're good, confirmed by symptom relief and test results, why tweaking? But we're not the same it seems....

[MissFG in reply to Caesard]

Agreed! I think I may consider taking a small increase in winter months if I struggle but never a decrease.

[MMAndrea52 in reply to MissFG]

Hi Miss FG thanks for that. I hear ye sister why mess with it if it’s ok. You take care 😊

[Marz]

We often read on the Forum that exercise at certain levels can use up T3 - so for my way of thinking it does depend on how active you are during the Summer. I swim lots daily in the summer months - sometimes up to a kilometer so need all the help I can get

[Caesard in reply to Marz]

In my case severe fasting and/or exercising affects my energy and cognitive levels, supposedly by decreasing conversion in the case of fasting and decreased FT3 levels in the case of exercising. Therefore I avoid doing the first and supplement a little bit the T3 (20%) when doing the second (it happens rarely)

[MMAndrea52 in reply to Caesard]

Thanks for that and yes I certainly feel it the more I do. But u can’t add and decrease daily can you? As the hormone has to build up over weeks.

[Caesard in reply to MMAndrea52]

Daily can be done only with T3 supplementing and in special cases (hard exercising)

I wouldn't recommend making that a habit though.

[MMAndrea52 in reply to Marz]

Hi Marz well I’m learning ha. It does seem if I do more one day I suffer the next day or sometimes more days. Thanks and u take care 😊

[waveylines]

Hi I dropped my ndt by 1/2 a grain three weeks ago. I always reduce it a little in hot or warm weather as I dont need as much.