Hi I have been called back to the GP due t o bloods results showing I am over medicated again. They want to bring me back down to 75mcg. I went up due to the issues I was having such as Achilles pain (which I still have) all joints hurting, constipated ect. I am terrified that if I go back to 75mcg I will feel awful again and I will not be able to walk. I have hashis but I do not know what to say to gp. Results are TSH o.00006 (0.38-5.33) T4 21.7 (7.0-16) T3 6.1 (3.8-6.0) could this also be a hashi flare as last time i was tested on 75mcg was 0.016 range the same as above and feeling awful. I’m running out of ideas last year I was fine in 100mcg my vit d has come up to 123 (50-150). Can anyone let me have their thoughts on this please. I’m going on holiday in 3 days and now feeling depressed. is it worth Discussing 100 mcg every other day?
Over medicated again and have had enough of it ... - Thyroid UK
Over medicated again and have had enough of it all.
What are your most recent results and ranges for B12, folate and ferritin
What supplements do you currently take?
Are you on strictly gluten free diet as you have Hashimoto's?
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
Is this how you did the test?
January this year when I was previously over medicated were B12-242 (150-900) Folate 7.5 (3.1-19.9) Ferritin 101 (10-210). Didn’t get in with gluten free after being on it for 4 month as I didn’t have time cook Although I do shy away from stuff a I know it’s in and will retry once I have moved and thing settle down. Yes it’s how I did the test didn’t take morning does until after blood test. I cannot to any exercise due to ankle issues so I am Ina bit of a mess.
B12 very low and folate low.
Very likely to find daily good quality vitamin B complex of benefit. Eg Igennus Super B complex or Jarrow B right
If you have symptoms of low B12 (pins and needles etc) then also sublingual B12 lozenges as well for 3-6 months
You need vitamin D retested twice yearly - £29 postal kit
Low B vitamins and low vitamin D linked
drgominak.com/sleep/vitamin...
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Strictly gluten free diet helps many. For large numbers of us it's absolutely essential (as if coeliac)
Rowing Machine is good exercise and doesn't hurt feet
What do you suggest the stretch of folate and ferritin so I can order them. I have to take vit d by spray as my stomachs will not obsorb it will it be the same for these vitamins ?
Like very many with Hashimoto's, I also take vitamin D mouth spray, but vitamin B complex is always a tablet. Seems absorbed ok
If you need the extra B12 as well as B complex then that is either Better You B12 spray or sublingual B12 lozenges (Jarrow are good)
Ferritin level is fine
Strictly gluten free diet helps improve gut and absorption
Personally it wasn't until adding small dose of T3 that plantar fasciitis slowly faded (more info on profile)
Recommend DIO2 gene test if you want to push for T3 prescription
But will most likely need to be gluten free to tolerate T3 anyway
My apologies for gatecrashing Slowdragon but I would appreciate if you could explain the relationship between taking T3 and being gluten free. Thank you!
If we have hidden gluten intolerance it can affect adrenals, vitamin levels and gut function
Gluten intolerance is extremely common with Hashimoto's or Graves.
Going strictly gluten free helps gut heal and is less inflammatory. Many of us find brain fog improves too
Leaky gut is thought to be present in most (or all?) autoimmune diseases. Then holes in gut lining allow gluten to cross into blood stream. Gluten can then cross blood brain barriers
You do not need any gut symptoms suggesting IBS, coeliac etc
Ideally ask GP for coeliac blood test first before giving gluten up, just in case. To rule it out, rather than with expectation of result being positive
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
thyroidpharmacist.com/artic...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
thyroidpharmacist.com/artic...
Much appreciated. Another piece of the jigsaw in place. I had gluten testing done very early on post diagnosis and apparently all ok BUT sometimes I just do as I'm told is best for me and gave it up. I knew about the leaky gut issue but gluten possibly affecting adrenals and nutrient absorption is new to me.
Yes took me over 20 years terrible ill health between both negative coeliac tests ....more on my profile
Off to read now!
Good grief what a journey. You may have suffered many symptoms but determination sure won the day!
Oh and thanks for all the references.
Would adding some Selenium as a supplement help Binky45296 ? I'm under the impression this mineral assists in utilising thyroid hormone
Many of us do take selenium
I started it after it was recommended by gastroenterologist. I can't say I noticed any change, unlike most other supplements which gave clear positive improvements. But I do still take some selenium 2-3 times per week
Just take it daily with multi vit with multi vitamin tablets
Really not advised on here to take a multivitamin.
In part it's too little of what we actually need
But also usually has iodine in. Definitely not recommended with Hashimoto's
drknews.com/iodine-and-hash...
This one does not have iodine and to be honest I don’t take that very often the only vit I was down on was d which is resolved; Ian still taking) It seems I have issues with all kinds of antibodies ie hashi ms anti d anti k (last two are pregnancy related so they are out of the picture) so looking for the right mix these just help me along till I find it. I will take b12 when they come and selenium is in order.
It could very well be a Hashi's flare, yes. Does your doctor know anything about Hashi's? Probably not. If not, you might have to educate him.
100 mcg every other day might work at the moment, whilst your FT4 is high, but it will go down, if they is a flare, and then it won't be enough. But, you could go for the 100/75, and cross that bridge when you come to it. 
Will speak to him tomorrow.
Hopefully he will agree, he does know some about hashi and hubby is coming with me to argue the case.
Spoke to her she’s agreed to allow me to go to 100/75 until I have a blood test in 8 weeks, of it come up I am still over medicated then it will be down to 75. She admitted to me this is past her knowledge as I am not fitting in with how I should on Levo. However she feels ankle issues are due to me being over medicated. Have an appointment to see endo in September. So will now have to wait and see. I know something is not right as I was fine on 100mcg late last year. I have all my vitamins in range now.
You do look overmedicated on 100mcg, however if you know from past experience you feel ill on 75mcg then (as gg said), compromise the dose, do 100 one day and 75 the next. Since you are going on holiday in 3 days do not drop down to the dose which you know will make you ill. So long as your blood pressure and/or pulse rate are not sky high a dose of 87mcg (the compromised dose), can do no harm over a couple of weeks. Your critical or optimal dose is between those two values. Now it is time for fine tuning - that's good, your almost there!
Dear Binky,
GPs are constantly wanting to lower their prescribed doses of Thyroid medication. However, their Code of Conduct - Good Medical Practice - says they have to:
work in partnership with patients and respect their rights
to privacy and dignity (paragraph 2)
listen to patients, take account of their views, and respond
honestly to their questions.
(paragraph 31)
give patients the information they want or need to know in a way they can understand.(paragraph 32)
work in partnership with patients, sharing with them the
information they will need to make decisions about their care (paragraph 49)
i suggest that when the GP suggests reducing your dose you tell him/her that you do not want that, you feel good on your dose and you don't feel good on his/her proposed dose, therefore you want to stay on the dose you are on.
He/She is likely to then say that there is risk of Atrial Fibrillation and/or Osteoporosis.
You should then tell him/her that recent research shows this not to be true.
See Effects of Long-Term Combination LT4 and LT3 Therapy for Improving Hypothyroidism and Overall Quality of Life
2018 by Anam Tariq, DO, Yijin Wert, MS, Pramil Cheriyath, MD, and Renu Joshi, MD
If necessary be firm and resolute in staying on the dose you feel good on.
Make sure you have someone with you to back you up and confirm what was or wasn't said.
She’s agreed to allow me to go 100/75 u til the next blood test and she said all of that. Hubby was really good and helped a lot. Now endo to deal with in sept.
If you feel good on 100mcg and you don't have any HYPERthyroid symptoms, then that is probably the best dose for you. Some people would suggest to carefully INCREASE the dose to see if the Achilles tendon symptom goes away but be very careful to monitor for signs of HYPERthyroidism if you do that and reduce the dose if you have the signs and symptoms e.g. palpitations, sweats, fast heart beat, etc.
Really, only you know what your optimum dose is and you and your doctor should be aiming for that. Sadly, most doctors are stuck in old ways of working, when what they say goes. And 3 cheers for your Hubby supporting you.
Being slightly overmedicated can make you feel just as bad as being undermedicated. If you are currently on 100mcg why not try to negotiate 100mcg and 75mcg on alternate days?
Bonny I was in the same boat as you. I ended having to switch t4 meds to tirosint. I stepped down a dose from 112 mcg to 100mcg when starting because it is a pure form of t4. I was either allergic or not metabolizing ndt, Levi, or synthroid appropriately and dr kept over prescribing due to labs not based on how I felt. Last week my endocrinologist suggested coming off tirosint for two days and reinstating a lower dose. I took lower dose for4 days until I felt that awful hypothyroid hit. I reinstated regular dose of t4 Monday and feel a little better. When I am swinging hyperthyroid my calcium, magnesium, and potassium get depleted. I have to request a magnesium because it’s not on cmp. It also took a year to indicate that I had low vitamin d due to parathyroid destruction. I am now feeling the confusion between hyper and hypo but had labs drawn yesterday to determine that I was truly hypo and experiencing side effects of tsh coming back down.
Thanks will look into that
I stopped thyroid meds long enough to stop diaherea and tremor. It did ease off. I experienced extreme depression and anxiety with hyperthyroid. I have never experienced depression like that in my life. It is still lingering.
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