I was just wondering if you can be overmedicated or exhibit overmedication symptoms with an above range TSH? For example if your tsh is 12 and you're taking 125 mcg of Levo or 2 grain of NDT and experiencing shakiness, tremors, anxiety, insomnia and heat intolerance. These are textbook symptoms of hyperthyroidism but the TSH indicates hypothyroidism....Any thoughts would be much appreciated !!!!
Overmedication????: I was just wondering if you... - Thyroid UK
Overmedication????
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maymay28
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Tsh is not a perfect indicator of thyroid hormone levels. Getting tsh, ft4 and ft3 done at the same timemay give you a better idea of what is going on.
Thanks for responding Greybeard. ft4 1.0(.9-1.8) ft3 2.7(2.3-5.7) tsh 12(.4-5.0)
As the others have said, you are under medicated. Most of us feel best when our ft3 is in the upper part of its reference range maybe around 5.0. You also need to get vit d, vit b12, Folate, ferratin and your thyroid antibodies tested.
Those results show undermedication. You can get shakes and palpitations etc from being undermedicated as the body revs up adrenaline production to keep you going.
The TSH is a very bad indicator of thyroid status. Doctors who dose by the TSH are very wrong, and are keeping their patients sick. Lots of things can affect the TSH quite apart from the level of thyroid hormones. So, you cannot know if you are over-medicated without seeing your FT4 and FT3.
You can't always go by symptoms, either, because those symptoms you mention could also be hypo symptoms. So, the TSH could be right and you are under-medicated. But, you won't know unless you get your frees tested.
It would be strange to have a TSH that high on 125 mcg levo. So, your doctor should really be doing a retest to check. But, how do you take your levo? Do you take it on an empty stomach, etc? Do you take any other supplements or medication at the same time?
Thanks for responding greygoose. This was more or less about the symptoms whilst having such a high TSH. The free t4 and free t3 are not optimal but within range; ft4 1.0(.9-1.8) and ft3 2.7(2.3-5.7)
Going by your TSH alone in the absence of other results, you'd be presumed to be hypothyroid and your symptoms would match that diagnosis. Many symptoms are evidenced in both hyper and hypothyroidism - with the exception of anxiety I have them all, and I've been hypothyroid for decades ........ Then when you add in your FT3 & 4 results, it appears you are also under-medicated, not over.
Yes, your FT3 is much too low. So, that's what's causing the symptoms and the high TSH. Your FT4 is also low, and you are under-medicated. 
thank you for your invaluable information. I will be increasing T4 and adding T3. I received an ineffectual batch of NDT that increased my TSH significantly and lowered my free T4.
I don't think the T3 is strictly necessary, because your conversion doesn't look that bad at the moment. But, you would need to bring down the TSH first to really know.
Don't increase your levo and add T3 at the same time. That would be too much. People often need to reduce their levo before adding T3, but with you we can't tell if that is necessary because you are under-medicated. You really should take one step at a time.
I’m not sure the symptoms you describe are necessarily signs of overtreatment. It might be useful to take your resting pulse rate and record it over time.
Some very similar signs occur for under and overtreatment, for instance insomnia. That is a sure sign of undertreatment for me, but I can also get it with overtreatment. (If overtreated i find it difficult to get to sleep, but with undertreatment I sleep poorly and gain little benefit from sleep and tend to wake in the early hours and are unable to get back to sleep, unless very hypo, when I barely wake up at all). Heat can also be difficult to cope with when undertreated.
Shakiness tremors and anxiety can result from feelings of pressure from normal life when you’re struggling due to undertreatment.
So possibly it is undertreatment. I agree with greygoose and greybeard63 that you need a test of free T3 and free T4. TSH shouldn’t be used to adjust dose. At least get a repeat test to make sure lab haven’t made an error.
thank you for responding Aurealis. My major issue is the sleeplessness. I am nowhere near optimal in my levels; hopefully it will resolve when that happens.
SlowDragonAdministrator
Low vitamins are extremely common and can cause these symptoms.
Essential to test vitamin D, folate, ferritin and B12
Ask GP to test or test privately
For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
thanks for responding SLOWDRAGON. In my particular case, I've had the bloodwork done for the above and I am now working on bringing all to the optimal level. I get monthly b12 injection which I don't think is enough so I'm looking to self medicate.
Do you also take a daily good quality vitamin B complex, one with folate in not folic acid, to improve folate and support other B vitamins too
I am taking the NOW B-100 complex but looking into trying another brand that one of the other member suggested. I think it was Ignessus (?) B Complex...not sure about spelling.
Igennus Super B
I use that one, now just at one tablet a day. Full dose is two per day. If you have symptoms of low B12 you may need sublingual B12 as well for few weeks/months
What's your actual vitamin D level?
Do you supplement magnesium?
Low vitamin D and B vitamins linked to insomnia
drgominak.com/sleep/vitamin...
When improve vitamin D, it can increase our need for B vitamins
experiencing shakiness, tremors, anxiety, insomnia and heat intolerance.
I would suggest getting your cortisol levels tested. You would also need DHEA measured at the same time as well.
Low or high levels of cortisol can give the symptoms you describe.
thanks HUMANBEAN...I have the kit..just waiting for a day where I'm home all day.
If you can, you really need cortisol to be measured on a day which is as normal as possible. If you get it tested on a relaxed day it will give you unrealistic results.
Good point about testing on an average day. Could you possibly suggest the best saliva cortisol test (uk) to get? As I too have bad heat (as well as cold) intolerance.
Regenerus thyroiduk.org/tuk/testing/r...
or
Genova Diagnostics thyroiduk.org/tuk/testing/g...
Their tests include both Cortisol plus DHEA.
Mention ThyroidUK when ordering and we get a donation.
Regenerus sends results direct to you.
Genova sends results to ThyroidUK who act as your "practioner" as Genova don't deal direct with the public. TUK then sends the results on to you.
Thanks for all that info. I shall get one 😊
Have you tested reverse t3 as well? If you aren't converting t4 into t3, you may converting the t4 into reverse t3, which would make you hypo. I've had some symptoms and hypo. Check your temps.
Reverse T3 testing isn't really necessary. It can tell you if you are producing rT3 but not why. It's not just poor conversion that causes rT3.
Testing FT4 and FT3 at the same time will tell you if you're converting well enough and if not it's quite likely that rT3 will be made if FT4 is over range and FT3 low.
Reverse T3 testing is super important. I don't care if it's not the only thing that causes high t3.
My free T3 and free T4 very good, I was still converting T4 into reverse T3.
So the reason for you making reverse T3 wasn't poor conversion, it was one of the other reasons.
Some reasons for elevated rT3 are:
some medications
strict low calorie dieting
chronic physical or emotional stress
adrenal fatigue
chronic inflammation
low ferritin
acute illness
chronic disease
chronic gut infection
But testing can't tell you the reason.
You know you didn't have poor conversion as the cause of your rT3, did you find out what caused it? Because when it's one of the other causes, the cause has to be addressed.
No, my reason was poor conversion. I am now on T3 only and doing so much better!
my reverse 3 is very good. thanks for responding.
My reverse T3 was very good before I started taking naturethroid, the t4 in the naturethroid converted into Rt3.
Just had my bloods taken and the first time since I became underactive in 2005, I've had to cut down on the thyroxin! The Doctor rang me and asked if I was having hand tremors or palpitations! Luckily it's been caught in time. Just goes to show how important regular blood checks are!!
Hello may may28
I too had terrible insomnia up until about a month ago and these are some things I’ve done that helped me. Not sure if my improvements are as a result of these so I can’t say that they will work for others but thought i would share in case it does.
-Take b vitamins and vitamin D before 2pm as they can stimulate the immune system & keep you awake (so I understand).
- stopped drinking caffeinated drinks after 1pm.
- I take magnesium glycinate 300mg in evening.
- I stopped the antibiotics I was on and focussed on gut health & have used a product called Restore which is supposed to help with leaky gut.
- I still wake up once/twice in night and I use a magnesium oil & rub onto arms & legs
- sometimes I take liposomal melatonin when I wake up but trying to wean myself off it.
For me I really think improving gut health was the key- improved my mood anxiety and sleep. If of course I should say I increased my Levothyroxine slightly and made sure I didn’t get Teva brand.
I learnt a lot of this from the many brilliant helpful people on this group. Thank you all!
I wish you better sleep. Without it I know how awful it can make you feel.
P x
It's only likely you are over, it's very difficult to o we medicate someone hypo thyroid into over thyroid.
Your TSH is well off though, I finally got a good consultant and he essentially said to take levo until the tsh was zero, then see what t3 is like. Looks like you have plenty room to go and your symptoms could well be more under or coincidental.
Thank you for responding. I am working on getting my levels optimal. I'm hopeful.
Had same issue but my tsh was higher it was ndt causing symptoms. I ended up hospitalized.
Check out the Levo, it has been withdrawn in USA ie the generic brand that is made in China. The fillers are the proble, I can’t take it, makes me shake.
helvellaAdministratorThyroid UK
I am not aware of any recent withdrawal of levothyroxine in the USA.
There has been a withdrawal of a desiccated thyroid product (branded "Westminster") as discussed on this thread:
healthunlocked.com/thyroidu...
The precise wording used at points could be misleading.
The Levo fillers are being investigated. Westminister is apparently a Chinese generic drug manufacturer from what I have read.
Westminster is a USA desiccated thyroid product.
It is manufactured from Chinese desiccated thyroid powder. It is not a Chinese generic product. Did you follow my link above? And to the FDA notice?
Could you please clarify what you mean by The Levo fillers are being investigated. ?
It could mean so many things.
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