Overmedicated

[I5296]

I was diagnosed sub clinical hypothyroid in 2016 at the start of pregnancy. I was on 100mg levoeltroxin and the told to reduce it to 50mg 6 weeks after the birth. Since then I have increased a few times as bloods kept showing I was underactive. I am now on 162.5mg and last week my bloods showed free t4 22.3 (normal 9.0-20.0) and TSH 0.01 (normal 0.35-4.94). I have been told to reduce to 125mg one day and 150mg the next and continue like that for 8 weeks and then get bloods done again. I feel awful. Any advice or anyone have a similar story?

[Treepie]

I think you may need to have private testing .You need to know FT3 which is the active hormone.Also,Vit.D,B12,Ferritin,folate and also antibodies ( if not tested previously) .

[shaws Administrator]

I am sorry you're not too well at present. It seems to me (and I am not medically qualified) that to reduce 100mcg of levo to 50mcg at a stroke was a bit drastic as it is usual to increase/reduce in 25mcg increments.

Do you have your blood tests for hypo at the earliest possible? Fasting? - you can drink water - and allow a gap of 24 hours between last dose of levo and the test? If not your results will be skewed.

You have my sympathy in that with a new baby and not feeling too well yourself no-one can understand how much under the weather you feel.

What you need is a new test and I doubt GP will do all of them. If you can afford it we have private labs which will do all or the ones the GP will not do - these are pin-prick blood tests.

Following the method above to get the best results, request TSH, T4, 3, Free T4, Free T3 and thyroid antibodies. (antibodies will confirm or not whether you have an Autoimmune Thyroid Disease (treatment is the same for hypothyroidism).

thyroiduk.org.uk/tuk/testin...

GP should definitely check B12, Vit D, iron, ferritin and folate.

Everything has to be optimal.

[SlowDragon Administrator]

If you needed a dose reduction, just to 150mcg daily would be large enough and retest in 8-10 weeks (takes longer to rebalance going down than up)

But just testing TSH and FT4 is completely inadequate

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

low vitamin levels are extremely common and tend to cause low TSH

Ask GP to test vitamins and antibodies and FT3

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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 .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

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