Is my levothyroxine too high?

[Whitney2017]

Hi i am diagnosed hashis and worked hard to reduce my antibodies. I am having some symptoms of too high levothyroxine and wondered what you might make of my labs. Thanks in advance x

[SeasideSusie Remembering]

You've gone slightly over range with FT4 and FT3 is close to top of range. If you are experiencing symptoms of overmedication, just drop dose of Levo slightly. This should reduce both FT4 and FT3. You could be approaching a Hashi's hyper-phase.

Are you still on 75mcg Levo? What size tablets do you have? Maybe try reducing by 12.5mcg for now. You could even try 6.25mcg if you have 25mcg tablets and can cut them into quarters. Or juggle doses to give 68.75mcg average daily, or 62.5mcg.

[Whitney2017]

Hello thank you so much for your response. I've been on 100mg for a good 5 months now but have lost quite a bit of weight through dieting and wondering if the levothyroxine is now too high x

[humanbean in reply to Whitney2017]

If 100mcg Levo is too much and 75mcg is too little, then you could try alternating between 75mcg and 100mcg per day. Another possibility might be taking 100mcg during the week and only 75mcg on weekends. If you are lucky you may just need the tiniest tweak in dose to get it absolutely right for you.

[Whitney2017 in reply to humanbean]

That's my gut feeling too. Thank you

[Whitney2017]

Although I'm still tired all the time! X

[Marz in reply to Whitney2017]

Have you had B12 - Folate - Ferritin - VitD tested ? If low they will be the cause of your fatigue.

[Whitney2017 in reply to Marz]

All fine apart from Iron- been prescribed ferrous fumarate.

[Marz in reply to Whitney2017]

So being prescribed Ferrous Fumerate suggests your level of Iron was very LOW. How much are you taking ? - and are you taking it with VitC to aid absorption ? Was it your Ferritin that was low or the Serum Iron ? Hope you obtained copies of your results. Being told your results are fine is not really a result - fine can mean just in range when you need some results to be high in range. If your Iron is low then it could mean other results will be too - due to mal-absorption. So was your B12 around 500 - VitD around 100 and folate mid-range ?

Your results a year ago were not optimal - the Active B12 is good around 70+ ...

[Whitney2017 in reply to Marz]

I really need to get copies of my tests from gp. They said the b12 was in range but iron was low. I enquired about b12 injections but they said they wouldn't recommend as my b12 was in range.

In all honesty I'm fearful of taking the ferrous fumarate- I've researched too much and scared that it is going to negatively affect my health. I've been trying to raise my iron through lentils, green veg etc and taking a daily regime of vitamins.

[Marz in reply to Whitney2017]

Maybe your surgery has on-line records - so worth enquiring. Am not sure food will raise your Iron levels - eating liver and Black Pudding may help Which vitamins are you taking and how much ?

You need to know where your B12 was - along with all the others sorry to be a nag !

[Whitney2017 in reply to Marz]

Vitamins I'm taking are selenium, apple cider vinegar, minerals, vitamin d . I'll get hold of my results today .

[HLAB35 in reply to Whitney2017]

Not sure I understand you wrt being concerned about the negative effects of iron supplementation. Have you had bad reactions in the past? You need copies of your full iron panel and other blood results today, so it is easier for many to help you. It is possible to have weird reactions to iron, but that would be unusual if both Ferritin and stored iron are low in range unless you have liver issues and that could be a reason to be cautious.

[Hashihouseman]

If you are taking levothyroxine as your only replacement and it seems that you could feel better with less yet still have some fatigue, particularly muscle fatigue, it may be that the size of the dose itself could be reduced by splitting the daily amount into 2 or even 4. This potentially does 2 things, it reduces the peak of absorbed levothyroxine which could be reducing DI02 enzyme activity in the cells through the normal feedback loop and the overall absorbed dose will probably reduce through decreased absorbtption efficiency compared to a single nighttime/waking dose when you are in fasted state...... apart from that it looks like you are a terrifically efficient t4 - t3 converter, I’m on the same dose and that only gives me 4-5 pmol free t3. I’m 70kg. If I take 100mcg at one go my blood levels are worse and I feel unwell. The thyroid gland doesn’t dump 100mcg of free t4 on the body like the standard approach to levothyroxine dosing does! Food for thought

[McPammy in reply to Hashihouseman]

I’ve recently had to start splitting my dose to avoid peak absorption as if this happens I get very tingly, feel like flooded with adrenaline and near fainting, then later in the day I can’t walk properly.

[Whitney2017 in reply to Hashihouseman]

Interesting, thank you for your response. I'm going to see my gp today and will suggest we split the dose. Thank you x

[Hashihouseman in reply to Whitney2017]

Hope it helps

Incidentally GPs sometimes slavishly follow the pharmaceutical company info on levothyroxine dosing, focusing on maximising absorption instead of physiological and individual responses to peak levels from one big dose. It’s past time the drug companies reviewed this dosing issue - all the research data I have found states absorption between 60 and 80 % so the difference on a 100 mcg dose is actually quite small and no more or less significant than many other individual variables that affect dose titrations. If split dosing is less challenging to normal thyroid homeostasis then reduced absorption is a very small price well worth paying. The biggest issue may be the extra attention and effort we have to make to take all the doses more or less consistently. Anyway that was the reasoning I presented to my GP, which went well as a footnote my T3 levels actually improved from this alone so gut absorption of levothyroxine may not be anywhere near as significant as DI02 suppression from unphysiological levothyroxine peaks......

[McPammy]

Hi.

I’ve just switched to liquid thyroxine. I didn’t even know it existed. Great thing about liquid is that you can take a more precise dose to tailor to your needs. Rather than trying to cut or split tablets you take take the correct dose by measuring in a syringe. I can take 85mcg daily equivalents quite easily now. Just a thought. Plus it hasn’t got excipients in like tablets. If you’re tired and your thyroid is fairly optimal, try checking your cortisol levels at 9am. A lot of dieting can affect your adrenals along with vitamins. I was dieting trying to lose weight also in doing this my vitamins dropped and my cortisol was also effected.

Thanks. Pam

[Whitney2017 in reply to McPammy]

I had my cortisol tested through the endo- via morning bloods and 24 hour urine. They said it was in range but I really do need to start requesting copies of my results x

[weescone]

Can I ask how one reduces antibodies?

[Whitney2017 in reply to weescone]

I've been taking ldn for just over a year and finding this seems to help with reducing antibodies. I also take selenium daily and have cut out lactose and gluten. My antibodies upon diagnosis were over 1000 and now both antibodies are down into the 160s.

[weescone in reply to Whitney2017]

Thanks Whitney, i’ve just started seeing a naturopath and aim to search all avenues. 👍🏻