Hyperthryroidism/ anxiety

[nothyroid2018]

Hi all.

I have really lost my mind at the mo and need your help

Story

Had Totalthyroidecty Aug

Rai in Oct

Was on 150mcg levothroxin

NHS let my TSH go up to 5.03

On Xmas eve put my tablets up to 200mcg

Had bloods 4 weeks later tsh 0.48 (0.38 - 5.33) and T3 was 6.7 (3.8-6.2)

T4 was not done

My anxiety is off the scale just can’t cope doing anything

Question could I now be Hyperthryroidism

Want would the level need to be for a person with no thyroid?

Next bloods are this Monday

[MaisieGray]

If you have no thyroid it is impossible to be hyperthyroid. You are hypothyroid because you have no thyroid function of your own and are entirely dependent on exogenous thyroid hormones to make up the loss of your own. You may at any point, become over-medicated, and any dose increases or reductions should be by 25 mcg increments, and not 50 mcg as was yours, to avoid too big a change. There is no level of thyroid hormone that is right for a person with no thyroid, nor indeed, for anyone else that is hypothyroid for any reason. We each need what we need, which is individual for each of us. So you may need to reduce your dose by 25 mcg but it isn't possible to advise you with accuracy without knowing what the reference ranges are for those results, for the fT3 in particular - can you edit your post to include them, and add the result for your fT4 too?

[nothyroid2018 in reply to MaisieGray]

Done

[Nanaedake]

You may be overmedicated which can cause similar symptoms to hyperthyroidism. I have found that increasing and decreasing levothyroxine needs to be in 12.5mcg or at most 25mcgs at a time or I get terrible tachycardia which makes me feel anxious. Doctors seemt to have this idea that levothyroxine is a very tolerant drug. In my experience this is not the case and it can be a very small window between being over medicated and under medicated.

Levothyroxine acts like a low index drug which means very small changes make a very big difference. Whoever advised you to increase more than 25mcgs needs to read up on levothyroxine and understand the hormone better. People who have had thyroid surgery can be very sensitive to changes in drug doses it seems. I find the symptoms of being undermedicated are more tolerable than those of being overmedicated but everyone is different. I always increase doses slowly and retest in 4 weeks rather than 6 if needs be.

All sorts of things seem to interfere with thyroid hormone absorption so you will have to be careful about how you store and take the tablets. Making sure you do not take other medications within 2 hours of taking levothyroxine and some like iron and calcium need 4 hours between. Foods containing calcium such as milk also reduce absorption.