Hi all
If I am over medicated on levo
Do the symptoms get worse as the day Goes on?
Current symptoms
No sleep
Anxiety
Erratic
Only feel safe when with wife
Depression
Shakes
Cold and chills
Brain fog
I get very worried as the day goes on
Bloods getting done Monday what should I be looking out for in the results?
It all sounds more as though you are under not over medicated to me but you need to post your recent blood test results for anyone to give you a sensible answer. Ask your GP for free T4 and free T3 and TSH plus any vitamin and mineral checks they or will do. We need iron, ferritin, B12 folate and Vit D. Start a new thread with these and members will advise. What dose are you taking of which medication?
I think you may be undermedicated - not over - and I hope you have the earliest appointment for your blood test, and blood drawn when fasting and a gap of 24 hours between your last dose of levo and the test and take afterwards.
It would be excellent if the doctor tested TSH, T4, T3, Free T4, and Free T3.
Usually only TSH and T4 is taken. However, you are suffering from symptoms of hypothyroidism I'm sure, due to not yet being on an optimum dose. You will tick off more than a couple of symptoms on the following link:-
thyroiduk.org.uk/tuk/about_...
You may have to get a private test for FT4 and FT3.
thyroiduk.org.uk/tuk/testin...
thyroiduk.org.uk/tuk/testin...
Of the tests above, Free T4 and Free T3 are more informative and, as I stated, rarely tested. You can get a private test for these if you wish and TUK have several recommended labs.
Thanks. I am on 200mcg of levo
TAke them on a morning about 7am and wait 1 hour before any thing.
Regards fasting. Can you go into more detail for me.
Bloods will be at 9.40am on Monday
Re fasting - if we're having blood tests for our thyroid hormones, it has to be at the very earliest, fasting (no breakfast but we can drink water) and allow a gap of 24 hours between our last dose and test and take it afterwards.
However, if you're not feeling well you really need a Free T4 and Free T3 blood test and few doctors will do these. I will give you a link for an explanation why these are important, especially if you're not feeling well.Both should be in the upper part of the ranges.
thyroiduk.org.uk/tuk/testin...
excerpt from above link:
"FT4 = FREE T4
Thyroid hormones not bound to proteins. FT4 lowers when the thyroid is struggling.
The approx. reference range for this test is 10 to 24
FT3 = FREE T3
T4 converts to T3 and is the only thyroid hormone actually used by the body's cells.
The approx. reference range for Free T3 is 4 to 8.3
We at Thyroid UK believe that you need to know your Free T3 level too because this will often show low if you are not converting, and high if you have blocked receptor cells. Even if you are converting, the body needs the extra T3 that a normal thyroid produces. There has been some research to show that people feel better on a mixture of Thyroxine (T4) and Triiodothyronine (T3). Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in patients with hypothyroidism – The New England Journal of Medicine Feb.11, 99 Vol. 340. (Click here for this article).
With all of these tests, your results could be anywhere within the range and you would be classed as "normal". If you are at the very edge of the range, either at the bottom or at the top, you could be classed as "borderline". Neither you nor your doctor truly knows what your normal is, if you did not have a blood test done before you became ill. There are also particular reasons why the blood tests remain in the normal range. If you are not converting from T4 to T3 or if your cells are not taking up the T3 normally, your T4 levels and your TSH levels will still show as normal.
The Broda Barnes Foundation tell us "Dr Barnes found that the primary reason for the inaccuracy of the blood tests for thyroid function is that the thyroid hormones are not utilized in the blood, but are utilized intracellularly. Therefore a patient can have enough thyroid hormones circulating in the blood to give a "normal" reading, but if the hormones are not getting into the cells, the patient will be hypothyroid.
I'd echo that your symptoms may well be signifying that you are under-medicated. However, sometimes people get better results by swapping when they take their meds ie If you take them at night, by the following evening you're longer away from the most recent dose than had it been taken that morning, and the simple expediency of swapping, so that if the same effect happens, it is when you are sleeping, can resolve things. But on balance, your up-coming blood test results will perhaps show a need to increase your dose.
You don't need to be looking out for anything in the results yourself unless you want to; simply post them all here and folks can comment.
I was put up to 200mcg 6 weeks ago and they did my bloods after 4 weeks
I don’t have a thyroid. cancer.
TSH 0.48 (0.38-5.33)
T3 6.7 (3.8-6.2)
This time they are only doing
TSH
T3
T4
Bone profile
Thyb
You need to have not taken your Levo thyroxine in the preceding 24 hrs before your blood draw, and not to have eaten since your evening meal of the day before. Really, testing 4 weeks is too soon after a dose increase, as Levo takes about 6 weeks to reach a steady state ( where the level ingested is in balance with that eliminated), but how big a dose increase was it, that took you to 200 mcg?
He put it up by 50mcg on Xmas eve
It may be that if your symptoms have arisen, or worsened, since that increase, that it is because it was too big a jump for you - the NICE guidance is that Levothyroxine should be increased in 25 mcg increments if you are over 50 yrs of age, or 25-50 mcg if below 50 yrs:
For Adult 18–49 years
Initially 50–100 micrograms once daily; adjusted in steps of 25–50 micrograms every 3–4 weeks, adjusted according to response; maintenance 100–200 micrograms once daily, dose to be taken preferably at least 30 minutes before breakfast, caffeine-containing liquids (e.g. coffee, tea), or other medication.
For Adult 50 years and over
Initially 25 micrograms once daily; adjusted in steps of 25 micrograms every 4 weeks, adjusted according to response; maintenance 50–200 micrograms once daily, dose to be taken preferably at least 30 minutes before breakfast, caffeine-containing liquids (e.g. coffee, tea), or other medication.
I am 39
Sounds fairly heavy-handed.
Once on a dose anywhere near reasonable, I always think that dose adjustments should be small increments. For example, 25 micrograms a day being the largest that seems sensible.
By alternating doses day by day (e.g. 150 and 175), you could have incremented your dose by just 12.5 a day. See how it goes. Then 175 every day and see how it goes. etc.
(I don't like alternate day dosing but it is better than significant over- or under-dosing due to excessively large increments.)
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