Unstable!

[Littledancingtiger]

Can you suddenly become intolerant and unstable on meds when you’ve been stable for years? I’ve become buzzed, jittery, wired and almost manic. But can’t figure out why or what’s going on. It’s like my body is dumping out adrenaline and I can’t calm down “wired but tired”. I have not had cortisol problems before but haven’t had saliva tested in a year. My last blood result showed ok levels beginning of Jan - 426 (133-527)

I’ve also got a UTI and oral thrush. Skipping my thyroid meds seems to help. I meant to test my levels but I was bordering on psychotic and really out of it my partner was worried so we spent days in the hospital where I didn’t take my meds at all. I had slight fever and the UTI and thrush was picked up then. Nothing else was found. My HR is a bit up and down but they’ve said my vitals are normal and released me.

I seemed to feel a bit better without taking my meds though two days later I felt like my head was back on right and did manage to sleep naturally - I hadn’t slept in 5 days!

I’ve been on NDT for years. Last labs in November were fine on 3 and a half grains, I had just raised my dose by a quarter and retested. However important to note last time I did this and raised to 3 and a half grains is where I became overmedicated last time. I saw no need to check bloods again however as hadn’t raised the dose further after this. However GP did test in January but forgot T3 so the labs were useless.

These labs were about 7 weeks after the raise.

TSH 0.02

T4 12.7 (12-22)

T3 5.39 (3.1-6.8)

I did begin to develop poor sleep a few weeks before my manic episode - was waking up around 3-4.30am. It took me a long while last time to feel overmedicated from an August raise I didn’t actually feel particularly bad until back end of October. So timing would probably fit. My first clue though was faster HR and lots of palpitations. This time it’s more buzzed, jittery, can’t sit still.

Any clues what could be going on? I know it’s a little difficult without labs. I was going to skip a few days until I felt more hypo and reduce back my dose. Can one suddenly develop adrenal fatigue?

Another important note - I’ve increased My B12 intake and have read this may have an impact on better absorption. My routines are also all over the place with feeling unwell. As soon as I became unwell with the UTI I stopped drinking my morning coffee for a weeknsomething I had always done not long after taking my meds. I know, I know but I figured it didn’t matter as consistency was key in how I took them! I wonder if I’ve thrown my whole system out of whack here?

[SlowDragon Administrator]

Have you recently had change in brand of Levothyroxine?

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

verywell.com/should-i-take-...

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

There is some evidence that UTI and being hypothyroid are more likely

Your FT4 is low, but the. You have been skipping doses

Bloods need testing After 6 weeks CONSTANT dose

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all 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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

[Littledancingtiger in reply to SlowDragon]

Yes I always test AM fasting. On NDT not Levo so this is why T4 is lower end. Same brand nothing new. Can’t figure out what’s going on unless I’m suddenly swinging (I do have Hashimotos).