I would like to ask for your opinion on what to do next.
Since Nature Throid made me feel awful I have decided to switch to 150 mcg Letrox (German Levo with no allergens).
At 4 weeks this is where I am:
TSH = 0.02 (0.35-4.94)
FT4 = 17.1 (9-19)
FT3 = 3.54 (2.89-4.88)
TT4 = 148 (63-151)
TT3 = 1.37 (0.98-2.33)
Antibodies as always on the higher side.
My vit D is just under excessive at 119
My ferritin has risen to 42, still working on it.
B12 over mid range.
Folate unknown right now
What's better: mood is stable, no weird crashes throughout the day, no crying, hair is nicer and doesn't break, not brittle anymore and not tangled, skin moister and clearer, feeling more like myself, period almost on time (at 26 days) and no pains, falling asleep easily, no anxiety or adrenaline rushes, pulse 66, stable temps between 36.6 - 37.
What's not great since changing: near zero libido, puffiness on face and body, slow metabolism, neck swelled up a little just the last few days, weight gain/water retention, energy stable, but low, can't exercise, need to do things slowly, I fall asleep no problem and wake up mostly refreshed, but I have a light sleep and wake up briefly sometimes, big bags under eyes...
Question: do I add more T4, the smallest I can add is 12.5 mcg to my 150 mcg, or do I add T3 e.g. 2.5 mcg thybon + 150 mcg T4 or add T3 and reduce T4? Or - should I not change from anything as it's been only 4 weeks?
I added T3 the last two days, my mood is better, however, my neck is stiff again and I feel a bit anxious, quite dizzy and spaced out.
Your FT3 is below halfway thru range, so ideally you need to get this up...in theory could be by adding more levo., or by adding T3. You don’t give range or units for your ferritin result, many go up to 130-150; yours needs to be at least halfway thru the range...likely at about 70/80. I wouldn’t add T3 till this is sorted, as you won’t know if symptoms are the result of low iron, or supplemented hormones....so i’d only up the T4 levo. at this stage. If you get the FT4 just above range yet the FT3 hasn’t risen enough then yes T3 might be your answer eventually.
Thank you so much for replying Judith! I need to look for the ferritin range, but from memory the range was up to 200 or even 250, these tests were done in Poland so different ranges. Ferritin is still quite low currently taking Floradix, it has already helped a lot, but hopefully will see a better improvement in a couple of months. I took Galfer and it wasn't doing much in the end, probably due to absorption.
I think this sounds good - I am tolerating levo well, which I am delighted about, but yes, t3 seems a bit too low, would like it at mid-range or just above.
Do you think it is possible to experience panic attacks and some horrible symptoms going over on ft4?
If your ferritin range should be 200-250 top of range then that makes yours even worse...wonder what the bottom of range was and whether your dr. should be investigating for eg anemia, or providing your with iron supplements. Sorry don’t know Floradex, so can’t comment. Look out for Seasidesusie’s replies to posts re supplementing, brands and doses...you in U.K.? I can only go from personal experience, as not a dr., but I didn’t feel bad with FT4 itself going over range, but as I said my FT3 was still low...which gave me hypothyroid symptoms.
The range is 5-204 and I was 46, so definitely need to be at least at 100. By taking Floradix my ferritin has gone by up already, but t I might try to take it three times a day as opposed to two. My doctor thinks that I'm okay once I'm in range...the usual
Thank you - makes sense, I don't think my ft3 will go high if I add 12.5 mcg of t4, only t4 might go up and over.
Looked up Floradex...as a herb etc mixture it isn’t great for raising vit/ min levels ...yes there are 18 mcg iron per portion but iron ‘wraps ‘ around other compounds so your body won’t be absorbing everything else like B vits. Get a better dose ferrous fumarate pill, and don’t take your thyroid med. within 4 hours of it ..for same reason of ‘wrapping’ round. Sadly many members have to DIY dosing as doctors know so little about how to manage thyroid....but do go very slowly, 6-8 weeks on one dose and test bloods ( have a diary , which you seem to be doing, to record basal temp, bp, pulse, how you feel just in case you have to go back a dose or two to progress).
Thank you for looking it up! I used to take ferrous furamate, but it did almost nothing for me, maybe due to absorption issues, not sure... this is why I switched to Floradix and I feel better, my ferritin had gone up in a month on it. But will keep an eye on it. I know it doesn't have as much iron as other pills
Do you think it's possible, since half of my symptoms are better including temps on 150 mcg levo, that I just need more time on it? (Been only on it for 4.5 weeks by now). I don't want to change to soon. I added a tiny bit of that t3 and I am not convinced it's the right way...
I’d concentrate on getting iron up, rather than changing thyroid ‘meds’...bloods might have improved in 6 weeks as iron up. You might be right about absorbing your liquid iron, but you’ll need up to 10 doses a day perhaps....must be an expensive way. I just bought some high dose ‘ff’ pills on Amazon for under £2 with free postage...might be worth trying with vit C. , which I do, as that helps absorption.
Good point, Floradix would be expensive if I need to take so much maybe I could take Floradix and Galfer every day for 4 weeks and see if this improves anything. I have also heard that low TSH slows conversion so not sure if having it supressed at 0.02 is good? Thanks again for your help, really appreciate it
Unless you are a doctor/consultant you should not be tinkering with your prescription.
You will know that it takes many weeks to benefit from a change of dose and that increases or decreases should be done slowly. My sister's doctor gave her too much thyroxine when she went underactive and now she looks like a frog because her eyes bulged.
You are playing with fire and should let your doctor decide.
Thanks - I have a call with my doctor this week. 12.5 T4 and 2.5 mcg T3 are small doses. I am very far from being overmedicated. I have been overdosed in 2017 and that was awful, and happened on much higher doses. Sorry to hear about your sister, obviously the doctor didn't know what they were doing, this is why some members here have trust issues with their doctors and that was certainly the case with me too. Take care!
Absolutely! Just reminded myself that there was a reason why I went off t3 so definitely will have to work on my patience with t4! Will exhaust all options first to improve conversion and most likely will talk to my endo about increasing levo by 12.5 to see if ft3 will budge
Are you still having some symptoms with T4 only ? It takes time for your body to acclimate to dose changes . If you feel fine and are taking all the nutrients that help our thyroid meds work better for us . I wouldn't worry . Going gluten dairy soy sugar free works wonders too .
I was on NDT, changed to T4 only about 4.5 weeks ago and have found the change to be quite positive, but yes, I still have hypo symptoms - puffiness is back, neck swelling currently, libido is gone ( I'm 34 years old), metabolism slow, bloated, mood a bit flat, bags under eyes. Improved in terms of my hair, skin, stability re moods, before I was crying every day. I sleep better, I am refreshed in the morning, so maybe this hasn't taken the full effect as of yet? I take all nutrients, I am super healthy , gluten dairy free, but still eating soy, mainly fermented, and some sugar...
Some resolved, some got worse, but then it's been only 4.5 weeks I guess forgot to say my temps are stable between 36.6-37 and pulse 66, period was almost on time and it was not painful...
Patience is a virtue that I personally had to learn for myself too . In a perfect world We as thyroid patients want/like to see instantaneous results . Who can blame us ???
We have all been waiting so so long I remember the time my doctor told me I had Hashimotos. I didn't even flinch, took the tablet and got on with life...was lucky for the first 5 years almost
I think most of us where at one time or another MIA at first . Or until something went wrong and didn't get the proper care from Dr/Endo to feel our optimal self . Out of desperation in my case I felt I had to educate myself as much as possible to be able to navigate my thyroid journey feel my best as possible .
One question, if you don't mind, how long would you wait on this dose? I am tempted to add about 7 mcg of T4 to see if there is any improvement on FT3 levels. I think what bothers me the most is this choking feeling in my throat I have now for about a week
Personally I give myself 8-10 weeks Minimum . If I don't have an unusual symptoms I wait up to 3 months to do BW . Allowing the body *Time* to acclimate to new changes is Very Important and Necessary .
I can do it. My issue is I'm starting a new job in 1.5 weeks (on a break now) and I will travel with them for the first two weeks to US, which will be taxing. This may sound very vein, but it bothers me how exhausted I look like with those bags under my eyes and puffed up face
Not sure about symptoms, they go up and down. Is this normal that you get over some bad ones and then there are more emerging and make you feel horrible, even on the right dose? I certainly don't want to rush anything and make it worse
It might be and this is *only* my hunch that the T4 brand might not suit you and *Maybe* switching to another brand can suit you better . Some T4's have fillers in them that just doesn't work well for us and it might not be the dosage problem .
That is something that you will have to siphon for yourself .
I have ruled this one out already, I'm on the cleanest levo right now, no gluten no corn no lactose no soy, previously taken Eltroxin and that wasn't great in comparison - even had a rash. My conversion is not there yet, most likely because of years on massive doses of T3 added to T4 on NDT and low ferritin, 20% of the range. I might be adding 6-7 mcg to see if this makes a difference for now, since my conversion is 2.1, my calculation states I should have ft3 mid-range on that. Looking at times when I felt okay, my ft3 was minimum 40% on Eltroxin, so I need a tiny bit more and if conversion works better in future I can reduce.
Quick update on my progress I am staying on 150 mcg. I again have problems falling asleep, I am quite hungry a lot, a bit anxious, puffiness is gone, metabolism works like crazy - I feel my levels must be up, so I will test next Wednesday, that would be 6 weeks at 150 mcg. Stay tuned xxxx thanks for all your advice so far!
in reply to
Hi jgeliss, Judith - I have overdone it. About two weeks ago I felt my foot started to vibrate like before. I have increased from 150 to 155 mcg t4 and now I'm on a beta blocker, I am incredibly hungry, digestion is crazy , have diarrhoea, anxiety and start to lose touch with reality. I had this when overdosed before. I will know my results tomorrow, but either my ft3 went up significantly in the last two weeks/conversion worked or my ft4 is too high for me. I'm flying on business to US in 3 days for two weeks and I'm so scared
My sister's doctor gave her too much thyroxine when she went underactive and now she looks like a frog because her eyes bulged.
For the record, I don't think there is any evidence whatsoever that adequate, high or even extremely high levels of levothyroxine cause bulging eyes. (I assume you mean Thyroid Eye Disease.) The cause is usually identified as antibodies which are more commonly found in people with high levels of thyroid hormones but can also occur in those with "normal" or low levels.
Helvella your advice is very well taken and very *Sound* . Personally I think that many on thyroid meds are not aware that hypo/hyper symptoms can over lap . I was one of them too . Continuous Journaling my symptoms and doing BW is what helps me find my dose that works well for me .
I second that - for me hyper and hypo symptoms are almost ideal! It's so important to write things down, when I was overdosed for example - I both gained weight and one time lost weight...
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currently taking Floradix, it has already helped a lot, but hopefully will see a better improvement in a couple of months. I took Galfer and it wasn't doing much in the end, probably due to absorption.
Blood results after starting Levo. advice please
Bloods from March on 150 Levo that's when he upped it from 125 
New Blood Results & present symptoms
Help with blood results with 125 mcg of T4
Confused by new blood results
