Answers please!

[krm13]

I have been diagnosed with Hashimoto’s a few years ago and was proscribed 25mg of Levothryoxine along with 50mg of Zoloft. I eventually upped to 50mg on the Levo and did fine until April of this year and was upped to 75mg as I had put on weight and was lacking iodine in my diet. (I’m still so new this disease) Anyways, three months ago I stopped taking Zoloft and felt fine with minimum withdrawals. The two month mark of my last Zoloft pill I had lost 12lbs in a week and ended up in the ER with muscle spasms, strong pulse, facial flushing, and loss of appetite. Was sent home with all tests being fine. A week later I saw my Doctor’s nurse practitioner (couldn’t get into to him any faster) and she suggested I go back on Zoloft since she thought I was having a relapse of anxiety and depression. Fast forward a month (being this week) I noticed my thyroid is a lot bigger than normal and I am still having extreme anxiety, dry mouth, insomnia, muscle spasms, joint pain in elbow and shoulder, strong heartbeat all day long (it’s not fast, but I can feel it beating strongly and I can hear it when I’m trying to sleep) night sweats, shallow breathing, loose stools, and lightheaded. I ended back in the ER this past Friday because I was having what I thought were skipped heartbeats but turns out they were extra heartbeats and I couldn’t get them to stop. The ER Doctor suggested that I take two days off the Levo and then take half of my Levo dose (35mg) until I see my doctor again. I also had an echocardiogram a couple of weeks ago that showed nothing wrong. So today I saw my doctor and he decided to run all autoimmune tests and I won’t get results back for a couple of weeks. He then asked what type of multivitamin I take and I told him and which it contains iodine and I started taking them around the time I stopped Zoloft. So he said I may be overmedicating myself and he brought my dosage down to 50mg instead of 75mg even though my labs are showing normal from when I saw the nurse. I guess my question is could iodine really cause me to be overmedicated? I’m just scared about how bad I’ve been feeling and if I’m ever going to get better. Is 50mg enough to come down from being overmedicated and how long will I feel better? I have health anxiety and I’m afraid this strong pulse isn’t going to go away and that it’s eventually going to lead to a weak heart. I’m also afraid that maybe stopping Zoloft has caused my thyroid to react badly and reinstating it is only making my symptoms worse. Although my mood has been lifted since I started back on Zoloft but my anxiety is still through the roof. It’s only been a month since all of this has gone downhill but I’m seeing no relief and I’m afraid it’s all ruining my life and I’m going to be stuck like this 😞

[greygoose]

Oh, dear. You haven't seen one single person that knows anything about thyroid, have you. So sad. It's difficult to say without seeing any labs, but it seems more likely to me that you were under-medicated, rather than over-medicated.

OR, as you have Hashi's, you could have had a Hashi's 'hyper' swing, which has nothing to do with your levo dose. But, it was totally irresponsible of those doctors to mess around with your dose without first doing labs.

my labs are showing normal from when I saw the nurse

So, what are these 'normal' labs? Did you get a copy? It's really, really important to always ask for a print-out of your results and ranges, every time you have a blood test. There's no such thing as 'normal'. In doctor-speak it just means 'in-range'. But, just being 'in-range' is not always good enough. So, ask at reception for a print-out of your results, and post them on here, with the ranges. And, let's have a look.

Anxiety is a symptom of under-medication. And, if you were properly medicated, you probably wouldn't need an antidepressant.

As for the iodine, no, I would say that it's highly unlikely that it caused you to be over-medicated. Iodine is not a treatment for under-active thyroid. In excess, it's anti-thyroid. Why do you think you weren't getting enough iodine from your food? Did you have any sort of iodine testing?

You shouldn't be taking a multivitamin, anyway, for all sorts of reasons.

* If your multi contains iron, it will block the absorption of all the vitamins - you won't absorb a single one! Iron should be taken at least two hours away from any other supplement except vit C, which is necessary to aid absorption of iron, and protect the stomach.

* If your multi also contains calcium, the iron and calcium will bind together and you won't be able to absorb either of them.

* Multi's often contain things you shouldn't take or don't need : calcium, iodine, copper. These things should be tested before supplementing.

* Multi's often contain the cheapest, least absorbable form of the supplement : magnesium oxide, instead of magnesium citrate or one of the other good forms; cyanocobalamin instead of methylcobalamin; folic acid instead of methylfolate; etc. etc. etc.

* Multi's do not contain enough of anything to help a true deficiency, even if you could absorb them.

* When taking several supplements, you should start them individually at two weekly intervals, not all at once as you would with a multi. Because, if you start them all at once, and something doesn't agree with you, you won't know which one it is and you'll be back to square one.

With a multivitamin, you are just throwing your money down the drain, at best, and doing actual harm at worst. Far better to get tested for vit D, vit B12, folate and ferritin, and build up your supplementation program based on the results. Nothing will help you if you don't need it, more is not better.

[krm13 in reply to greygoose]

I just got approved today for insurance so I can see a specialist this December. I appreciate your comments though. I don’t have any lab results but was just told I was in the normal range. Do you think it’s possible that I could have started absorbing more meds since I stopped taking Zoloft? I know what it feels like to be under medicated. I was that way earlier this year. I’m still in early stages of Hashimotos. The weight loss has really effected me tremendously and I honestly believe it’s from over treatment.

[greygoose in reply to krm13]

It's perfectly normal to lose weight when in the throes of a Hashi's 'hyper' swing. And, I see no way you could know the difference between that and over-medication, just from the way you feel.

Always, always ask for a print-out of your labs, otherwise, you'll never going to be able to keep track of where you are. Having a doctor tell you that your results are 'in-range' is no substitute for seeing the actual numbers for yourself. In fact, it's meaningless. The ranges are far too wide. And, you should be keeping your own records, with your results, what you were taking at the time, and how you feel, which will be invaluable in the future if there are any problems. If I were you, I'd ring reception and ask them to print out your results, and you'll collect them at their convenience.

Unless you were taking your zoloft at the same time as your levo, I see no reason why you would now be absorbing more levo because of stopping the zoloft. One normally takes that at least two hours away from levo.

How do you know you're in the early stages of Hashi's? Have you had an ultrasound?

[krm13 in reply to greygoose]

I have an ultrasound scheduled for next month. I’ll know my labs next Tuesday. But the ER told me to split my 75mg in half until I see my doctor and so I took the 35mg for about four days and then my doctor sent me home with 50mg until the hyper symptoms go away because he said the iodine I was taking made me “hyper”. I’m still so new to this and am seeing a specialist next month. Thank God. I’ve been feeling like major crap lately and I need my life back. But I have noticed the past couple of days my resting heart rate is 59. But as soon as I get up it rises to like the 80’s. Could be from my shallow breathing as well, but do you think my body is now responding to the 35mg and will eventually level out with the 50? Or do you think my body is responding to the 50? I started taking the 50 about a week ago.

[greygoose in reply to krm13]

he said the iodine I was taking made me “hyper”

Well, I'm pretty sure he's wrong about that. For the iodine to make you 'hyper', you would have to have a fully working gland. Iodine by itself does not raise thyroid hormone levels, it needs to be converted into thyroid hormone with the addition of tyrosine. So, unless you were also taking tyrosine AND had a fully functional thyroid, the iodine is unlikely to become thyroid hormone. Pretty certain you had a Hashi's 'hyper' swing - if indeed you were 'hyper' at all. But, you sound more like hypo, to me. Still the labs will settle it when you get the copy.

do you think my body is now responding to the 35mg and will eventually level out with the 50? Or do you think my body is responding to the 50? I started taking the 50 about a week ago.

Depends what you mean by 'level' out. If you're asking do I think 50 mcg is going to be enough thyroid hormone replacement to make you well, then no. I don't. And, I don't think your body is doing much responding to the levo at all, because you haven't been on those lower doses long enough to make that much difference.

But, it's crazy trying to talk about this without seeing any labs, because symptoms aren't specific enough to tell you anything much. You need to take them in conjunction with lab results. Could be that the results will prove us both wrong, and it was something else entirely.