Upping to 75mcg- what symptoms to look for for over medication?

Hello

Bit of advice please-

My TSH has now dropped from an initial 5.8 pre Levo (and extremely ill) to 1.86 on 50mcg at the 7 week mark (eg now) and feeling much improved although not there yet. My doctor is happy for me to trial an increase to 75mcg based on symptoms not bloods.

Incidentally, my previous bloods when I’d only been on Levo for 3 weeks was TSH at 2.96, T4 reading was 17.9 and T3 at 4.3, but I was still feeling v poorly then. That was 4 weeks ago.

I’m on Vit D mega doses and have introduced B Complex and will add Magnesium in a week or so.

My question is- the doctor has quite rightly asked me to monitor blood pressure, pulse rate and symptoms to ensure I don’t over medicate so what should I be looking out for? It’s my decision to increase but I have promised to be vigilant. We will review in 6 weeks.

Is the general feeling that I’ll still be safe at 75mcg? I know we don’t medicate on weight but I’m 60kg. I’ve also been diagnosed as Hashimotos with high antibodies.

Any help gratefully received x

[SlowDragon Administrator]

Actually new guidelines do recommend dose by weight.....1.6mcg levothyroxine per kilo of your weight .....which for you would be 96mcg daily (but some people need more....others less )

So increasing to 75mcg should be fine

New NICE guidelines

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

BMJ clear on dose required

bmj.com/content/368/bmj.m41

Recommend wearing a Fitbit or similar to record resting heart rate.....good to print out and show GP

Are you on strictly gluten free diet yet?

Had coeliac blood test done?

[Hidden in reply to SlowDragon]

Hi SlowDragon- thank you!

Coeliac negative. I’ve not started GF yet (but have bought some cook books in prep) as this is the next step. I know I’ve been experiencing Inflammation throughout all of this- I can literally feel it inside- but as I think I’ve had CFS alongside, didn’t want to start eliminating until a bit more powered up. I’ve looked at the links you’ve shared so know in my heart I need to do this and give it 3 months to see impact. Ps I’ll get a Fitbit never thought of that! X

[SlowDragon Administrator in reply to Hidden]

You need the one that records heart rate ...and wear it at night

I find it extremely helpful....as my resting heart rate is low (54-57) but TSH suppressed (typical when also on T3 alongside levothyroxine)

Printed Fitbit summaries have helped in persuading GP I am not overtreated. (Ft4 and Ft3 both within range)

[Hidden in reply to SlowDragon]

Great thanks, as always! I’ll get one of these! X