Accidentally overdosed help!: Is there anyone out... - Thyroid UK

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Accidentally overdosed help!

greenfingers profile image
60 Replies

Is there anyone out there who has accidentally taken there dose of thyroxine at night as well as the morning dose? I have just done this half an hour ago, I then drank some salt water in the hope of being sick. I am frightened now!

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greenfingers
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60 Replies
humanbean profile image
humanbean

Don't be frightened.

Some people take all their Levo in one go once a week having been instructed to do so by doctors.

When pharmaceutical companies test new formulations of Levo they test them on healthy people with doses of 600mcg in one go.

If you've taken an extra dose then miss a dose tomorrow. But truthfully, the chances that you will develop any problems from an extra dose are very, very, very small.

greenfingers profile image
greenfingers in reply to humanbean

Thank you so much. I just don’t want to have a heart attack!

greenfingers profile image
greenfingers in reply to humanbean

All’s well this morning and thanks for putting my mind at rest.

Morgansare profile image
Morgansare in reply to greenfingers

I've always worried about this, I have a pill pot now because I would instantly forget if I had taken it or not, always thought I would have a heart attack too! Did you have any side effects at all? X

greenfingers profile image
greenfingers in reply to Morgansare

No not really. I was expecting my heart to race but it didn’t. I had taken my morning dose then for some strange reason I took it at night too!! Goodness knows why, think I have lost the plot. I don’t recommend drinking the salt water my mouth still tastes a bit salty.

Morgansare profile image
Morgansare in reply to greenfingers

Haha sounds like something I would do ! Glad you are ok and it's made me feel better knowing it's not just me that worries needlessly ! X

FancyPants54 profile image
FancyPants54 in reply to Morgansare

It's a storage hormone. You won't have a heart attack from a storage hormone.

SeasideSusie profile image
SeasideSusieRemembering

greenfingers

Don't worry.

Just miss tomorrow's dose and get back to normal the day after.

Levo (T4) is a storage hormone, it's not quick acting and nothing will happen. You didn't need to try and make yourself sick.

greenfingers profile image
greenfingers in reply to SeasideSusie

Thank very much. I am frightened of having a heart attack. I rang 111 they are going to ring me back.

SeasideSusie profile image
SeasideSusieRemembering in reply to greenfingers

You wont, as Humanbean has said, some people have their whole week's worth of Levo in one dose, often supervised at their GP surgery. If 111 tell you to go to A and E then it's wasting everyone's time and they wont have a clue about how Levo works.

greenfingers profile image
greenfingers in reply to SeasideSusie

Ok. Thank you. I don’t want to go there, hopefully they won’t. It’s 14 hours ago since my last dose so hope I won’t be too bad. I haven’t been sick either just feel queasy! What an idiot I am.

greygoose profile image
greygoose in reply to greenfingers

To be honest, and extra dose would probably do you good! Most people are under-medicated. :)

greenfingers profile image
greenfingers in reply to greygoose

Thanks, I may get more done tomorrow! 😊

greygoose profile image
greygoose in reply to greenfingers

No, you may get more done one day in six weeks. That's how long it takes to have an effect. :D

greenfingers profile image
greenfingers in reply to greygoose

👍

greenfingers profile image
greenfingers in reply to greygoose

All ok thanks

Kimkat profile image
Kimkat in reply to greygoose

This is interesting, why leave off taking Your Levo prior to early morning blood tests if it takes six weeks to react? Or am I missing the point 😬

Timetraveler67 profile image
Timetraveler67 in reply to Kimkat

I also wondered about that too

SeasideSusie profile image
SeasideSusieRemembering in reply to Kimkat

Kimkat

The blood test shows what's in the blood at the time of the blood draw.

T4 peaks in the blood 2-4 hours after ingestion, so testing after taking your Levo will show the dose just taken.

The full effects of a dose of Levo at cellular level can take up to 6 weeks.

Timetraveler67

Kimkat profile image
Kimkat in reply to SeasideSusie

Thanks Susie, I wasn’t even aware that Levo and T4 were the same thing or have I got that wrong?

greygoose profile image
greygoose in reply to Kimkat

Levothyroxine is the synthetic T4 that we take. Levo for short.

SeasideSusie profile image
SeasideSusieRemembering in reply to Kimkat

Kimkat

Yes, Levo is T4.

greygoose profile image
greygoose in reply to Kimkat

You're missing the point. :)

Levo is a storage hormone. It does very little to make you feel anything on its own. It has to be converted to T3, the active hormone. That usually takes about six weeks, one way and another. You don't instantly feel something after taking it.

On the other hand, if you want to measure your T4 levels in the blood, you want to know your normal circulating level, which is found 24 hours after swallowing the pill.

The two things are totally unconnected.

Kimkat profile image
Kimkat in reply to greygoose

Ok. I think 🤔 😂

greygoose profile image
greygoose in reply to Kimkat

Well, if you have any other questions, just ask. :)

greenfingers profile image
greenfingers in reply to SeasideSusie

All ok today and thanks

JAmanda profile image
JAmanda

When I feel over medicated, I drink a large glass of milk. My theory being the calcium stops absorption- but I’m no expert!

greenfingers profile image
greenfingers in reply to JAmanda

Thanks, panicked unnecessarily 🙄 x

Hafa profile image
Hafa in reply to JAmanda

When I first started on thyroid meds the dosage was too high (25 mcg) and I could feel the difference pretty quickly, my heart was pounding. I couldn't reach the doctor and took 2 activated charcoal capsules because I knew this was used in medical settings to reduce absorption of harmful substances.

healthline.com/nutrition/ac...

pubmed.ncbi.nlm.nih.gov/118...

If you're wondering about my "high dosage" the doctor stopped treatment and then re-introduced it with liquid T4 (1 drop 5 mcg was enough at that time, I am now up to 5 drops = 25 mcg)

Lily288 profile image
Lily288 in reply to Hafa

The exact same thing happens to me if I’m on too high a dose. I also feel jittery so I cut back my next dosage. And yes, my doctor is aware.

Hafa profile image
Hafa in reply to Lily288

I hope you get the right dosage sorted out Lily

NWA6 profile image
NWA6 in reply to Hafa

Eh? 25mcg? Too high? This is a starter dose for children, elderly and this with other conditions to take into consideration #confused 😂

Hafa profile image
Hafa in reply to NWA6

I started taking thyroid meds at age 60, I'm 62 now, so I guess I'm "elderly"...most days I don't feel that way though! lol My TSH was 8 and I felt miserable (tired, weight gain, losing hair, etc.). But when the doctor started me on 25 mcg it was too strong so he stopped it and said let's wait and see. I recall him saying "I have patients with a TSH of 16 and without treatment". I moved to a new city and another doctor suggested starting with liquid thryoxine, each drop is 5 mcg. This has worked well, after 2 years I'm at 25 mcg.

NWA6 profile image
NWA6 in reply to Hafa

Ok I see, I guess the wording ‘dosage was too high (25mcg) got me confused, that wouldn’t touch the sides for most. Maybe your body just doesn’t react well to Levo.

TSH is such a rubbish indicator, I felt so rough below 5 and in the 12yrs of history it’s only ever reached 14, I felt hypo but not as bad as when it was 1. Crazy how it all works. Outcome for me was that I needed T3, that was always too low all along.

Hafa profile image
Hafa in reply to NWA6

NWA6, you're further ahead on the journey than myself, hope all's well now!

If I take more than 25 mcg I become hyper-thyroid and need to take a suppression medication. Last time this happened the TSH increased to 3.5. I was told not to restart the thyroid medicine until several blood tests showed if the TSH would rise again. TSH rose to 4 and stayed there (no medicine) for almost 6 months, then rapidly rose to 8 and I restarted the whole process again, first with 5 mcg, a test, another 5 mcg.... Now hovering around TSH 4. Yes, "crazy how it all works".

NWA6 profile image
NWA6 in reply to Hafa

Intriguing! How can you be hyper with a TSH of 3.5? Only thing I think is that when I pushed more Levo. I got to 200mcg and had ‘hyper’ symptoms, anxiety, couldn’t sit down but so tired I wanted to sleep but couldn’t switch off. I didn’t take Levo for a few weeks and felt better but hypo again. Through all of that my FT3 never rose beyond the lowest range even though my FT4 was high.

What were your FT4/3 results during all these ups and downs?

Chaliza profile image
Chaliza

I did that yesterday- thought I was taking my split dose of T3 but took an extra 100mg Levo. No problem .as it was in the middle of the day and I had eaten so I just had coffee As that inhibits the absorption. There again I’ve been taking thyroid meds for 35 years 😁 and I’ve done it many times before and never had any issues.

Lily288 profile image
Lily288 in reply to Chaliza

Just to clarify, I think you meant to write 100mcg.

Chaliza profile image
Chaliza in reply to Lily288

Yip all the mg and mcg with autocorrect can be quite tiresome 🙃

greenfingers profile image
greenfingers

Thanks for that. I have taken it for 25 years plus, first time I have ever done it. I am ok except tired from waiting up till 1am for NHS to ring me back! Thanks again.

Kimkat profile image
Kimkat in reply to greenfingers

What advice if any did the NHS give?

greenfingers profile image
greenfingers in reply to Kimkat

I only spoke to the person taking the initial call. I was told someone from the medical team would ring within 3 hours. After two and a half hours after reading the advice from humanbean, seaside susie and greygoose I rang them back and cancelled the call. Unfortunately someone did ring me but by then I was asleep. They left a voicemail but there was a lot of interference so unable to tell what they were saying. So I don’t know what advice they would have given.

just-typing profile image
just-typing

If it worries you, your best course of action is to buy a 7 day pill box. That way you can have peace of mind. I hope you okay now

Kind Regards

Knackeredoldhag profile image
Knackeredoldhag

You’ll probably feel loads better, LOL 😂

penny profile image
penny

I once took 500mcg of T3 in one go (a mistake, obviously); no discernible effect.

Cassandra profile image
Cassandra

Don’t worry I have done this myself and nothing happened so you will be fine x

Foxtrot89 profile image
Foxtrot89

Just to add some further experience to the pile - my partner used to (on advice of his doctor) take 14 pills all in one go once a week.

1400mcg and the only thing that seemed to happen was irritability/restlessness about 60-90 mins after he’d done it. No harmful effect.

Lily288 profile image
Lily288 in reply to Foxtrot89

Taking a bunch of Levo like so puzzles me big time. 😱

greenfingers profile image
greenfingers

Thanks to you all for replying, it’s good to know I am not on my own in this. When it happens at night it always seems worse.

Ossuryak profile image
Ossuryak

I take exception to all previous advice as unless they know your personal health condition they don't know how it will effect you , we are all different, some of us very different. If that was me my heart would go off it's head as I have to devide my daily dose into 4 lots of 25 mcg over 24 hours as my heart is very sensitive to 100mcg all at once. I know some people take 2 days dose every 2 days and they are OK with that , I think if your frightened or unsure phone your doctor.

SeasideSusie profile image
SeasideSusieRemembering in reply to Ossuryak

Ossuryak

And are you still taking "natural thyroid hormone" (NDT) because if you are we are talking about 2 different things. The NDT contains T3 and often better taken in divided doses. As Levo is a storage hormone and doctors, in some cases, supervise taking it once a week, then it's not the same thing at all.

Ossuryak profile image
Ossuryak in reply to SeasideSusie

The effect of both T4 only and NDT has the same effect on my heart, just carnt take once a day dose ,need it to be devided. To me this makes commonsense as the thyroid doesn't dump the entire daily dose of Thyroid hormone into your blood stream all at once and I feel it's a massive job for your liver and other organs to process it all at once to the point of it being toxic

NWA6 profile image
NWA6 in reply to Ossuryak

No need to ‘take exception’ just offer your thoughts or personal experience that’s all most of us can do here. They’re aren’t many/any who are endos or have a medical background and anyone who joins this forum should be very aware of that. We’re all adults just trying to figure shit out. Let’s face it most of us are much more knowledgable than any GP or Endo we’ve encountered, so chill, your experience is just as valuable and helpful as any others. The adult poster will make up her own mind what ‘advice’ suits her.

KatnissCat profile image
KatnissCat

I have over medicated myself before. My normal supply was out so I got a lower dosage bottle and would double up. Well, I didn’t think right and tripled up! This went on for a month. I swore I was going into menopause! I had a higher heartbeat, night sweats and always hot. I finally thought about it, wondering what could cause this and it finally clicked what I did! Hahaha.

Crazy! But I was ok.

helvella profile image
helvellaAdministratorThyroid UK

I'm posting this in the hope that it will make you feel more comfortable, more reassured less concerned should anything like this ever happen again.

Although correct dosing is highly desirable, and necessary for effective treatment, it is mainly long term under- or over-dosing which is a concern.

Accidental Thyrotoxicosis Caused by Inadvertent Ingestion of Levothyroxine “Dog-Tabs” by a Veterinarian with Hypothyroidism

Harmeet Singh Narula, MD

Department of Medicine, SUNY Stony Brook, Stony Brook, NY

DOI: doi.org/10.1016/j.amjmed.20...

To the Editor:

A 33-year-old veterinarian with Hashimoto's thyroiditis and hypothyroidism, stable with a levothyroxine replacement dosage (thyroid-stimulating hormone, 0.9; normal, 0.4-5.0 mIU/L) of levothyroxine 50 μg/d, presented with mild anxiety, jitteriness, and insomnia. Repeat thyroid-stimulating hormone was undetectable. Serum total T4 was 15.4 μg/dL (normal, 6.0-10.0 μg/dL), and free thyroxine index was 14.9 (normal, 6-10). On further questioning, the patient realized she had recently run out of her prescribed levothyroxine tablets and had been taking levothyroxine “dog tabs” 0.5 mg/d, thinking that would be the same as the 50-μg tablets she had been prescribed, inadvertently taking 10 times the prescribed dose. Her levothyroxine therapy was discontinued, and repeat thyroid function studies 2 months later revealed a thyroid-stimulating hormone level of 5.1 mIU/L. The patient was restarted on levothyroxine 50 μg/d, and repeat thyroid-stimulating hormone level 2 months later was 1.0 mIU/L. The patient was instructed to take her prescribed levothyroxine tablets and not use her levothyroxine “dog tabs” in the future.

Hypothyroidism is common among humans and other mammals, including dogs.1 The dosage requirements in dogs are substantially higher than in humans. The recommended starting dose of levothyroxine for hypothyroidism in dogs is 44 μg/kg/d, far more than the 1.7 μg/kg/d in humans.1, 2 Commercially available levothyroxine tabs for dogs come in dosage strengths of up to 1 mg tabs (or a 1000 μg dose, a high dose for humans).1, 2 Levothyroxine has a narrow therapeutic index, and errors in levothyroxine dosage may occur as the result of inadvertent prescribing or dispensing of the wrong dose.3 Electronic prescribing systems may decrease such preventable errors.4 Healthcare professionals should be aware of the easy availability of levothyroxine for pets in fairly large doses (by human standards) and cognizant of such errors, especially animal health professionals.

amjmed.com/article/S0002-93...

Salmos profile image
Salmos

I'm glad you are ok! I'm always afraid of this happening to me also! I always write it down in the morning when I take my pill cause I think I'm gonna forget. Lol. Just out of curiosity, what is your dose? I take 1 pill of 150 mcg for 5 days and 1 1/2 pills 2 days out of the week, and even that freaks me out!

greenfingers profile image
greenfingers in reply to Salmos

I take 75mcg. I used to take 125 then down to 100 now down to 75. No idea why it’s decreasing.

Salmos profile image
Salmos in reply to greenfingers

Are you hypo or hyper?

GERALDDAVID profile image
GERALDDAVID

Once I got a double dose of my thyroid meds so I drank coffee because it blocks thyroid meds if taken before 1 hr. Also took calcium or iron because they do the same for 4 hrs. It worked for me just fine.

Salmos profile image
Salmos

I didn't know about the coffee thing, I take my pill in the morning then drink my coffee, I might have to wait awhile.

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