Long long story short, I was overmedicated at my initial diagnosis of hashimotos. I saw my primary care doctor after an acute illness, which my body hadn’t healed from yet, which caused my TSH to be a little high, and got put on 50mcg of Levothyroxine. 8 weeks later I am experiencing lots of hyper symptoms, my TSH is extremely low, my t3 and t4 are both high. I’m not here to argue the numbers or look into it, just simply know i was overmedicated. Doctor has taken me off all thyroid medicine. I know this is a bit of an odd case, but if you experienced overmedication, how long until the hyper symptoms went away? Thanks!
Has anyone experienced Hyper/ over medication? ... - Thyroid UK
Has anyone experienced Hyper/ over medication? If so, how long did it take you to recover?
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I was over-medicated once. My endo put it down to my Hashimoto’s - that I had thyroiditis and as my thyroid was being destroyed it ‘dumped’ an unregulated amount of thyroxine into my system at the same time as I was building up my medication.
For me, the first signs I had were a slightly sick feeling - like a syrupy sweet feeling. Then, if I just stood up to make a cup of tea, my heart would race - literally. It would suddenly be at 120bpms. It was like a dynamo spinning every time I moved! Even resting it was higher (normal for me was 56-66bpm) suddenly it was up to 80 at rest. I had to lay very still to stop it from suddenly racing and it was scary. I’ve never experienced anything like it before and it gave me new respect for what potent drugs thyroid meds are. The heart speeding up when I moved was the real sign. Watch out for fast palpitations, they can lead to AFib. I did lose more hair - that was noticeable too. Shower plug was a nightmare!
I was only on T4, which stays in the system longer and despite reducing the dose twice and waiting a couple of weeks each time the symptoms continued (though not as severe.) I ended up having to come off Levo for about 6 weeks and start again from scratch, very slowly, as my heart is now, it seems, sensitised to it in some way.
Coming off was certainly the best way for me to get rid of the over-medication symptoms. I felt fine when I was off the meds, which is a peculiarity a lot of people report - though I think it is a short term thing! I had a blood test in the sixth week and my TSH had shot up to 90, so I probably shouldn’t have left it so long. Good luck. 🤸🏿♀️🥛
Thank you for all the tips and personal experience. I’m sorry you had to go through all of that! The thyroid is such a tricky thing it seems, quite hard to get it right. I imagine it will take about 6 weeks for me to fully feel like I have no meds in my system which is sadly just the reality of it! Hopefully sooner, wish the dang thyroid hormones worked a little quicker haha. Best of luck with your thyroid!
Not an odd case at all. Sounds like typical Hashi's to me.
But, without wishing to argue the numbers - although, frankly, I don't see you'll get much decent info without doing so - are you certain that you were over-medicated, and not just having a Hashi's 'hyper' swing?
And, this is where the actual numbers become important, because without the numbers, you can't know which it was. And, if you want to have an estimate of how long it takes for hyper symptoms to go, knowing which it is, is important.
If you were over-medicated, it depends by how much. And on what. T4 has a half-life of about 7 days, and T3 a half-life of around 23 hours (sorry about the numbers ). So, the more you were taking, the longer it will take for the FT4/3 to come down, and the symptoms to go.
However, if it was a Hashi's 'hyper' swing, there's no knowing how long it will last. Depends how high your FT4/3 went. Every case is different - with different numbers - so it's a bit like asking 'how long is a piece of string?' Oh, about that long, I would say.
Well, my case is that I’m here in the states, so I originally was diagnosed by just a regular ol doctor. I wasn’t on any thyroid medicines at all, was very very healthy, and then everything went downhill after an acute illness (diverticulitis).
I got put on 50mcg levothyroxine and was told to tough it out and I’ll “feel better in 8 weeks, hashimotos was what was making me feel this way.”
After seeing a true endo for it after the 8 week point because I was still feeling lousy, my TSH had dropped from (range of .5-4.5) 4.5to .2. So, the 6 week point was 4.5-.6. The next 2 weeks I dropped from .6-.2. My T3 was also at the very upper limit of my range, along with my t4. Even with both T3 and T4 being high along with a surpressed tsh, I was still feeling just not me, very lousy.
The thing my endo explained to me, was that, because of my hashimotos, my body will eventually need medicine. We are in no debate over that, but she said probably not yet (healthy, 20 year old male) She indicated that my levels when I was initially tested were off due to my acute illness, and my body would’ve eventually naturally fluctuated down on its own, but my primary care doctor just rushed me into meds, and skipped 25mcg, and went straight to 50.
She said that she believes since that acute illness is now fully recovered, my thyroid is back to producing what it was before my illness, and therefor I’m very over medicated. She said I should go back completely off meds, retest, and go from there.
So, essentially I did have a “hypo to hyper swing” in the sense that my body wasn’t initially super hypo, but became hypo due to another big illness I was dealing with, which caused my bloods to be off, which caused my primary to overreact, which cause to me having 2 months of poor poor life of overmedication.
My symptoms at the beginning (When tsh was a 4.5) was simply just tiredness, but was also still recovering from illness.
Now, I’ve lost an additional 10-15 pounds, no appetite, horrible insomnia like I have ever experienced, profuse sweating, digestive system is horribly off,horrible mood swings, muscle aches, tired but wired feeling, (believe me when I tell you I was in very good shape, gym every single day, heavy weight lifting. Never experienced aches like this before). All of these I am 100% are medicine related as I had not a single one of these before starting Levo.
So, end of the story, knee jerk reaction from a lousy doctor, led to initial overmedication of levo, which I do not need quite (yet).
Also, luckily here in the states I am able to see my own endo on my own dollar, so I picked a very very highly rated one in my area. She spent about an hour with me going over my case as it is quite a unique one. I believe everything she said makes sense, and wants to start back at square 1 with my regular thyroid results when I’m not battling another illness, then medicate from there. Said likely a 12.5 mcg dosage, probably most of that being T3! She really likes the NDT route, and understands the benefits of t3. Lucky me moving forward!
my TSH had dropped from (range of .5-4.5) 4.5to .2.
Well, first of all, a low TSH - even a suppressed TSH - does not automatically mean you're over-medicated. The most important number is the FT3, and if that is still in-range, you're not over-medicated. TSH isn't even a thyroid hormone, it is a chemical messenger from the pituitary to the thyroid. And, if your TSH is low, it just means that your pituitary is satisfied with the amount of hormone in the blood. But, let's just say that the pituitary is easily satisfied, so a low TSH doesn't mean much. Other parts of your body might still be struggling.
my thyroid is back to producing what it was before my illness, and therefor I’m very over medicated.
Of course it is. But you don't tell us how much that is. And, it's only done that because you've stopped taking the levo, and your levels went down, so the thyroid picked up. You don't have both the exogenous and endogenous hormone in your system at the same time.
But, you don't give us any sort of a time line for all this. When were you ill? How long have you been off levo?
my primary care doctor just rushed me into meds, and skipped 25mcg, and went straight to 50.
Very wise man. The starter dose is 50 mcg, not 25. So, he didn't do anything wrong there. And, according to your TSH of 4.5, you were hypo, and - presumably - had high antibody levels. But, most important question, how long after your illness was this?
Said likely a 12.5 mcg dosage, probably most of that being T3! She really likes the NDT route, and understands the benefits of t3.
12.5 mcg what? Levo? That would be rediculous. As I said above the normal starter dose is 50 mcg. And, these days, the 'experts' are suggesting that staring even higher might be a good idea.
12.5 of T3 would be too much, One starts T3 at 5 mcg for two weeks, and then increases by 5 mcg every two weeks.
I cannot relate 12.5 to NDT.
There was something else I was going to say, but it's gone completely out of my head! lol
Oh, yes. the half-life of T4 is 7 days, which means that the 50 your took on a Monday morning, will be less than 25 mcg - presuming your body used some - the following Monday morning. The Monday after that, it will be less that 12.5, etc. etc. etc. So, about four/five weeks to get rid of it completely. BUT, your thyroid won't kick back in until it's pretty much gone, and your Free levels are low again. As I said, you won't have your exogenous hormone and your endogenous hormone in your system at the same time. So, symptoms of 'over-dosing' - if that's even what it was - should go pretty quickly, and you will feel hypo before you get back to normal.
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Of course it is. But you don't tell us how much that is. And, it's only done that because you've stopped taking the levo, and your levels went down, so the thyroid picked up. You don't have both the exogenous and endogenous hormone in your system at the same time.”
But, you don't give us any sort of a time line for all this. When were you ill? How long have you been off levo?
So, I haven’t gotten my blood results back from being off of Levo yet. I have been off levo about 1 1/2 weeks. What I was told by my endocrinologist, is that my thyroid initially went out of whack due to my colon infection, which caused my bloods to be off, which caused me to be put on medicine. That is what I mean by my thyroid going back to producing what it was before, and why she thinks I am now currently over medicated.
Timeline
No sort of hashimotos symptoms leading up to this.
April 25th- Diagnosed with colon infection
May 20th- Got put on 50mcg levothyroxine due to my TSH being a 4.5 and my antibodies being high. My doctor said I should be recovered from the diverticulitis by now, and my thyroid is what is making me feel bad.
July 5th or so- TSH dropped from 4.5 to .6, doctor told me I was a little over medicated but stick with it and see if I feel better.
July 10th- Saw an endocrinologist, ran a bunch of other tests for vitamins, adrenals, all sorts of things.
July 25th- Ran more blood work. TSH has now dropped to a .2 with High T3 and High T4.
August 4th- Saw a different endo this time around as I still am feeling horrible.
The final word I was left with by my endocrinologist was that due to my colon infection, it caused my otherwise currently good and functioning thyroid(which eventually will not be too good and functioning due to my hashimotos), to go bad while I was ill. She said now that my body has recovered from my illness, my thyroid has started producing what it was before my illness happened (a normal, good amount.) This mixed with the premature diagnosis of medicine from my primary care doctor, has now lead to my increase in T3, T4, and surpressed TSH. She advised I go off all medicine, and we retest to see where my true thyroid numbers are, when I am not battling an illness, and that will give me an indication of whether or not I should be medicated at this time or not.
What I was told by my endocrinologist, is that my thyroid initially went out of whack due to my colon infection, which caused my bloods to be off, which caused me to be put on medicine. That is what I mean by my thyroid going back to producing what it was before, and why she thinks I am now currently over medicated.
Yes, any sort of illness, infection, whatever will affect your conversion, therefore your FT3 drops and your TSH rises. I agree with that. But, that doesn't mean you're not hypo, anyway. Especially if you have high antibodies, meaning you have Hashi's.
But, your thyroid would not have gone back to producing the same amount of hormone as it did when you were well, whilst you were taking the levo. Taking thyroid hormone replacement suppresses thyroid activity. It would only be after you'd been off the levo for a while that the thyroid would start producing hormone again. So, I do not agree with her that that is why your are currently over-medicated. And, in any case, if your FT3 is still in-range, you are not over-medicated.
In any case, it's not hormone production by the thyroid that is affected by the illness, it's the conversion of T4 to T3.
However, I think your GP may have been a little over-optimistic about recovery time from a bowel infection! He could have waited a little longer before testing thyroid. But, I suppose he thought he was acting in your best interests.
July 5th or so- TSH dropped from 4.5 to .6, doctor told me I was a little over medicated but stick with it and see if I feel better.
As I said before, a TSH alone cannot tell you if you are over-medicated or optimally medicated. So, he was wrong on that one.
July 25th- Ran more blood work. TSH has now dropped to a .2 with High T3 and High T4.
High, but not over-range?
This mixed with the premature diagnosis of medicine from my primary care doctor, has now lead to my increase in T3, T4, and surpressed TSH.
No, this is stupid. As I said, the thyroid won't have been affected, it's the conversion that is affected. And, the thyroid certainly won't start making more hormone whilst you're taking levo. Taking levo suppresses your thyroid's natural production. In other words: it stops making hormone.
Once you stop the levo, FT4 will start to drop. Then, FT3 will drop as there's not so much T4 to be converted, then TSH will rise. That levo you've been taking doesn't hang around in your body indefinitely. But, there's absolutely no point in testing until you've been off the levo for at least six weeks, because you won't get a base-line before that.
You've been off levo for 1.5 weeks, is that right? And you've already done labs? Won't tell you anything - well, it will tell you something, but not what you want to know. It will tell you how much levo is left in your system, not how much your thyroid is capable of producing. Must say, I'm not impressed by your endo.
Hi again,
If it was a case of NTI (Non Thyroidal Illness) causing deranged Thyroid Function Tests temporarily , and you were treated with just Levothyroxine -T4, instead of waiting for the NTI to resolve , then it shouldn't take too long after you stop taking the T4.
T4 has a half life of about 7 + days ? forgotten the exact details, So after 7 day's , half is left , (less any that you've used) after another 7 days half of that half is left, etc etc .
So most of it goes away within a couple of weeks, and after that there are diminishing tiny amounts hanging around for longer.
That's the theory ....... but i imagine the human body has it's own ideas about following 'theorys' . It has very complex mechanisms for maintaining T3 as a priority above all else , and for maintaining Homeostasis after 'challenging events'........ so ? it could well take longer than simply waiting for the exogenous thyroid hormone to be removed from your bloodstream.
In your position i'd still be curious about the >1000 TPOab (Thyroid Peroxidase antibodies)
though. I've been trying to understand more about which antibody shows what , and have recently been reading these. So if you are curious , you might find something here or in other parts of this really good Canadian blog.
thyroidpatients.ca/2020/04/...
thyroidpatients.ca/2020/04/...
Best Wishes
Tat
Thank you so much for the response! Everyone just say “a couple weeks” it seems, and that’s just annoying because I wish there was just a set date! I understand though the half life though, and just need to trust the process. I’m just under 2 weeks off the medicine, so just a little anxious over here. Just gotta give it some more time for my body to stabilize properly.
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