Overmedicated low TSH: Hi all...one of the golden... - Thyroid UK

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Overmedicated low TSH

Shazy-B profile image
32 Replies

Hi all...one of the golden oldies here who hasn’t been on for a good while! So 2 months ago my latest labs revealed my TSH at 0.22 I was advised by my GP to reduce my Levo to 75mg from 100mg daily...I politely declined. However last week I encountered what I can only describe as a ‘near death experience’ (slight exaggeration) it was truly awful, something which I have only ever had happen to me once before after taking propanalol 8 years ago! I do suffer from anxiety which I have under control through years of practice and dedication. I can only attribute this episode to my low TSH and being overmedicated. I have no idea why after 20 years I am now overmedicated? Any ideas? I stick to the same brand (Actavis now changed its name to Accord) as I know this suits me. The problem I’ve got is obtaining the 75mg dosage...it seems my chemist can only get 50mg and not the 25mg so I am currently alternating between 100mg and 50mg daily to give I’m the overall dosage of 75mg. I have just spoke to my GP again and he has suggested repeating my bloods to see what’s happening, he said I don’t need my T3 doing as my TSH gives the overall picture anyway (yes I sighed too) any comments, suggestions recommendations for a different brand of Levothyroxine are truly welcome and much appreciated.

Thanks a million 😊

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Shazy-B
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32 Replies
Lora7again profile image
Lora7again

Do you have the results for your T4 and T3? The TSH is a pituitary gland hormone and it is the T4 and T3 that counts. Just to add your dose is very low and most people take 100mcg or more to feel well.

Shazy-B profile image
Shazy-B in reply toLora7again

Unfortunately I don’t have my T4 or T3 results. I have been taking 100mcg for nearly 20 years so I’m confused as to why all of a sudden I would be overmedicated..it makes now sense to me. Thanks for you response :)

Batty1 profile image
Batty1 in reply toShazy-B

Are you taking medications for anxiety or any new medications since you started having the feeling of being over medicated ? I ask because I was prescribed Cymbalta for pain and after a month on this medication I started having issues with shaking that increasingly gotten worse to the point I could not hold a cup of coffee and I panicked and I opted for a reduction of my thyroid meds thinking it was this to only find out that anxiety meds interact with thyroid meds and I never took this medication until 4 hours after my thyroid meds.

Shazy-B profile image
Shazy-B in reply toBatty1

Hi Batty nope not taking any anxiety meds...I learned my lesson with the propanalol 8 years ago...it nearly finished me off! I have a HRT patch that I change twice weekly and that’s it.

Batty1 profile image
Batty1 in reply toShazy-B

HRT patch could be the culprit.

Shazy-B profile image
Shazy-B in reply toShazy-B

I’ve been on it for 8 years and never had a problem, I was taking HRT orally which was interfering with my thyroxine hence the change. It’s not an option for me not to have HRT I’m afraid!

Noelnoel profile image
Noelnoel in reply toShazy-B

Just a thought, you could try changing your HRT patches more/less frequently by a day, for example just to experiment to see if -at this point in your life - the HRT Is slightly too much/inadequately because nothing in life ever stays the same and this is true of our hormones too. So, what was once just right could now need adjusting a little

However, I’m sure you’ll get lots more good advice regarding your thyroid meds

SeasideSusie profile image
SeasideSusieRemembering

Shazy-B

Actavis/Accord don't make a 25mcg tablet. Why alternate 100/50? Why not just cut a 50 in half and take 1 and 1/2 50 tablets per day?

And why not do a private thyroid test to include TSH, FT4 and FT3. Cheapest is MonitorMyHealth which is an NHS hospital in Exeter doing the test for the public, normal price £29, 10% discount code here:

thyroiduk.org/getting-a-dia...

then you'll have a full picture and know whether or not you are overmedicated.

Shazy-B profile image
Shazy-B in reply toSeasideSusie

I feel cutting a 50mcg tablet might be a bit tricky as they are so small and will I be getting exactly 25mcg...thanks for the suggestion though :)

SeasideSusie profile image
SeasideSusieRemembering in reply toShazy-B

Shazy-B

I have Actavis 50mcg and cut them in half with no problem using this pill cutter which I bought from my local pharmacy

amazon.co.uk/Safe-Sound-Pil...

It doesn't matter if you're not strictly accurate, it will be near enough and you'll take the other half the next day and as T4 (Levo) is a storage hormone there will be no problem.

That would be better than taking a different brand if you know that Actavis suits you.

Shazy-B profile image
Shazy-B in reply toSeasideSusie

Oh excellent idea, I didn’t think of that. I’ll order one now...thank you :)

Kevz3016 profile image
Kevz3016 in reply toShazy-B

I take 125 daily of accord, the 50 pill has a slice through it, place it on a clean hard surface Place your thumbs either side and push down, it breaks clear every time. 👍

Salsybar73 profile image
Salsybar73 in reply toKevz3016

you can also buy tablet cutters online amazon do them. that is where i bought mine from if that is any help

SlowDragon profile image
SlowDragonAdministrator

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if under medicated.

Can see you only ever had TPO antibodies tested. NHS refuses to test TG antibodies unless TPO antibodies are high

Ever had ultrasound scan of thyroid?

20% of Hashimoto’s patients never have high thyroid antibodies...scan can be very helpful

Ask GP to test vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

Anxiety is common hypothyroid symptom, 75mcg is low dose levothyroxine

Shazy-B profile image
Shazy-B

Thanks for your reply. I have had low Vit D in the past but it’s fine now (within range) apparently, also low folate at the beginning of the year for which I took 5mg of folic acid for 4 months. I had a thyroid scan a few years ago, nothing remarkable. I agree the best way forward is to have private bloods done! It’s a bit of a mine field though as there are so many and also knowing whether they are reliable or not?

Angel_of_the_North profile image
Angel_of_the_North in reply toShazy-B

All the tests recommended by TUK are from properly accredited labs

TSH doesn't make you feel anything - it just tells your thyroid when it needs to make more hormone. If you are taking thyroid hormones, it doesn't need to tell it to make more, so it usually stays low. What are your actual thyroid hormone levels: FT4 and FT3? You are probably not overmedicated. If you have autoimmune thyroid disease (Hashis) you might have had a flare up, which makes you feel (and test) hyper for a while and then more hypo as more of your thyroid is destroyed. Anxiety can be caused by low T3, which can also be a side effect of propanalol, although people tend to assume it is cause by too much hormone. TSH rarely gives the correct picture once someone is on levo, of course. If your GP won't test FT3, buy a proper private thyroid test. Medichecks has cheap offers on a Thursday

Oatcake profile image
Oatcake in reply toAngel_of_the_North

Hi, I am facing a similar situation with my current GP. His take, unsurprisingly, is that as we age we need less thyroxine not that after years on levo the pituitary produces less TSH. I have googled to find papers supporting the latter idea but haven't found anything. Does anyone know of any publications that support this? Many thanks.

Angel_of_the_North profile image
Angel_of_the_North in reply toOatcake

There are studies showing that old people produce more TSH, but none that show that they are healthier because of it: academic.oup.com/jes/articl...

Oatcake profile image
Oatcake in reply toAngel_of_the_North

Thanks Angel. I think that might add to the GP wanting higher levels of TSH. I want to convince mine that pituitary gland has given up the ghost and TSH can be ignored🤔. A difficult one to prove.

Sewit1 profile image
Sewit1

I would like to say get your Rt3 which is cortisol and your b12 and DHEA checked. What no one tells you is if your anxious or stressed you can stop absorbing thyroid hormone and so it converts to cortisol or what is known as reverse T3 (rt3) I was over medicated for years and suffered several severe anxiety episodes which were treated with antidepressants which slowed down my thyroid and stuck a plaster over essentially an uncontrolled over medicated thyroid. Your TSH is effectively hyperthyroid at that reading so you could experience fast heart rate, anxiety, toilet trips, hallucinations at the extreme end. I have had to come down from 200 mcg of Levothyroxine to 75 As my dosage had been increased from 125 to 200 in December. I’m now under an endocrinologist who tells me it should never have been about a numbers game of reducing TSH alone and the doctor should have been checking T3, Rt3, t4 as well as TSH as I have Hashimoto autoimmune. Also if we lose a stone or 2 our meds usually need decreasing. You may not have anxiety at all but the symptoms of anxiety brought on by metabolic increase due to your therapeutic over medication. Check out thyroid storm symptoms and read what foods support thyroid health to reduce meds. Take care

in reply toSewit1

Sorry, do you have any sources confirming that thyroid hormone can convert to cortisol when under stress...I would have thought that to be impossible since thyroid hormone and cortisol are two different hormones produced by different organs.

tattybogle profile image
tattybogle

I have to disagree with Sewit1's advice to test reverse T3. It's an expensive and unhelpful test.

You need an FT4 and FT3 in conjunction with TSH AND how you feel, to tell you if you are overmedicated.

I must also disagree with the statement that 'Your TSH is effectively Hyperthyroid at that reading' . (The lab range is missing, so it may not even be much below range )

But more importantly, there is a difference in interpreting low TSH in untreated people and people taking Thyroid hormones.

Also 'Thyroid Storm' is a totally different situation to 'symptoms of overmedication on Levothyroxine'

We need to be careful not to confuse information that relates to the risk's associated with Actual Hyperthyroidism (Graves), with information relevent to possible overmedication on Levo thyroxine

I was about to post some links for you, but have just posted them on another post on the same subject, so i'll link you to that since you may find the rest of the comments helpful;

healthunlocked.com/thyroidu...

in reply totattybogle

Well said, I agree that it´s important to avoid unnecessary confusion!

Sewit1 profile image
Sewit1 in reply to

naturopathiccaresw.com/post...

Sewit1 profile image
Sewit1 in reply totattybogle

naturopathiccaresw.com/post...

tattybogle profile image
tattybogle in reply toSewit1

Just had a quick read . The information here seems to be based on an outdated /disproved idea that rT3 blocks the T3 receptors on cells , but i believe it's since been shown that rT3 does not in fact block T3 receptors. So however much you have , for whichever of the many reasons rT3 appears it doesn't prevent T3 working in cells, I'll have to do some rooting around to find a link to a paper about it, rather than trying to explain exactly off the top of my head. please excuse me if i do it tomorrow instead, i'm past my best a this time of day.

Sewit1 profile image
Sewit1 in reply totattybogle

Thanks for your help

Rosebud1955 profile image
Rosebud1955

Hi, follow SeasideSusie’s advice. You’re already taking 100/50, so cutting a 50 in half will do the same. Even if it’s not exactly accurate pieces, there is no difference when you’re already taking different doses alternate days.

Couldn’t help but to comment.

Good luck.

PirateQueen profile image
PirateQueen

I swear up and down that Accord have made me feel overmedicated. Nothing's changed but the brand (apparently), yet all of a sudden I've got classic overmedicated symptoms.

Shazy-B profile image
Shazy-B in reply toPirateQueen

Oh that’s good to know, not good for you obviously! I feel like I’m going round the bend, trying to explain to my GP there’s something not right. My anxiety has reared it’s ugly head and it’s only since having the Accord and not Actavis. I’m wondering if I should try another brand but I’m very cautious in case it’s makes things worse.

PirateQueen profile image
PirateQueen in reply toShazy-B

Yes, I’m exactly the same! I’m jittery, full of anxiety for no reason, upset stomach etc. I’m also going round the bend, I can’t bear this constant over-caffeinated feeling!

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