Everything and everyone is making me angry... am I overmedicated on levothyroxine?

[Zazbag]

I had my dose increased to 150 mcg on 6th July and since then I've noticed I've gradually become more and more irritable and angry and reactive to even the slightest things. It feels like extreme and constant PMS, but even with PMS I am able to keep my mouth shut. I feel so on edge and frustrated and irritable. I am actually openly getting pissed off with people and it's scaring me a little. Am I overmedicated?

17th August

TSH 0.03

FT4 19.4 (74%)

FT3 5.2 (56.8%)

A Medichecks blood test from the same sample gave me different results saying my FT4 is too high:

TSH 0.023

FT4 22.6 (106%)

FT3 5.6 (67.6%)

I'm starting to lose weight without making any effort or changing my diet and I'm constantly exhausted. I've been falling asleep at 8pm on my sofa which is not like me. Then last night I felt so angry and emotional I couldn't sleep until 3am.

Sorry to anyone on here that I've been rude to, I know it has happened and I apologise. I don't feel like myself right now.

[jimh111]

I found I was very irritable when hypo but I believe it can work both ways.

In your situation I would skip the levothyroxine dose for two or three days and see how you feel, whether you feel better. This will have a small effect dropping your fT4 by about 20% but it will be compensated to some extent by a little more T4 to T3 conversion. If you feel better you will know your current dose is a little too high and vice-versa. Your blood tests suggest you are slightly over-medicated but some patients need these higher levels.

[Zazbag in reply to jimh111]

Thanks for the reply. I get very irritable when hypo too but it feels different. When hypo I'm irritable because I have zero energy to deal with any kind of stimulation or problem or annoyance. Even sound or movement bother me. Right now the irritability just feels like pure anger and impatience, not exactly because I'm too tired, although I am very tired, but more just this feeling of tension and anything could make me snap.

Are you sure that by withholding my dose, that will be the clinical outcome? I'm a bit wary of skipping it because I've accidentally missed doses in the past and it's made me super tired. But I've also heard people say they feel loads better off levo for a few weeks or months until they start to feel awful again. I wouldn't feel confident knowing how to interpret my reaction to being off it for a few days, whatever that reaction ends up being. When I was on 125mcg my FT3 was only 17% through the range so I'm thinking maybe the issue is that I have too much T4 in my system and not enough T3.

[jimh111 in reply to Zazbag]

You can only try it. If you feel better resume your current dose and try reducing again. That way you can confirm the outcome.

[jgelliss in reply to Zazbag]

You might want to alternate between 125 and the 150 mcg T4 dose and see if that works better for you . Especially if you tried the 125 mcg and that dose caused you fatigue and the 150 mcg T4 was to high for you and caused irritability for you.

[hipolion]

One option would be to reduce the levo dose a bit and add t3.

[Zazbag in reply to hipolion]

Yes, that's what I was thinking too, because on 125 mcg (one dose level below) my FT3 was only 17% through the range and I was still having hypo symptoms. I just called my GP to ask to be referred to an NHS endocrinologist for a trial of combination therapy. I am also going to see a private endocrinologist next week as I imagine it will take months to see an NHS endocrinologist and I'm tired of waiting.

[hipolion in reply to Zazbag]

"I'm tired of waiting",....yes I know the feeling.

[SlowDragon Administrator]

What are your vitamins levels like

Are you strictly gluten free?

[Zazbag in reply to SlowDragon]

I'm strictly gluten and dairy free and I avoid egg and soy.

Vitamin levels optimal, ferritin needs improvement:

Ferritin: 53.1

Vitamin D: 96

Vitamin B12: 548.2 (180 – 900)

Folate: 18.4 (2.5 – 19.5)

[tattybogle]

Sorry i was short tempered with you the other day x

I'd suggest it's worth trying half way between the two doses for a while. ie 137mcg/day (Cut a 25 in half for each day and add it to 125 , or take 125/150 alternate days )

I recently found 125 too much, 100 left me constipated, and 112 is not perfect but better than the other options. Until i get to try adding some T3 and reduce T4 cos i'm over range and not doing well on Levo.

I am calmer too.

I would suggest just reduce it, and continue at 137mcg, rather than missing any days entirely. It will take a few days longer to achieve lower levels this way , but avoids large changes which i find unsettling.

[NWA6]

I think the same A’s jimh111 leave off for 2/3days so that your FT4 can drop which may in turn raise your FT3 which may not be optimal. When you reintroduce Levo I’d probably do 125/150 alternate days.

If you raised from 125 then your weekly dose has gone from 875 per week to 1050 per week which is a significant increase. Alternate days would raise you to 925 per week. 125 x 3 and 150 x 4. See how you feel and then add another 150 day if needed and so on.

[jgelliss]

I feel your pain . From my personal experiences I felt irritable and had insomnia moodiness palpitations and more with high FT4. Lowering my T4 and adding a small dose of T3 made a huge difference for me.

I would in addition suggest that you check your vitamin "D"/K2 , B-12/folate/ Iron/ferritin levels. You would be surprised that nutrients or lack of them can cause many of the hypo/hyper symptoms too.