Hi, I've just joined and would love some advice please.
I'm hypothyroid & have been taking 125mcg of levothyroxine for 15 years but my blood results show I'm now hyperthyroid and have been for at least the past 4 months. My TSH is 0.1 and T4 is 22. I've been loosing lots of hair am unsure what dose I should be taking and how long it will take to feel the change in dose?
Just an important technicality, you are overmedicated not hyperthyroid, a big difference in treatment. What has your gp suggested? You are not massively over medicated so you could drop 25mcg 3 or 4 days a week and retest in 6 weeks. If you drop 25 mcg everyday you risk going under and missing your optimum dose. Do you have recent blood results for vitamins and minerals to ensure your body can utilise the levothyroxine efficiently?
TSH is low so GPs usually like to lower dose based on that.
Was you dose reduced? By how much.
Do you’re have the range of your results. Depending on your range (which vary between labs) Your FT4 could be top or just above range. Was FT3 tested? this is the active thyroid hormone and can often be the source of most symptoms.
Apart from your hair loss are you having any other symptoms? Low Ferritin can cause hair low has that been tested.
Orchid2025
Welcome to the forum.
I'm hypothyroid & have been taking 125mcg of levothyroxine for 15 years but my blood results show I'm now hyperthyroid and have been for at least the past 4 months
That's not possible, if you are hypOthyroid it's impossible for you to suddenly become hypERthyroid. However, you can be overmedicated which would account for an over range FT4.
A few questions first which, if you can answer, will help us to help you:
* What are the reference ranges for your results (if you don't have them, ask the receptionist for a print out of your test results - we are legally entitled to them in the UK or if you have online access see if the ranges are with your results there). Your TSH will be below range as most ranges start around 0.2ish, but is your FT4 over range?
* Was FT3 tested as well?
* When did you take your last dose of Levo before the test?
* Do you take a Biotin supplement or a B Complex, if so did you leave this off for 7 days before the test?
* Do you have autoimmune thyroid disease (known to patients as Hashimoto's) which is confirmed by raised thyroid antibodies or an ultrasound of your thyroid?
* Do you have any previous test results/ranges that you can also post (also mention what dose of Levo you were taking at the time).
* Low ferritin can cause hair loss. Have you had that and any vitamins tested?
A FT4 at 22 and TSH does not indicate overdosing. The healthy TSH range is about 0.5-4.5 when the thyroid is whole and working properly. When you lose it completely and take T4 instead, studies have shown that a TSH between about 0.05 and 0.5 is necessary to produce adequate dosing. The range applying to treatment is not the same as the healthy one. And FT4 high in range does not signify overtreatment either.
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
What vitamin supplements are you currently taking
When were vitamin levels last tested
Hair loss is frequently caused by low iron/ferritin
Important to regularly retest vitamins
Do you always get same brand of levothyroxine
Which brand
Do you have Hashimoto’s
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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
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)
If Ft3 is NOT over range you are not over medicated
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 antibodies and vitamins
medichecks.com/products/adv...
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
Thriva also offer just vitamin testing
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 down to £26.10 if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
Also vitamin D available as separate test via MMH
Or alternative Vitamin D NHS postal kit
Hello, I have to be well over the range to feel normal on Levothyroxine but I've never felt over medicated. Not saying it's 100% perfect but anything less and I can't function. My hair will fall out, can't sleep, pounding heart and anxiety, aches and pains. Suggest you get the Free T3 tested to see the whole picture. 🙂
Hi, thanks for all the helpful comments and there's lots for me to consider and take in with all the various results. I did a fasting test (14hrs apart from water) & hadn't taken levothyroxine for 24hrs.
I've tried to attach my results but it keeps cropping the side of the image, sorry! By row they are:
Ferritin (high)
B12 (high)
Folate (normal)
Thyroid stim. hormone (low)
T3 (normal)
T4 (normal to high)
Thyroglobulin antibodies (high)
Throid Peroxidase antibodies (normal)
Total thyroxine (normal)
My GP isn't very helpful, the junior doctor tried to up my levothyroxine dose to 150mcg by mistake and when I queried this the GP said to lower my dose to 100mcg so I haven't got much confidence in the surgery.
I take 100mcg of Aristo and 25 of NorthStar and don't know what the difference is between brands. I take B12 and iron supplements as I have autoimmune alopecia but the hair loss recently is diffuse as well as patches. As for other symptoms, I feel wired and anxious but that could be a pandemic and home schooling 3 kids!
Thanks for all your advice
I take iron supplements 12hrs apart from levothyroxine, have Hashimoto's and am probably perimenopausal
Orchid2025
Your Ferritin is very high so doesn't suggest the need for taking an iron supplement. The first thing I would say is stop the iron supplement. Is this prescribed? If so are your iron levels being monitored?
Your Active B12 is also very high, are you supplementing, if so with what?
Folate, again, is high. Are you supplementing, perhaps a B Complex? If so did you leave this off for 7 days before the test? If not then the biotin it contains has likely caused false results.
If you did leave off your B Complex and your results are accurate, then you are not overmedicated because your FT3 is in range, it is in fact quite low in range compared to your FT4. FT4 and FT3 should be balanced. Your FT4 is 100% through range whereas your FT3 is only 43.24% through range suggesting poor conversion of T4 to T3.
Good conversion relies on optimal nutrient levels which are :
Vit D - 100-150nmol/L
Active B12 - over 100 but within range
Folate - at least half way through range
Ferritin - half way through range
Supplementing with selenium l-selenomethionine is said to help conversion, also zinc but you should test zinc and copper before supplementing, I've read that a good level for zinc is half way through range.
Suggest you stop the iron supplements immediately
Technically speaking if you have too much thyroid hormone activity due to excess thyroid medication it is called 'thyrotoxicity' rather than 'hyperthyroid' which strictly speaking means too much secretion from the thyroid. I always use the term hyperthyroid because the symptoms are much the same and you can never be certain the excess hormone isn't coming from the thyroid (unless it has been removed). I also dislike the term thyrotoxic because it suggests thyroid hormone is a toxin, it is not. It also generates the wrong attitude, thyrotoxic is an aggressive term tilting the balance away from providing sufficient hormone.
The thyroid can have erratic secretion if there is any left. This usually happens in authoimmune hypothyroidism but I notice your antibodies are not too bad, one slightly high. If this was happening your fT3 would probably be high and it is not.
Apart from your TSH being a touch low your blood levels look fine. It wouldn't do any harm to try lowering you dose by 25 mcg but whack it back up if you feel worse. I would skip your levo for a couple of days and then resume on 25 mcg less. This way the effect will be sooner and it's easier to see any change.
It would be worthwhile checking your iron levels but they would have to be very low to affect hair loss.
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