Advice please how to reduce Levo. Slightly overmedicated on block and replace.

[Cavapoochonowner]

Hi everyone.I have graves, currently on block and replace with 40 mg carbimazole and 100mcg levothyroxine per day. Been having hyper symptoms eg racing Heart, losing weight, constant shaky feelings so had medichecks thyroid bloods done on 5th July.Results TSH 0.68(0.27-4.2) T4 20.7(12-22) T3 4.5(3.1-6.8).heart rate in 90's even when sitting.Also 4 migraines in as many weeks.Yesterday had another bad migraine and really thumping heart spent 6 hours in a packed A and E.Full bloods done 2ECG's resting heart 106.Thankfully everything fine, not going to have a heart attack,all bloods Good,neutrophils back up, liver ,kidneys Ok.Hadn't done thyroid bloods though.She said she's do them but I'd have to wait at least half an hour for results(11.30 by then).I said I'd call my doctor for them and my endo would be able to see them on the system.She suggested reducing Levo slightly.Not taken it yet this morning, heart still pounding and mind racing.She gave me 1 beta blocker(Not proprananol)1.5 of something but can't remember name.It did help.Suggested getting some more from GP until levels come down. Will ring today. Before I email endo (nice man but don't think he knows what he's doing with graves)how much of a reduction to get down to around T4 18.Could I suggest missing one dose a week or maybe splitting a tablet over the weekend and taking 50 each day.Would that be enough to test again in 6 weeks or not.I know I need to request bloods in 6 weeks.My next phone appointment isn't for about 2 months.Sirry for long rambling post hope someone can help.I'd be very grateful the migraines have me at the end of my tether.Thanks in anticipation.

[Nadine70]

Hi there, I was on block and replace for a while and it took a while to get me into a sweet spot. Obviously I can’t give you medical advice but when in your position I would often alternate my Levo dose to try and get more of a balance as 50% reduction might be too much and you may go hypo. I used to alternate 50 one day and 100 the next so I averaged 75 mcg a day etc. They usually tested me six weeks after any dose change. I also recommend keeping a diary of how you feel on what dose as it helps when you see your endo as it can get confusing if you become hypo and are unable to process things properly. Hope you feel better soon 😊

[Cavapoochonowner in reply to Nadine70]

Hello, thanks for your reply.I have been given beta blockers by my GP to help with symptoms until my levels come down .My endo has just rung me and wants me to reduce Levo to 50mg per day and retest in 6 weeks.At first I thought it might be too much of a drop but to be honest I think I'd rather be a little under for a short time as I think I'm getting the migraines because it's too high.I just can't cope with them at all.I think I'll probably end up on about 75 like you said. I feel a lot better today thankyou.I'm writing everything down as you recommend.Thanks again.