Overmedicated- advice needed on tapering down - Thyroid UK

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Overmedicated- advice needed on tapering down

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Hello šŸ‘‹

I was diagnosed with Hashimotos 2 years ago, underactive. I had flu/ chest infection and pleurisy recently and have recovered from this with clear X Rays. However, just did not feel well. Had bloods done and Iā€™m normally between 1-2 TSH with T4 around 17-19.

I have felt like I was displaying hyper symptoms with burning sensations, high anxiety and panic, muscle weakness, insomnia etc so had bloods done. I currently take 150mcg Levo.

My headline results this week:

TSH 0.99 range 0.27-4.20

Free T4 23.0 range 12.0-22.0

Iā€™m awaiting T3 result.

This suggests/ confirms my thoughts about possibly being overmedicated or a Hashi flair post infection.

My question is my consultant was meant to call back today but didnā€™t so I need to know what to do in the morning re my dosage. None? Taper by 25? Take to 100?

I was very ill when hypothyroid 2 years go so donā€™t want to plummet.

All my other bits were ok including B12 etc and inflammation marker low so infection resolved- I take all the vitamin supplements recommended on here.

Any help about what to do in the morning re meds be gratefully received. I need not to add to hyper symptoms as Iā€™m climbing the walls šŸ™

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Anthea55 profile image
Anthea55

I see you are on levo. Levo is a storage hormone so timing isn't important. I suggest you miss the morning's dose until you've spoken to your consultant. If you need to you can make it up later.

When I say 'storage' hormone that means that it doesn't do anything, but waits to be converted to T3 which is the active hormone. It's a bit like the petrol tank in your car - the petrol waits to be used when you drive.

in reply to Anthea55

Thank you šŸ™ I was nervous to keep piling it in at the mo. Hoping I get my T3 result tomorrow so should give me a true picture if Iā€™m overmedicated as usually poor converter. Can upMy Levo and T3 stays static. Thank you Anthea. This was my gut feeling and as Iā€™m already living in constant state of anxiety taking it in morning again would make me worse. Fingers crossed he rings tomorrow šŸ¤žšŸ¤—

Meanbeannyc profile image
Meanbeannyc

Do you think youā€™re overmedicated because FT4 is over range?

in reply to Meanbeannyc

Hi yes and because of symptoms. Iā€™ve felt wired, waking every 2 hours, shaky etc twitches. So when I saw T4 at 23 Iā€™m usually around 17-19 ( not high in range) but I function, I thought the 2 are linked.

Meanbeannyc profile image
Meanbeannyc in reply to

Idk, Iā€™ve never felt hyper on any dose or combo of doses. So I canā€™t relate.

But I think your tsh being around 0.99, I think your pituitary is satisfied with the amount of hormone youā€™re getting. Have you retested a few times before lowering?

in reply to Meanbeannyc

Iā€™ve only had these tests this week as I pay privately itā€™s all getting v expensive. Iā€™m useless at doing my own via Medichecks and as is the way GP will only do TSH. So frustrating.

JAmanda profile image
JAmanda

Iā€™d only go down by 10 or 12.5 per day. Youā€™re barely over range. It will be interesting to see what your T3 is and whether thatā€™s the real issue and you need lio.

in reply to JAmanda

Hello Yes small drop then. I had to request T3 again as theyā€™d missed it off (I pay privately for all things Thyroid- costs a fortune but??) so maybe a day or so for results. If this is in range or low Iā€™m not converting. However in uk I believe itā€™s impossible to get T3 even via a consultant. All so frustrating.

I wonder if the high T4 alone can cause hyper symptoms even if the T3 comes back in range? What do you think?

JAmanda profile image
JAmanda in reply to

I get T3 on nhs. From Endo. Many do in the UK.

in reply to JAmanda

Thatā€™s good I genuinely think something is going on. I didnā€™t realise it was available here. I defo need to explore this with my doctor. Thank you šŸ™

JAmanda profile image
JAmanda in reply to

Doc will need to refer you to an Endo for them to prescribe. Thyroid U.K. has a list of thyroid friendly Endoā€™s - you could try to get referred to one locally. Iā€™ve had a few Endoā€™s now in Kingston upon Thames and theyā€™ve all been ok ish with T3.

in reply to JAmanda

Thank you! Iā€™m in the Manchester area will look at the site. I did see an endo a couple of years ago privately but didnā€™t find her helpful so am mainly working with a private GP who is up to speed on all things thyroid. He might need to refer me.

JAmanda profile image
JAmanda in reply to

Of course thereā€™s also the ā€˜taking things into your own handsā€™ route! Get full thyroid tests done privately from Medichecks etc then post results here for advice then self source T3 etc!

in reply to JAmanda

Thanks JAmanda. Iā€™ve just had blood work done and awaiting T3 result tomorrow as they forgot to run this at same time so will pop on here for advice šŸ‘

Carna profile image
Carna

It isnā€™t impossible to get T3 in UK but you may need to go privately before anyone will listen to you. I was prescribed T3 from a private Endo but NHS still wonā€™t pay for so I source and buy myself. I have read how changes in GPs can mean a change in strategy and what medication you are given so I prefer the stability of buying my own via a private prescription for now.

in reply to Carna

I do have a fantastic private GP who would do their best to help. Iā€™m having a review next week when T3 in so Iā€™ll see if this is an option if necessary. So fed up with it all.

I am feeling the same and I am scared the doctor will reduce dose and make a mess again. Good luck!

Same here itā€™s just awful, isnā€™t it? Sending positive thoughts. Letā€™s hope we get sorted!

SlowDragon profile image
SlowDragonAdministrator

Just testing TSH, Ft4 and ft3 is inadequate

Essential to also test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently

ALWAYS test thyroid levels as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

High Ft4 and low Ft3 would show poor conversion

Good conversion of Ft4 to Ft3 needs GOOD vitamin levels

High Ft4 can make you feel wiredā€¦but important to consider the whole picture

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimotoā€™s or Ordā€™s thyroiditis)

Low vitamin levels common as we get older too

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 and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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

List of private testing options

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

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

bluehorizonbloodtests.co.uk...

Thank you SlowDragon for your detailed response. Iā€™ll be repeating bloods next week so will ask for full vits to be checked. I know my B12 and vitamin D was good šŸ‘

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