over medication symptoms

[Almondo]

Hi everyone. I was diagnosed with hypothyroidism mid September with TSH level of over 100. I started immediately on 100 levo, and gradually started to feel a little better. Then, in mid November I started experiencing symptoms such as severe anxiety, heart palpitations, chest pain, weight loss, breathlessness. Had bloods done and TSH had dropped to 0.25, so my medication was changed to 75 levo. I have been on this for 9 days now and if anything I feel worse - terrible anxiety, chest pains being the worst symptoms. I feel so worried. Doc says it's anxiety and symptoms brought on by over medication and it'll get better. Any ideas / advice much appreciated. Thank you x

[SlowDragon Administrator]

Just testing TSH is completely inadequate

Likely low vitamin levels, rather than too much levothyroxine

Do you always get same brand levothyroxine at each prescription on 100mcg

Which brand

Presumably now you are on Teva brand levothyroxine on 75mcg…..as Teva is only brand that makes 75mcg tablets

Teva brand upsets many people

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.

Have you had thyroid antibodies tested yet

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)

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)

Is this how you did your most recent test

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...

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...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s.

Gluten intolerance is often a hidden issue too. Request coeliac blood test BEFORE considering trial on strictly gluten free diet

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[fuchsia-pink]

You are ONLY over-medicated if free T3 is over-range - not if TSH i suppressed ... But to know that, they'd need to test it ...

As SlowDragon says, just testing TSH is nowhere near enough - you want to know what your actual thyroid hormones are doing - at the very least testing free T4 - but with your extreme initial TSH reading, you really want full testing to be done, including key nutrients, so you know where you stand - so TSH, free T4, free T3, antibodies and ferritin, folate, vit D and B12. Have an early morning, fasting blood test (before 9 am) with a 24 hour gap from your previous dose of levo and a week from taking any supplements with biotin in.

I've had some success with my GP by saying that these are the tests recommended by Thyroid UK. Good luck x

[DippyDame]

Starting straight away on 100mcg would have been quite a shock to your system....any change should be slow to allow the body to adjust.Your poor body went straight from standing position to 100miles an hour!!

It may have been easier on you if he had started you on 50mcg....just my opinion!

Unfortunately recovery is a slow process with no quick fix ( think headache/ paracetamol!) so patience required!

How does this GP know you are overmedicated if he only tests TSH?

That, along with many GP's lack of knowledge about thyroid disease, is the downfall of many thyroid patients.

T3 is the active thyroid hormone required by the body in a constant and adequate supply. Your high TSH which is the message the pituitary sends to the thyroid to produce more hormones, signals how low your hormone level had become.

When correctly medicated this should be close to 2.

Anxiety can be a symptom of wrong/ under medication. This GP is flying by the seat of his pants!!

As SlowDragon says you need a full thyroid test to enable accurate evaluation of thyroid function....her advice is sound.

If you can have this done post the results and members will help.

With the correct medication things will improve though it may feel an uphill struggle at times but here we're all in this mess together, I found knowing I wasn't the only one with a problem a great help.... so come back, have a moan if it helps, and ask for any information and support that you need.

There are some very experienced and knowledgeable members here who could put medics to shame.....I can vouch for that. Without this forum I would still be very unwell!

Best...

DD

[radd]

Almondo,

Welcome to our forum and I am so sorry you are feeling like this.

Year 2011 and I too was suddenly started on 100mcg Levothyroxine with a TSH of 45 after a lifetime of cold sluggishnesss, and experienced "severe anxiety, heart palpitations, chest pain, weight loss, breathlessness". It took the addition of T3 to my Levo after another 5 years to feel anything resembling "normal-ish", and adrenals eventually to catch up, and I have since had troubles maintaining this stamina.

fuchsia-pink states 'You are ONLY over-medicated if free T3 is over-range - not if TSH is suppressed' but I beg to differ as consider over-medication could happen with far lower thyroid hormone levels if they don't correspond with other supporting systems. One day in the far-off future the medical profession will realise that people who have suffered long term undiagnosed hypothyroidism must be introduced slowly to replacement meds, and the adrenal glands supported accordingly as ALL bodily systems HAVE to work together (ie HPT axis, HPA axis, HPG axis, etc).

If I was repeating the starting of my thyroid hormone replacement meds I would say 'support, support, support' adrenals and take as little thyroid meds as possible (which goes against the grain) until adrenals can withstand that increase in metabolism. Better still to first increase adrenal reserve advocated with the likes of Dr Peatfield. To have different systems working so far apart brings the 'severe anxiety, palpitations, chest pain, weight loss & breathlessness' but also disorientation from the real world, loss of energy, motivation and so many extreme highs and plummeting lows I have lost count. Now I am 'normal' 😁 but it has taken a lot of research and hormonal understanding.

Adequate iron & nutrients are hugely important in getting Levothyroxine to work effectively but are only part of the picture and if you are feeling like this I would also advise a saliva stress test that measures not only cortisol/DHEA levels but circadian rhythm patterns within a 24 hour period, thus allowing appropriate supplementing of adrenal supports.

Cortisol is an adrenal stress hormone that becomes compromised after supporting inadequate thyroid hormone and is (together with other adrenal & thyroid hormones) neuro-active, meaning they will activate/ inhibit neurotransmitter systems (brain chemicals) that influence how we feel, manage ourselves and how our bodies react.

regeneruslabs.com/products/...

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cnslab.co.uk/products/adren...