Taking a double dose in one day by mistake

[Jacarilla]

I take my levo dose of 88 mg at 8.30am and have just accidentally taken another dose at 10.30pm mistaking it for another tablet. I’m worried 😟 will I be ok?

[Lalatoot]

Yes, it is not a problem. Just skip tomorrow morning and carry on on Saturday as normal.

[Jacarilla in reply to Lalatoot]

Thanks you 😊

[nellie237]

You're the 2nd one today🤦‍♀️. I've done it too, but fortunately not with anything drastic either.

[Jacarilla in reply to nellie237]

Thanks for the reassurance … I’m fairly new to levo and have had trouble with dosage so it worried me, but I seem to be fine apart from a somewhat sleepless night which was probably due to worry 🙈😂

[lau99]

You'll be okay I had an absorption test at the hospital on Monday where I was given 1000mcg of levothyroxine to be taken all at once! It just meant that I don't have to take any more of my usual levo until next week. Try not to worry or fret too much

[radd in reply to lau99]

lau99,

Gosh, I didn't know they still did this. Did it make any difference to how you feel?

[Lalatoot in reply to radd]

Yes it would be very interesting to know what the effects of that were partic given the theory that for some even the spike of a daily amount in one dose can derail conversion necessitating some to split daily dosing of levo .

[radd in reply to Lalatoot]

Lalatoot,

Yes, it feels at the moment thyroid scientific research is storming ahead and although widely available, medical practices remain as obsolete as ever.

[lau99 in reply to radd]

Indeed, and they'll be making me do it all again on Wednesday! It's a fasting test where I can't eat or drink anything from midnight until the end of the test at around 3pm...

Honestly, I don't think I feel any different at all, surprisingly...I had a slightly upset tummy the night of the first absorption test after I'd gone home, but other than that, I still feel just as hypo as usual.

[nellie237 in reply to lau99]

So they're giving you 2,000mcg over 10 days, which in theory should have less overall impact than taking 200mcg per day? I will be keeping my fingers crossed that you get some answers/resolution lau...............it's been far too long. x

[lau99 in reply to nellie237]

Thank you nellie xx Who knows what their rationale is, honestly I've sort of given up hope in the NHS after all of this...I'm kind of just letting them do their thing with regards to this test because I know I'll probably just switch to trying the NDT I was prescribed privately as soon as the next absorption test is over.

[Alanna012 in reply to lau99]

Surely that's dangerous...if you had adrenal or heart problems??!

[lau99 in reply to Alanna012]

I was as shocked as you were when the dose I was meant to take on the days of the tests arrived in the post! (They didn't even attach a letter with the medicine saying what it was for, and it arrived at my door over a month before the test was due to take place, and before I'd been given a date for it! The organisation/communication at my current hospital is a bit shocking to say the least).

Apparently it isn't uncommon for some endos to prescribe megadoses like that to be taken once a week for people who are particularly forgetful, at least in the opinion of one of my registrars...

[Alanna012 in reply to lau99]

You learn something new everyday! How bizarre and the communication seems quite off with your hospital but you're alive so all good I guess!😄

[shaws Administrator in reply to lau99]

I have also read that we can take one week's dose - once a week!

I prefer a daily dose.

[Alanna012 in reply to shaws]

How is it possible?I'm really mystified.

Surely it would feel awful at least for a couple days?

Then there's the heart. I know T4 doesn't stimulate the heart quite as much as T3 does but at the very least I would think heart rate would jump up quite high?

'You know nothing Alanna'

😶

[waveylines in reply to lau99]

Wow thats a big old dose to take in one! Ive never hesrd of that. Seems a bit weird. why not just your daily dose for them to track!!

[lau99 in reply to waveylines]

I wonder the same thing! Maybe it's so that they can clearly compare exactly how much is proportionally meant to be absorbed in theory with how much is being absorbed by me in reality? I'll have to ask at the next one on Wednesday...

[jade_s in reply to lau99]

If you do ask, please report back! We're all dying to know their rationale 😆😂

[tattybogle in reply to jade_s]

absorption tests have a simple rationale . they are basically just investigating whether when the levo is taken as prescribed over a few weeks.... does the the TSH reduce as expected , or not ? .... and does the fT4 rise as expected or not? . They give a dose they expect to work eg 100mcg / day .. but they give a weeks worth, ,or 10 days worth , all in one go, so it can be observed to be taken under optimal absorption conditions. They would usually repeat this over a few weeks and then test to see if TSH went down as expected .. or of it didn't.

if TSH goes down / T4 goes up as expected when patient was observed to have taken equivalent of eg 100mcg/ day ... then absorption isn't a problem .

If TSH still doesn't go down /T4 doesn't go up when they are sure 100mcg / day was taken for a few weeks .. then absorption is proven to be a problem.

I don't know whether they do anything more intelligent while they are at it , like look at fT3 levels etc ... so it will be interesting to hear the results of this one

[jade_s in reply to tattybogle]

Interesting, thanks. I had never heard of this type of test.

[helvella Administrator]

In testing levothyroxine, the standard approach is to give 600 micrograms to healthy volunteers. (For example, a new formulation.)

It is well tolerated and no-one seems to worry at all.

[radd in reply to helvella]

helvelka,

There’s a difference between a healthy volunteer and someone like many members who have acquired more & more various deficiencies and other (possibly autoimmune) conditions , possibly cardiac or adrenal, having been left chronically under- medicated for years.

Mind you I have mistakenly double dosed thyroxine before and felt nothing but double dosing F3 made me hot, jittery and feel horrible.

[helvella Administrator in reply to radd]

True - but the original poster had only taken double 88 - so only a bit more than a quarter of the 600 micrograms!

I agree that it is more likely to have an impact that will be noticed than a healthy volunteer. But 600 micrograms is clearly recognised as usually being safe.

[Alanna012 in reply to helvella]

No way on gods earth I could take that much levo in one go and not possibly end up in hospital.

I have attempted several occasions to raise my levo by 50mcg in one jump and been left breathless and struggling and have to drop back. I really don't understand how it is possible to do something like this. It's dichotomous.

Plus how do they establish the baseline for a 'healthy' volunteer?

We know that there are population standards established for TSH for healthy individuals that are anything but healthy.

[helvella Administrator in reply to Alanna012]

Healthy volunteers are defined at least partly by no observed thyroid issue. Probably young adults. Of course, such definitions are always difficult and could be argued forever.

[Jacarilla]

Thanks for the reassurance and the interesting thread that followed. I felt quite unwell on 100mg but 75mg was too little hence the 88mg I’m on now. I was worried that maybe I’m quite sensitive to dose … anyway another question - I’m due a blood test in two weeks to see how I’m doing on the current dose. I haven’t taken my dose today and will continue as normal tomorrow.. will this affect my blood results?

[Lulu2607 in reply to Jacarilla]

Hi. I'm sensitive to dose and asked for 88, splitting a 25 to do it. The Dr wouldn't hear of it (?) with a ridiculous argument that you can't get an exact split etc. ( but I take the other bit the next day....!!) He wants me to alternate 75 and 100 but I felt shattered on 75 days and 100 felt too much. Going to have to push for 88 at next prescription.

[Jacarilla in reply to Lulu2607]

I tried alternating and it didn’t work for me… I felt worse. I concluded that I need a steady dose as my body doesn’t cope with the changes.

[Lulu2607 in reply to Jacarilla]

I agree, glad I'm not the only one!

[jade_s in reply to Jacarilla]

Same here. I split a 75 and 100 both in half and that gives 87.5. The halves are close enough and much more 'exact' than alternating 75 and 100. Where do they come up with these ridiculous theories. The tablets are even scored just for that reason for goodness sake.

[nellie237 in reply to Jacarilla]

"will this affect my blood results?" I don't think so. The half life is 7 days (I think) .

[jade_s in reply to nellie237]

Oops missed this question. You're correct. Half life is 7 days. You skipped the next day's dose so your total dose is the same, so it won't affect results 2 weeks out Jacarilla Some people use a weekly pillbox and keep it next to their bed. Something to consider, if you're not already using one.

[Jacarilla in reply to jade_s]

I use a weekly pill box but my brain fog (which I put down to menopause) sometimes beats me 🙈👍

[jade_s in reply to Jacarilla]

Haha happens to the best of us! 😅