Found out I was over medicated. They’ve reduced my medication from 200 mcg to 50mcg. I went from hypothyroidism to hyperthyroidism. My results for April 28th was T4 12.43 and TSH .05.
Went back to the Er because I was having heart palpitations. My results for May 22 was T4 ~ 4.88ug/dL and my TSH 31.44 which puts back to hypothyroidism. I actually had to stop taking the medications for four days for so my T4 went down. Now that I take the 50 mcg but my head still hurts. Is this what brain fog feels like? And I’m still waiting to see an Endocrinologist.
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Npitts
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Npitts, welcome to the forum. Are you able to add the laboratory reference ranges to those results please? Our U.K. ranges are very different to US ones so it isn’t very easy for us to gauge what’s going on without them.
What I would say is that if you’ve had a total thyroidectomy it’s really unlikely that 50mcg is going to be enough for long.
As far as I know, brain fog doesn't hurt. It's just foggy thinking, forgetfulness, difficulty concentrating. But, it wouldn't be surprising if you had that on only 50 mcg levo. And such a drastic reduction won't have helped, either. Levo should only be reduced by 25 mcg every six weeks.
Was your FT4 really over-range? No FT3 tested? You're only really over-medicated (not hyper) if your FT3 is over-range.
Now, you are drastically under-medicated. So, not surprising you feel bad.
if you had become overmedicated on 200mcg and have then had quite a few changes of dose in quick succession, with few days off thrown in as well , and are now on only 50mcg, it is to be expected that you will feel a bit rubbish and your 'headache' is not a surprise.
if you had a total thyroidectomy ? , then you can't actually become 'hyperthyroid' as such .. because you have no thyroid left to make too much thyroid hormone.. but you do become overmedicated it your dose of Levothyroxine was too much for you .
How long had you been taking 200mcg for before you became overmedicated ?
after being overmedicated , it can take a while to feel ok again as the effects of too much T4 can take a few weeks to settle down even after you have reduced the dose .. and you will now have to find the right dose again ,which will take some time .
but ,as jazzw say's 50mcg is unlikely to be enough .
When you had that TSH of 31.44 what dose had you been taking and for how long ?
The TSH takes a few weeks on a stable dose to catch up to what the fT4 levels are ( fT4 level changes quite fast when you change dose or miss doses, but TSH takes weeks to show the change ) ... so it's difficult to know what your TSH is at the moment , because you've had so many changes and missed days recently.
We need to know the lab range for the fT4 test, to see if it's high or not
It would help if you had a full thyroid testTSH, FT4, FT3, vitD, vit B12, folate, ferritin and thyroid antibodies TPO and Tg
Can you please give us reference ranges for the above labs....these vary from lab to lab.
200mcg is a large dose which appears to have caused you to be overmedicated
Dropping to 50mcg is probably far too rapid a reduction though this advice is not unusual from medics.
However unless your FT3 is over range you are unlikely to be overmedicated
But you may just need a lower dose...
50 mcg is only a starter dose so unlikely to be enough ...and causing symptoms like brain fog
Test and review dose 6 weeks after reduction
You are unlikely to feel great until your dose is correct and that may take time so we have to be patient
Increases should be low and slow to give the body time to adjust
Also, we don't yet know if your T4 to T3 conversion is adequate either....comparing FT4 and FT3 will tell
High FT4 with low FT3 = poor T4 to T3 conversion
If your T3 level is low this will cause problems/symptoms
Depending on your next lab results you may need some T3 since levo/T4 alone may not be what your body needs....right now we can't tell.
T3 is the active thyroid hormone and for good health it must be available in a constant and adequate supply
Low T3 = poor health.
Important to optimise vit D, vit 12, folate and ferritin as these nutrients support thyroid function
Brain fog feels as if you are in a thick fog and find it difficult to focus, think straight, remember and concentrate... an unpleasant spaced out feeling!
Bottom line...you really need a full thyroid test in order to evaluate your thyroid function status...not just TSH and FT4.
Here, we're all in this thyroid mess together and collectively have lots of experience and knowledge so come back with more info and members will help.
I got over medecated on t4 my heart went crazy v scary wen t4 goes v high an took abut 6 weeks too wash awayu need to go higher v v slow now or swich meds.
Poor you. Brain fog is a foggy feeling when we can’t think clearly and any change of thyroid hormone can instigate headaches. Being over medicated on Levothyroxine can make one feel extremely unwell and heart palps & anxiety are common when thyroid meds aren’t or can’t work well.
A common reason on this forum for meds not working well is inadequate iron levels but T4 over-medication can also bring about changes that risk preventing future meds from working well. Also, heart palpitations can be due to too little thyroid hormone, too larger changes of thyroid hormones carried out too quickly as well as over-medication of thyroid hormone.
Even without ranges it is prudent to assume those results are now well within range but reading your profile you appear to have had many dose changes in quick succession so will need to wait at least six weeks after reducing from 200mcg to 50mcg T4 for more stabilised levels to be measured.
Levo must only be reduced or increased by no more than 25mcg at any one time with a six week gap to allow complete cell saturation. It would be useful to assess FT3 levels to gauge future appropriate T4 increases.
Any thyroid hormone requires adequate nutrients to allow best performance so ask your doctor to test FT4, FT3, TSH, and also ferritin, Vit B12, folate and Vit D. Post results complete with ranges (numbers in brackets) for members to comment.
I hope you start feeling a bit better soon but the chances are you will first need to raise T4 levels a little whilst addressing any iron/nutrient deficiencies.
No, brain fog does not hurt - Brain fog is kind of like when you have to concentrate to do the simplest things. Things that used to come almost unconsciously now you have to consciously think through. In my experience the over medicated state that you’re feeling is from the T4 Synthroid type medication. You didn’t say what kind of medication you were taking but I’ve had this exact same scenario with Synthroid. And yes you do have to back off of the medication maybe not quite as drastically as you did but you do have to lower the dosage to get better again in my experience. T4 Synthroid type medication really don’t work that well for a lot of people - you might be one of them. I was. The good news is there’s lots and lots of ways to help with a thyroid that’s out of kilter. Naturally desiccated pig thyroid and bovine thyroid gland is one of them. You can get these by prescription or without a prescription. I understand that in the UK it’s hard to get the doctors to prescribe natural or desiccated thyroid gland type medicines like Armour Thyroid or NatureThroid. It is here in the US as well - what I’ve had to do is lean on the doctor just a little bit and they do what I ask them. It’s a battle though - one you get so tired of.
Another way to regulate your thyroid and perhaps get off of thyroid medication altogether is through diet. There are many people that don’t believe this and I was one of those too. But it can be done with lots of discipline and lots of research. Our modern day diet contains way too much non-natural things - things other than food. One of the simplest things to remove and that worked for me is the lowering of iodine. (it’s not desirable nor possible to remove all iodine we must have it for proper thyroid function) Hidden iodine in processed food abounds.
I removed Iodine salt from the table. It has been vigorously pointed out to me when I mentioned this on this site that the UK does not iodize salt - in general. I’m going to take that at face value and believe that. But there are so many other avenues where excess iodine exists - even in natural foods like things from the sea. One lady recently told me that she turned herself from hypothyroid to hyperthyroid by using Lugol’s iodine as a remedy for Hashimoto’s. She was advised to do that and she knows what a mistake that was. (It has long been cautioned here not to take iodine if one suspects they have Hashimoto’s - sound advice!) Again the good news is she stopped taking it and she got better but not before the roller coaster ride like you’re describing. It’s scary - especially the heart palpitations. (Diet related - right?) The American thyroid association has a website that lists a chart of foods and shows their iodine content. It has been suggested by one alternative doctor here (Allan Christianson - he is on the web) in United States to use that chart and eat only the foods that are lower in iodine for 30 days. It literally resets the thyroid in over 75%. And then you can go back to eating, within limits, things that are higher in iodine. It’s a 30 day experiment that I’m so glad - I can’t tell you how happy I am that I tried it. 40 years of being on a roller coaster and fighting with doctors who didn’t know what they were doing and now I have been off of all medication for almost 2 years. I feel fine! And it makes sense really. Iodine is one of the most important nutrients for a healthy thyroid. Too much iodine can be conversely, damaging. How and why it is that in our modern world we began to ingest too much iodine I think is a multi faceted (and as yet largely unknown) answer. I took a good long look at my diet and compared it to the high iodine foods on the list and sure enough I was eating mostly high iodine. (Egg yolks, dairy, SALT, processed meats, commercial bread). The single easiest thing for me to lower iodine was switching to kosher salt.
It sounds like you are over medicated. Trust how you feel. The numbers that you get from the blood tests and the endocrinologist are useful but you are so much more than the numbers. How you feel, in my experience, is much more reliable. In my experience you can treat (paint!) by the numbers for 40 years and still be unwell.
dtate2016 ... Npitts informed us she has had a thyroidectomy , so your comment "Another way to regulate your thyroid and perhaps get off of thyroid medication altogether is through diet. " will not apply in this case.
You own case of now feeling well without hardly any / no thyroid hormone replacement for the last year or so , is great for you , but did you have a clear reason for your hypothyroidism /thyroid hormone replacement in the first place ?
You never gave us any thyroid blood test results or antibody results , but have said you were diagnosed as 'borderline' and had a scan that was 'inconclusive' ....
Please be careful when suggesting to someone who has had a thyroidectomy that they might be able to manage without any thyroid hormone .. it is a very different situation to yours.
I was diagnosed by blood tests from a endocrinologist in the 90's as Hashimotos. I have had so many blood tests - yes, yes. The tone of your reply is less than friendly, and I will not go on the defensive.
But to your point of being careful...the intention was to share my 40 year experience. "Did you have clear reason for ....thyroid hormone replacement in the first place?" Again, I am not going to be offended by that question, but rather assume positive intent. Your care for my well-being is touching. Clear reason, you ask?
If it is assumed that main stream medical knows how to diagnose and prescribed treatment for Hashimotos (did I mention the 40 years?), then yes, more than a dozen different Dr.s came to that same conclusion over the years and continued to prescribe T4. I will not present to you the blood test numbers. (I am no longer looking for remedies, nor medical treatment). There was one Dr. - one very special Dr. that knew T4 synthroid type medications was not working for me. While he did have the credentials and the letters behind his name, he also admitted that main stream medical did not have all the answers. He also gave me, without charge, the most wonderful gift - the DNA test that found the MTHFR genetic polymorphism. (as much as 25% of the world population has this inherited genetic abnormality - the "numbers" are still coming in). You may be familiar, and it is factual, that people with this type of inherited genetic combination eliminate toxins slowly. It could be (I am no Dr.) but it just could be that excessive iodine, in fact an overdose of anything, would then eliminate slowly, more slowly than those without the MTFHR genetic twist, and for awhile present as a wide variety of aches and ills - perhaps a bit like a very long hangover? Oh yes, I did have clear reason for thyroid hormone replacement, according to main stream medical.
But thyroid hormone replacement doesn't cure - it's like crutches, and it does help us get from here to there and is not to be discounted. Unless they begin to hurt. Unless we find a way to heal. Dr. .Lowe knew that, (Great fan!) T3 can be a part of the arsenal (in my experience) on the road to healing, and probably should be. It was for me.
If one has had the thyroid removed, then we have a whole new set of criteria. One will always need thyroid hormone replacement. Excess toxins (including excess iodine) still apply, I would dare to offer for serious consideration.
my point was .. for those of us who use the forum to learn from real life patients by using them as case studies ... when posters don't give any actual test results it's difficult for anyone else to make their mind up about what might have caused anything, whether it be the original illness or the improvement . we have the perspective of the poster, but nothing else, to go on.
I do find your post's and your point's very interesting , no intention to be unfriendly , apologies if it came across like that .... but i would find them more interesting if there were results so i could form my own opinion.
And from a different perspective, that I learned here... from the Dr. Lowe - also discovered here....that blood test numbers are not the all in all, not even the last word. A different point of view. (More than one way too skin a fish) I bowed to the numbers for many years. Did not believe in the "diet" protocol with the goal towards "healing" hashimotos. It is scary to leave the crutches, the hormone replacement, the numbers. I will admit - it's not for everyone. Recently, here in the States, I learned of a gaining momentum, even among main stream medical, to "de-prescribed" / lower thyroid hormone replacement. They are also recognizing "clean" diet as a part of the equation. The ship is turning, slowly. Keep the ears, eyes, and mind open. The knowledge is spreading. It just might be a light at the end of the tunnel.
I can't believe the doctor actually took you down that much all in one swoop! I had a PCP do that to me years ago and it took me a year to get back to some sort of normal. Shame on that doctor.
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