Dropping & Increasing Dose - Self-Inflicted Mess?

[cam92]

Hey everyone, I posted last week that I was going through what was probably a Hashimoto's flare. Quick recap: over the last 1.5 years I had titrated my way up to 45 mg of NDT. About 3 weeks ago I started feeling hyper or over medicated, so I took a few days off my meds entirely and started to feel better. Started back slow at 7.5 mg for a week or so, then up to 15 mg the following week, then up to 22 mg, sometimes splitting the dose during the day, sometimes not. At first, I felt okay after stopping the meds and being on 7.5, but then I felt like I came crashing down into feeling hypo (strangling feeling around throat, swollen/painful thyroid, body pain, depression, brain fog, no energy, etc). I've been struggling through that the last 2 weeks as I've been slowly increasing the dose. To top it off, I've now come down with a head cold (testing negative for covid so far). Yesterday I took 30 mg in the morning and proceeded to have some tremors in my hands, internal thrumming, heart pounding, and hardly slept last night.

I feel like I made a mess of things by abruptly dropping from 45 mg down to 7.5 mg instead of just taking a day or two off meds and restarting at like 37 or something. Even though I've been feeling like I'm hypo, now 30 mg feels like too much for me??? I've read you need to go low and slow with NDT, which is what I did over the 1.5 years that I titrated up, but does the same apply now that I was previously on a higher dose? I know typically you wait 6-8 weeks for a dose increase, but I'm impatient to get back to where I was and feel "normal" and don't want to risk staying at too low a dose too long. Has anyone else been through this?

To get rid of this over medicated feeling, what should I do? Skip a day and resume 22 mg tomorrow or take something today like 15 and then 22 tomorrow? Being sick with a cold is also complicating things.

Thanks!!!

[tattybogle]

i think .... that effect of the few weeks of 'not enough' will take a while to get over . but since you know you were previously ok(ish ) on 37mcg ....then it all went wrong 3/4 weeks after increasing to 45mcg. then i would assume that the current affects are due to difficulty increasing , rather than it really being too much.

30mcg would seem a good place to aim for until you can get more test done on that to see what's happening. I would really try and avoid any more 'stops and starts' and try and aim for some consistency while you get used to the larger dose again.

So i think ? i would try splitting dose for now until hopefully you get used to it and things stabilise (and not worry too much about keeping it away from meals if its too tricky) .....why not take 15 mcg am .. and another 15mcg later in the day .as far away from meals and as consistently as possible.

What about bedtime ? ...... i always take half my levo at bedtime, and just don't eat after about 8pm for consistency. yes, the absorption will be be a bit less than it would be on a totally empty stomach , but at least it will be a consistent dose however much is absorbed. and it doesn't interfere with how you need to eat for most of the day.

There's a lot of ' i thinks' in this reply because i don't take NDT , just levo .. so i could be talking out of my A** .... but i think the principle of 'consistency' applies to all of us.

[cam92 in reply to tattybogle]

Thanks so much for the feedback! I think you're right about getting some consistency as well as splitting the dose. I never did split it before, but I keep reading it's important with T4/T3 combo treatment. It seems this will just require patience.

[Yeswithasmile]

I see your reply by the experienced tattybogle. I really don’t have anything to add except I feel for you.

I know how hard it is not to rush and just how dreadful you can feel as do most here.

I rushed adding t3 to my levo last year and in the end I have had to start again as slow is absolutely the only way. Unfortunately like you When I started again I had an awful cold and a month later got covid badly. This didn’t help one bit. However I just want to say you will feel better. I’m back on track now. You will get there but tatty is right. Consistency is what you need and reactions to medication can be so sensitive that you can miss your optimal with a tiny alteration so please try and muster as much patience as you can. It’ll save you time in the long run.

Good luck.

[cam92 in reply to Yeswithasmile]

Thank you--it's so comforting that others can relate. Great point about missing the optimal dose. I wish this didn't have to be so complicated!

[Yeswithasmile in reply to cam92]

Oh we really can relate cam92. I know you feel total pants and want to feel better NOOooow but it just doesn’t work that way. I am sorry it’s so drawn out and complex just keep the faith. I’m rootin’ for you 😊

[cam92 in reply to Yeswithasmile]

Thank you so much!

[HeartWoman]

Well it sounds like I am in good company! I am coming off of being overmedicated on NP Thyroid. I Had the bloodwork and the symptoms. I took a 4 day break and started back today on .75 grains. I was on 1.25 grains, but got there way too fast. Yesterday, day 4, the anxious, panic feeling started. Today, the first day back on and I had several meltdowns. I know this can't be rushed and I might now even need to go as high as I do. I hope this turns around quick, at least the emotional stuff! NOW, TO JUST STAY AT THAT DOSE FOR SEVERAL WEEKS!

Unfortunately, my estrogen dose had to be increased 5 weeks ago, so things got mucky. I wish I only needed to make one change one

at a time, but it couldn't be helped in this case.