advice please

[Goinginsane1]

Is it safe to take a higher dose of Levothyroxine (25mg more, from 75 back to 100) even though the drs are saying levels are ‘normal’? I have felt really ill and have so many symptoms since the reduction in dose. Initially thought it could be the change in brand, which I also think has played a role but have changed the brand back to what I’ve always taken for a good few weeks now yet I am feeling more ill and now having vision issues that I have never had before. Really don’t feel well but drs are saying I was being over medicated before hence they reduced it.

i have always been on 100 for years and years and it was only changed just over a year ago after having a baby. I have not felt right since and armpit pain has returned and my anxiety is through the roof. Worse than ever before ☹️

[SeasideSusie Remembering]

Goinginsane1

What are you actual results, including the reference ranges. "Normal" doesn't mean anything other than "somewhere within the range" yet it's where in range that's important.

Why was your dose reduced?

Does your GP test just TSH or do you get FT4 and FT3 tested as well. TSH is not a thyroid hormone, it's a pituitary hormone which is useful for diagnosis but not particularly relevant once on thyroid hormone replacement when emphasis should be on FT4 level, and more importantly FT3. Just testing TSH alone doesn't tell us anything about our thyroid status and many people are kept ill when doctors use just TSH to adjust dose.

If you don't have your results then ask the receptionist (not the doctor) for a print out. Your surgery may even have online access to results if you are in England so check that and register for it if they do. In the UK we are legally entitled to our results without charge or question.

[Goinginsane1 in reply to SeasideSusie]

this was from a private test at the end of October…

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[SeasideSusie Remembering in reply to Goinginsane1]

Goinginsane1

TSH: 1.46 (0.27-4.20)

FT3: 4.4 (3.1-6.8)

FT4: 21.3 (12-22)

The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges.

Your FT4 is 93% through range and FT3 is a mere 35.14% through range showing very poor conversion of T4 to T3.

From what I can see of your nutrient results Active B12 is good at 111, Folate is a bit low and would be better over 35 with that range and Vit D at 79 would be better around 125nmol/L. I can't see a ferritin level and guess this test was done by INUVI for Medichecks and they have strange ranges. Ferritin is suggested, by some experts, to need to be 90-110ug/L for good thyroid function.

I would try to optimise your nutrient levels but it's very likely you may need the addition of T3 to a slightly lower dose of Levo. Increasing your dose of Levo with these results will just push your FT4 level even higher (which wouldn't be a good idea) and may slightly increase your FT3 level.

Your GP can't prescribe T3, it has to be initiated by an endo for a trial and to be honest I don't know if an endo would agree to see you, many would just say your results are within range so no need to see you. The other option is to source T3 yourself.

[Goinginsane1 in reply to SeasideSusie]

thanks for your message. You mention I may need the addition of T3 to a slightly lower dose of Levothyroxine. Is T3 something I can get prescribed by the GP? Sorry I am not well educated on this. I have always taken 100mcg and been fine until the last year of so after having baby and now I am trying to make sense of it all due to so many symptoms since changing dose.

[SeasideSusie Remembering in reply to Goinginsane1]

Is T3 something I can get prescribed by the GP?

No, as mentioned in my reply above:

Your GP can't prescribe T3, it has to be initiated by an endo for a trial .......

[DippyDame]

I suspect your T4 to T3 conversion is poor and you needed the higher dose of T4 to produce enough T3 from conversion for your body's needs.

Do you have any recent labs which show low FT3?

FT3 is the most important reading followed by FT4

TSH is not a reliable marker once medication is started.

For good health almost every cell in the body needs a constant and adequate supply of T3

If you feel unwell the dose is wrong....no matter what the GP thinks the numbers indicate!

You will not be overmedicated unless your FT3 rises out if range.

I need high dose T3-only so have done the hard yards on that one!

In your shoes I would return to 100mcg....but you may have a lot of explaining to do to convince a poorly informed medic.

We need to stand up against poor thyroid treatment!

[Goinginsane1 in reply to DippyDame]

a little clearer…

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[DippyDame]

Can you give us ref ranges for FT4 and FT3 please?

[Buddy195 Administrator]

Increased anxiety has been the worst symptom of having a thyroid condition for me and it is always worse if thyroid medication or key vitamins (ferritin, folate, vitamins B12 and D) are not optimal.

My GP initially diagnosed me with ‘ health anxiety’, suggested I saw a psychotherapist & offered me anti depressants. Joining this forum helped me realise that my symptoms were related to being under medicated and I followed forum advice to improve this.

[Goinginsane1 in reply to Buddy195]

I feel like I am now being under medicated. But they are saying the bloods are ‘normal’. It really doesn’t feel like it. I was so much better taking 100.

[Goinginsane1 in reply to Buddy195]

when I say what I’m thinking they say that it is often being over active that can cause anxiety and heart racing/palpitations. I believe that I am under and having anxiety due to all the other symptoms. Not necessarily due to an over active issue 💁

[Hidden in reply to Goinginsane1]

You physically can't be over active. You could be over medicated but certainly not overactive.

Terminology is important.

Are these the results that prompted the reduction? Did your GP seriously suggest you're overactive with a TSH of 1.4??

[Buddy195 Administrator in reply to Goinginsane1]

I get increased anxiety when both under and over medicated or if key vitamins are not optimal.

[SlowDragon Administrator]

what was ferritin result in this test?