Mistake?

[Sark1]

Hi. I was pretty sure that I had swung from hypo to hyper so I reduced then stopped my Levo meds (75). Had blood test and have been informed that my TSH is 50. Still feel jittery anxious and headachey. But have resumed Levo at 25. Any advice?

[Lalatoot]

Sark the symptoms of hyper overmedicated and hypo undermedicated are not like the clear cut lists you read on the internet. The same symptoms can be experienced for both conditions. This is why blood tests are important when symptoms occur.I was truly hyperthyroid then had treatment and became hypothyroid. I can say from experience that my symptoms of being hyper were the same as the symptoms I suffered when I was an undermedicated hypo. Symptoms tell me my system is out of kilter but I rely on blood results to guide me as to whether I need an increase or decrease in thyroid hormones.

[Sark1 in reply to Lalatoot]

Thank you so much for your prompt reply.... I am sort of edging towards feel g very silly. I was away from home and could not easily see a doctor. Hopefully fix it now. Thanks again

[Lalatoot in reply to Sark1]

Sark don't feel silly. We all have done things we regret. I have an Oscar for my performance! I thought levothyroxine was causing my symptoms so I all but stopped taking it. I felt great for 3 months before I became very ill. Turns out my symptoms were because I had been on too low a dose for 4 years. My doctors were not the best but I didn't know any better back then.

[Sark1 in reply to Lalatoot]

You are such a comfort. Thank you!

[Lalatoot in reply to Sark1]

Glad to be of help.

[SlowDragon Administrator]

Suggest you get back on to 75mcg daily

Retest thyroid and vitamin levels in 6-8 weeks

Test thyroid levels early morning and last dose levothyroxine 24 hours before test

75mcg is only one step up from starter dose

Unless extremely petite most people need to be on at least 100mcg levothyroxine per day

What were your most recent thyroid results

What vitamin supplements are you currently

Low GFR and low kidney function are frequently linked to being hypothyroid

ncbi.nlm.nih.gov/pmc/articl...

The GFR is reversibly reduced (by about 40%) in more than 55% of adults with hypothyroidism[40] due to several reasons. 

[Sark1 in reply to SlowDragon]

Yes I do have CKD. Difficult to get full tests will get copy when I have 2nd set of bloods done on Tuesday but told on phone that THS is 50 and T4 is 8.1. T3 not done. Take vit. D and B complex Also Pro Bio cultures.

[SlowDragon Administrator in reply to Sark1]

retest CKD once thyroid levels are optimal

being extremely hypothyroid can feel very like hyper …..because body is trying to live off adrenaline

Anxiety, poor sleep etc etc

Approx how much do you weigh in kilo?

ALWAYS test full thyroid results

Most important results are Ft3, followed by Ft4

No point testing thyroid until done 6 weeks on unchanging dose and brand of levothyroxine

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine: 

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months. 

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range. 

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

[Sark1 in reply to SlowDragon]

Thank you. You are all so helpful. I'm around 70 Kilos

[SlowDragon Administrator in reply to Sark1]

70kg x 1.6mcg = 112mcg levothyroxine per day as the guide for dose levothyroxine you might need

Get back on 75mcg everyday

Retest thyroid levels early morning 6-8 weeks later

Likely then ready for next dose increase up to 87.5mcg (75mcg and 100mcg alternate days)

Retest again in further 6-8 weeks

Meanwhile essential to test vitamin D, folate, ferritin and B12 and improve to GOOD levels

Once you get levothyroxine dose up over 100mcg likely to see Kidney function improves

[Buddy195 Administrator]

As Lalatoot has detailed, hypo and hyper symptoms can overlap. Even though I have hypothyroidism. my symptoms often appear more ‘hyper’ (weight loss. Palpitations, increased anxiety. tremor) and these are heightened when my thyroid medication and key vitamins (ferritin, folate, B12 and Vit D) are not optimal. I get adverse symptoms when either my thyroid medication is too low or too high; that’s why I test my levels as soon as symptoms spike. As GPs are reluctant/ unable to test FT3 and FT4 in addition to TSH, I (like many other forum members) test these privately to have a better picture of my thyroid health.

[Sark1 in reply to Buddy195]

Thank you for your response

[Aghu in reply to Buddy195]

wow, first time hearing this from anyone else; always thought how strange it is to have all those hyper symptoms despite being hypo on tests everytime (can’t increase the dosage though because it overactivates my gi tract without a doubt- food passing through too quick)

[Sark1 in reply to Aghu]

This site is remarkable isn't it?. I hope to get my Levo increased tomorrow. Will post info on the site

[Buddy195 Administrator in reply to Aghu]

I only increase or decrease super slowly due to adverse reactions, eg 12.5mcg Levo alternate days at first, then 12.5mcg daily for 6-8 weeks before retesting. I find a pill cutter useful!

[Sark1 in reply to Buddy195]

I agree about the pill cutter

[JAmanda]

id be thinking you were likely under medicated and need to restart at 100. then retest in 8 weeks. You could build up from25.

[Sark1 in reply to JAmanda]

Thank you I think you are correct