Do you really need more levo

[Duchesse]

I had thyroidectomy in 1993 have benn on 150 level once 'within range' have since 1995 had episodes of AF needing hospital care on many occasions. Last November a severe episode. Hospital bloods showed I was off the scale for the tests. Cardiologist advised I had been overdosed for years and has cut my level. Currently on 75 but bloods indicate this may be too much. I feel fine a d have had no further heart problems. Am able to lose weight without too much difficulty so I am wondering for you if its the level of levo needs correcting or is there something else needs assessing. (My own gp said I was in range but I obtained a print out and he clearly had not read it... I was off the scale back in May) If you doubt your doc look at the actual test results and if not happy ask to see another doc.

[PurpleNails Administrator]

Often many do need more levo, but GPs see an in range TSH and are taught that this is sufficient proof of adequate replacement.

Are you saying your TSH was low >and FT4 & FT3 were high<? and this was not spotted and dealt with?

Sometimes only TSH is tested.

 It may be your TSH was low but FT4 & FT3 were in range in which case lowering you Levo might have left you unwell.

What were your results?

[tattybogle]

Hi Duchesse. did you manage to get hold of your blood test results ?

you were going to ask for copies after your last post at that point your levo had been reduced from 150mcg to 100mcg i think .

What were the overmedicated results that the GP had not noticed ?

What were the way over range results from the hospital

what were the result's that led to the reduction from 100mcg to 75mcg ?

What are the bloods that indicate 75mcg nay now be too much ?

if you can give us these results [and lab rangs] hopefully we can help you make sure they don't get it wrong 'in the other direction' by reducing your dose too much . ( which is the other mistake that is often made)

[Duchesse in reply to tattybogle]

I have the print out from latest test End Jan an t3 and t4 were right in range. The tsh showed <.02, hospital test e d Nov showed tsh < .01. As you recall started 100 after hospital tests and reduced to 75 after latest test. SO far I fell very well, no longer seem to have an AF problem hence reason I question whether even 75 is too much. Next test due end March

[SlowDragon Administrator in reply to Duchesse]

Next test due end March

ESSENTIAL that you also get vitamin D, folate, B12 and ferritin levels tested

Reducing dose levothyroxine drastically can result in very low vitamin levels

Low vitamin levels more common as we get older too

Low vitamin levels tend to lower TSH

Most important results are ALWAYS Ft3 followed by Ft4

For full Thyroid evaluation you need TSH, FT4 and FT3 tested 

Also both TPO and TG thyroid antibodies tested at least once 

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

[Duchesse in reply to SlowDragon]

Thankyou for that. I have test b4 eating and drinking by 9am and normally take levo on empty stomach on waking (about 630am) but not on day of test. I will ensure vtimin levels are done but other tests are on my list. Onee observation when in hospital end Nov with AF which led to diagnosis re over medication of levo I was put on a magnesium drip which did seem to give me quite a lift... any connection I wonder

[SlowDragon Administrator in reply to Duchesse]

Thousands of members find it beneficial/essential to take magnesium supplement daily

Low vitamin D and low magnesium often go together

If on gluten free diet, as many/most autoimmune thyroid disease (hashimoto’s) are…..this is especially low in magnesium

[tattybogle in reply to Duchesse]

pleased you are feeling well Duchesse,

re. thinking that 75may still be too much .. Do remember that TSH can take a long time to wake up and rise again if it's been low for a while . it can stay 'stuck' on low for a very long while after T4/T3 are comfortably in range , and after symptoms of overmedication have been resolved . ( this delay in TSH rising is partly due to a thing called 'Hysteresis'.. to 'lag behind' )

If dose is further reduced to soon, based solely on TSH that may not have had time to rise ,you can end up undermedicated and have to put dose back up a bit.. but this process can lead to feeling very under par for a few months .. so since you currently feel ok , be on your guard against this happening to you . Your dose reduction from 150 to 100 was already very substantial , the further reduction to 75 so soon is raising a few alarm bells for me .. so another reduction from based just on TSH, not fT4 / fT3 . symptoms, would make me wary.

( this happened to me a couple of yrs ago . 125 was a tad too much, 112.5mcg was ok, once it had settled in, but dose was further reduced to 100mcg based only on bloods ... 100mcg left me very undermedicated and i couldn't function well at all ... it was put back to 112.5 , but it took several months to get myself feeling ok again)

See what your march results say .. try to get them to do at least fT4 with it, not just TSH.. and see if you still feel well i a few weeks .

TSH can be a useful guide to dose ,..... but it can often be misleading unless everything else isn't taken into account .... it's not infallible.

[SlowDragon Administrator]

over 2000 posts on here mentioning magnesium

healthunlocked.com/search/p...

[pennyannie]

Hello again :

No necessarily - it depends on your Free T3 and Free T4 readings being balanced within the ranges - as I tried to explain in my last reply to you.

We were waiting on blood test results so presume you now can share these with forum members should you wish further information, support and advice.

[Brightness14]

We do mostly treat ourselves and obtain private blood tests too. It's a good idea to question everything a GP or Endo tells you. Your heart could have been damaged.