over medicated or ready for next dose? - Thyroid UK

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over medicated or ready for next dose?

Hypo32 profile image
14 Replies

I have recently started on t3 that I purchased in Corfu (along side t4). Been on it about 4 weeks I think. My GP knows and has agreed to blood tests 2 months after I started it but she cannot prescribe or even guide me on it.

On the whole I feel better, especially in the morning. Less tired, more focussed, better mood, less gastro issues. I felt like I could feel it wearing off so I started taking a second dose late in the day (time varied as I sometimes forgot).

Just the past couple of days I have felt weird mid to late afternoon (I take my first dose about 6.20am). Really tired and feels like a bit like my heart is racing (pulse around 80). It seems to be worse if I have eaten a lot. I think I feel better a couple of hours later if I take more t3 but I am not certain and it is early days.

Does anyone else feel it wear off and want more or does this sound like I am over medicated?

I am also getting breathless, my voice is squeaky and going and my ears feel like they want to pop a lot. I assume this is a virus but thought I would mention it in case anyone else has experienced it when over medicated.

Thanks

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Hypo32 profile image
Hypo32
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14 Replies
SeasideSusie profile image
SeasideSusieRemembering

Looking at your last post, did you reduce your Levo?

How much of Levo and T3 are you taking?

SlowDragon profile image
SlowDragonAdministrator

Previous posts…..several people asked what were your most recent vitamin D, folate, B12 and ferritin results

What vitamin supplements are you taking

Please add most recent vitamin results

On levothyroxine and especially on levothyroxine plus starting T3 it’s ESSENTIAL that vitamin levels are at optimal levels

How much have you reduced levothyroxine by

Hypo32 profile image
Hypo32 in reply to SlowDragon

b12 was 466, vitamin d 124, ferritin 87, folate 4.7 (now taking folic acid but sometimes forget - go thought I didn’t need it). I take magnesium when I remember but if I take it every day I get loose bowels and not enough I get cramps. At first I reduced thyroxine from 125 to 100 but after 2 weeks I felt exactly as I always do 2 weeks after a reduction despite being on t3 too so I went back up. T3 is 12.5 at a time (if I cut it smaller it crumbles). As I write it I think it is too much but I felt great until a couple of days ago.

I am feeling better a few hours after the weird feeling and I have had no more t3 so I think I am on too much (unless it is to do with carb heavy meals).

I also find it hard to remember to take anything when I have an empty stomach and can wait for food and coffee unless it is first thing in the morning. Maybe I drop to 1 dose of t3???? Blood test will be late April I think.

I wish I could find and afford a good endo but I am trying to work this out for myself and grateful that my GP will test t3.

SlowDragon profile image
SlowDragonAdministrator in reply to Hypo32

Get a sharp craft scalpel to cut T3 into 1/4’s

amazon.co.uk/Modelcraft-Sca...

It’s important to take exactly same dose everyday

1/4 tablet waking and 2nd 1/4 tablet Approx 10-12 hours later

Save the other two 1/4’s for the next day

Suggest you reduce levothyroxine slightly to 112.5mcg. Again cut 25mcg tablets in half and save other half for next day

Important

Do you always get same brand levothyroxine for 100mcg and 25mcg tablets.

Retest 6-8 weeks after being on constant unchanging dose and brand levothyroxine and T3

Meanwhile

Get weekly pill dispenser for vitamins so that you remember everyday

Vitamin B complex daily, rather than just folate (folic acid)

Are you on strictly gluten free and dairy free diet

Hypo32 profile image
Hypo32 in reply to SlowDragon

Thanks. I will try those doses. I think I make 10-12 hours later work on an empty stomach.

Do you think my b12 is low then? I assume I need to take that at a different time of day. I have ordered selenium too.

My thyroxine is mostly Teva. 1 batch a few months ago was different.

I am not gluten or dairy free and to be honest trying to be organised enough to be around a full time job and 2 kids and 2 kids and their activities would tire and stress me more than any symptom I have. I can function, I just want to feel to better and have more energy to do nice things after the essentials. I went gluten free for a bit last year, didn’t feel any better but it took my t4 over range so my Levo was reduced and that started a spiral of problems which in the end had lead me to the t3 (I want to see if t4 high in the range reduces my ca125 cancer marker since nobody knows or cares why it is raised).

Thanks for your guidance.

SlowDragon profile image
SlowDragonAdministrator in reply to Hypo32

Teva brand levothyroxine upsets many people

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets 

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz 

Accord only make 50mcg and 100mcg tablets 

Accord is also boxed as Almus via Boots, ....but Accord  doesn’t make 25mcg tablets

 Many patients do NOT get on well with Teva brand of Levothyroxine. Teva is lactose free.

Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome 

Teva is the only brand that makes 75mcg tablet. 

So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (usually if lactose intolerant, Teva is by far the best option)

Aristo (currently 100mcg only) is lactose free and mannitol free. 

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

 

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Government guidelines for GP in support of patients if you find it difficult/impossible to change brands 

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. 

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Similarly if normally splitting your levothyroxine, take whole daily dose 24 hours before test 

Increasing number of members find it smoother/more tolerable to split levothyroxine as two smaller doses, half dose waking, half dose at bedtime. 

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

SlowDragon profile image
SlowDragonAdministrator in reply to Hypo32

Folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance

Difference between folate and folic acid 

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay 

Other options 

healthunlocked.com/thyroidu....

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and separate B12

TaraJR profile image
TaraJR

Why can you not get T3 on NHS, if your dr seems to agree you need it? Which area are you in?

DippyDame profile image
DippyDame in reply to TaraJR

Why can't we get T3 on the NHS?

That is the eternal question!!

TaraJR profile image
TaraJR in reply to DippyDame

It sure is! I should have tagged Hypo32 , but I see they've replied anyway now!

Lots of reasons why Drs don't give T3 and why ICBs won't allow it. Patent groups are fighting this really hard, but it's like pushing water uphill.

Hypo32 profile image
Hypo32 in reply to TaraJR

Chesterfield. Even when I saw an endo he said he couldn’t prescribe. Said he knew there was someone who prescribed it privately in Sheffield.

TaraJR profile image
TaraJR in reply to Hypo32

Hypo32 I checked on the Chesterfield formulary. Their policy goes against all national guidance, and their position statement is awful. They also quote some out of date bulletins etc.

If you're on Facebook, please join us on ITT Improve Thyroid Treatment group. We have template letters, with all national guidance and parliamentary statements on T3. You can send them to Endo, ICB, MP, Healthwatch, PALS, GP, whoever you wish.

Hypo32 profile image
Hypo32 in reply to TaraJR

Thanks. I will.

Regenallotment profile image
Regenallotment

it’s counter intuitive but cutting out things that contain sugar, eg no cake, no snack bars, no biscuits, not even apples and yellow bananas. (I do eat berries, kiwi, dark choc occasionally)

Then only having tiny amounts of carbs via potatos carrots brown rice rarely, no bread, crackers, pasta etc. upping good fats and proteins, avo, nuts, oils, coconut everything. Stopping dairy and all grains…

I have loads more energy. Initially it’s awful as your body craves all the nice stuff.

But I have to say I can manage more, and I’ve lost a few kgs.

I’ve kinda combined paleo from Dr Sarah Myhill (not the keto bit) and the Supergut diet from Dr William Davies.

I have 2 kids, I know how exhausting it is, but it’s worth a shot 🌱

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