Over or undermedicated?: Can anyone tell me... - Thyroid UK

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Over or undermedicated?

Rainbow47 profile image
16 Replies

Can anyone tell me whether these recent results suggest I’m over or undermedicated? Have had Hashimoto’s for 25 years. Am currently on holiday and have developed awful anxiety. Just wondering if a simple medication adjustment might stabilise me! Currently taking 75 T4 and 25 T3. B12, ferritin etc seem ok, and cortisol was ok three months ago, so really struggling to understand why this has suddenly hit me! Holidays aren’t supposed to be a stressful experience, though it is quite warm, could that affect my levels?

TSH 0.02 (0.27-4.2)

Free T3 6.3 (3.1 - 6)

Free Thyroxine 14.6 (12 - 22)

A little guidance would be much appreciated!

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Rainbow47 profile image
Rainbow47
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16 Replies
Jaydee1507 profile image
Jaydee1507Administrator

How long before blood draw did you take Levo & T3? Recommended timing is 24hrs Levo & 8-12hrs T3, fasting for test. Also did you stop any biotin containing supplements 4-7 days before test?

What were your vitamin results? Being OK is not enough.

Have you changed brand recently?

Rainbow47 profile image
Rainbow47 in reply to Jaydee1507

Thanks for getting back to me Jaydee. I did everything as recommended as per the draw. Take no biotin. Vitamin results were all good as I’d been working on bringing up Vit D and Ferritin which three months ago were mid-range. Didn’t test them in this last test. Haven’t changed brand either. I wonder if everything is now coming together and I’m seeing the result of good conversion! It’s so difficult to know, and now being on holiday, in the heat, I wonder if I should be dropping my T3 a little.

Jaydee1507 profile image
Jaydee1507Administrator in reply to Rainbow47

25mcgs T3 is a pretty big dose. I see most members of this group on combo treatment taking anything beween 5 & usually 15mcgs top, rarely 20 so a 5mcg T3 drop certainly wouldn't hurt.

Your FT4 is on the low side at 26% of its range so on the low side. See how things look after T3 dose reduction in 6-8 weeks time.

Keep going with the vitamins, looks like they are doing their stuff.

Have a great holiday the weather is MISERABLE here!

Rainbow47 profile image
Rainbow47 in reply to Jaydee1507

Morning Jaydee - did you notice that I had written my T3 reference range wrong? Should have been 3.1 to 6.8 and not 6! Hopefully you realised they were Medichecks ranges!

Hope the weather’s cleared up a bit for you! Sun still shining but cool wind here.

Jaydee1507 profile image
Jaydee1507Administrator in reply to Rainbow47

I did and I wondered about that. Even so, that still puts you at 86% through range and your FT4 is low. Most people on a combination treatment need FT4 & FT3 to balance so same advice still applies.

Rainbow47 profile image
Rainbow47 in reply to Jaydee1507

Thanks - what you say is interesting because I reduced my T4 from 100 to 75 about a year ago and increased my T3, which seemed to make little difference to how I felt, though my T4 results are always low. Are you saying that I should possibly go back to more T4 and less T3? I have the support of a lovely psychiatrist who strongly believes that those with anxiety symptoms should be able to balance our medication to find that happy place without taking ADs. She’s very supportive but doesn’t have a lot of dosing experience, like me!

Jaydee1507 profile image
Jaydee1507Administrator in reply to Rainbow47

Are you saying that I should possibly go back to more T4 and less T3?

That might be better, yes.

Your psychiatrist sounds like a keeper.

Have you tried lactose free levo/T3 and a dairy free diet? The lactose in tablets gave me horrible anxiety.

What supplements are you taking? Anxety is often related to B vitamin deficiencies,.

Rainbow47 profile image
Rainbow47 in reply to Jaydee1507

Have never considered lactose might be a problem but will certainly bear it in mind. I had enough trouble getting the pharmacy to give me Mercury Pharma on a regular basis!

I take B12 and Folate, iron, selenium, magnesium, Vit C, Vit D & K, zinc, ashwagandha, betaine and pepsin and a daily probiotic. And Omega 3 when I remember to get it out of the fridge! I recently had to take antibiotics for a chest infection which I had a reaction to and they wrecked my gut despite taking probiotics. My psych said that could have been enough not only to upset my thyroid levels but to upset the gut:brain axis causing more anxiety.

McPammy profile image
McPammy

most definitely over medicated on T3!

How do you feel?

Rainbow47 profile image
Rainbow47 in reply to McPammy

I’ve just realised I wrote my T3 reference range as 3.1 - 6 which should have read 3.1 - 6.8 - what an idiot!! Do you think that I’m still over medicated?

McPammy profile image
McPammy in reply to Rainbow47

if those where my results I would be considering lowering my T3 intake. Do you split your T3 dose 8hrs apart. If not that could help reduce spikes of over medication. Importantly though how do you feel each day. Do you have over medication symptoms? Lack of sleep, hunger, dizzy, stiff, tired.

Rainbow47 profile image
Rainbow47 in reply to McPammy

Thanks for getting back to me McPammy. I take me doses at 7 am, midday and 5 pm. The only symptoms I have are bad fatigue, brain fog and anxiety. The anxiety has suddenly got worse in the last few days, hence my post!

McPammy profile image
McPammy in reply to Rainbow47

anxiety can be linked to over medication and fatigue. Like being tired and wired simultaneously. You can get all sorts of symptoms really. Depends on each individual. If you Google thyroxine over medication or read the leaflet with the medication it can hilight what you might feel. Your bloods show high T3 so it looks like that’s the culprit. Also check all the usual vitamins.

Gingernut44 profile image
Gingernut44

McPammy is one of the fortunate people who feel well with a TSH in range and FT3 and FT4 mid range. I would think by her experience that those of us with suppressed TSH and high in range FT3 and FT4 would all be over medicated. We are all different and have to find our own “sweet spot”. With your results, I would be inclined to reduce your T3 down to 20 mcg ( or by a quarter of a tablet if yours are 25 mcg) and retest in 6/8 weeks. Your FT4 is fairly low in comparison so you may need to increase that. Don’t do both at the same time. Go by your symptoms followed by your blood tests.

McPammy profile image
McPammy in reply to Gingernut44

When my TSH goes suppressed due to over medication I feel awful. I get very hungry, poor sleep, dizziness, muscles go very tight even in my stomach. I have keep my T3 and T4 levels in range or I really suffer the consequences of over medicating. I know from this site that many feel well when over medicating. There must be an issue I have that hasn’t been diagnosed possibly. I try to mimic a healthy persons levels and a TSH around 1.00. My sister who had thyroid cancer has to keep her TSH suppressed by deliberately over medicating with mono therapy T4 levothyroxine (they won’t give her T3 liothyronine) and she feels ok she says. Suppressing TSH for cancer patients is a must to stop any cancer returning. She does have bad joint pains all over though. I think she’d be better in combination therapy but NHS won’t do it for her.

Gingernut44 profile image
Gingernut44

Ah, the good old NHS. They wouldn’t prescribe T3 for me either because of cost not need. That was three years ago when the price was much higher than it is now. I have since “gone private” and pay for my own T3.

You are very fortunate indeed to feel well with your levels as they are. Unfortunately, I needed my T4 well over range to get my T3 even approaching mid range and didn’t feel well at all.

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