Hypo now hyper

[Pulp88]

I was diagnosed with hypothyroidism last year and had rests every three months. Now my recent test say I'm hyper

Has anyone been in this situation?

What were the next steps? Did you just stop the medication

[Lalatoot]

Pulp what makes you say you are hyper or overmedicated?

If it is because your TSH is low/under range the please understand that TSH is a poor measure of thyroid hormone status when you have a thyroid problem. You need to consider ft4 and ft3 and where they are in their ranges.

If it is because ft4 and ft3 are too high in their ranges for you or if they are over range then you ask yourself if you have hashimotos and is this a hashis flare where levels rise and then fall.

It should also be said that hyper and hypo symptoms are not clearcut and you can have the same symptoms for both conditions so actual blood results help guide with the next steps.

[Pulp88 in reply to Lalatoot]

Appended results below

[SlowDragon Administrator]

Please add actual results

TSH, Ft4 and Ft3

Was test done early morning, ideally around 9am to get highest TSH

Last dose levothyroxine 24 hours before test

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Do you have autoimmune hypothyroid, usually diagnosed by high TPO or high TG thyroid antibodies

When were vitamin D, folate, ferritin and B12 levels last tested

What vitamin supplements are you taking

On levothyroxine we need GOOD vitamin levels

Do not stop levothyroxine

You’re only over medicated if Ft3 is over range

If dose levothyroxine needs adjusting it should be done very slowly and carefully

[Pulp88 in reply to SlowDragon]

These are my results

Results

[SlowDragon Administrator in reply to Pulp88]

was test done early morning and last dose levothyroxine 24 hours before test

Next step is to get FULL thyroid and vitamin testing

TSH, Ft4 and Ft3

Both thyroid antibodies if not been tested yet

And test vitamin D, folate, ferritin and B12

How much levothyroxine are you taking

How long on this dose

[Pulp88]

was test done early morning and last dose levothyroxine 24 hours before test - yes was done early in the am and I took the levo before the test so levo was taken at 7am and I had the test at 810am

Next step is to get FULL thyroid and vitamin testing TSH, Ft4 and Ft3 both thyroid antibodies if not been tested yetAnd test vitamin D, folate, ferritin and B12 - ok

How much levothyroxine are you taking - 25

How long on this dose - since last year kine

[pennyannie in reply to Pulp88]

Hello Pulp and welcome to the forum.

So you took your T4 medication a couple of hours before the test and this may well be the reason for the slightly over range T4 reading and low TSH :

We need to leave 24 hours between last dose of T4 and blood draw - and most people take their daily dose after the bloods have been drawn.

You can't go from hypo to hyper - once on thyroid hormone replacement - but you can become over medicated - which is how your bloods have presented as you had just taken the medication.

If it is suggested that you reduce your dose - explain you had just taken the medication and so it is a ' false high ' reading as measuring your last dose before it had settled into the body and ask for a rerun.

Have you been told the reason why you have become hypothyroid - did you have your thyroid antibodies run when first diagnosed?

What symptoms are you currently dealing with and have any symptoms been relieved since taking the T4 - Levothyroxine medication ?

Do you have online access to your medical records and can look back at last years readings when first diagnosed as those can help forum members understand what's going on ?

[Pulp88]

Have you been told the reason why you have become hypothyroid - did you have your thyroid antibodies run when first diagnosed?

Not sure what that means, I became overweight and had other health issues then had a blood test and found out j was hypo. This was all last year

What symptoms are you currently dealing with and have any symptoms been relieved since taking the T4 - Levothyroxine medication ?

I don't really have symptoms, all the symptoms I was having was when I wasnt on the levo. Things have been OK since taking levo

Do you have online access to your medical records and can look back at last years readings when first diagnosed as those can help forum members understand what's going on ?

I don't have the access I've only started requesting for the results.

[pennyannie in reply to Pulp88]

OK - well you can register with your surgery for on-line access to your medical records and then be able to read everything , in your own time, and forum members here can explain to you what the blood test results mean and recommend your next steps back to better health.

Any new question generally means a new post , unless within the first day of posting as we try to answer as fully as possible on our first replies as the pressure of new posts demands we move on to new posts within a day or two.

[Pulp88 in reply to pennyannie]

Thanks so much for your help and support

[tattybogle]

it's surprising that the TSH is totally supressed on just 25mcg levo ...... taking the last dose levo 1 hour before the test may partly explain the high ft4 level , but it does not explain the supressed TSH.

The TSH result is NOT affected by the time of last dose.

There is a brief peak in fT4 level from approx 2 -6 hrs after you take the tablet , and we try to avoid measuring fT4 during this peak as it can be misleading .....but honestly i doubt that the peak from such a small 25mcg dose would be capable of taking fT4 level so far over range as your is .

(and you may not have even caught the peak , because an hour is a very short time for the tablet to get from your mouth to your blood)

..... so i strongly suspect that your fT4 level would still be over range even if you had tested 24hrs after last dose.

So these results DO suggest (to me) that that even your tiny 25mcg dose is more than you need to take AT THE MOMENT and if a GP see these tests it is extremely likely they will ask you to reduce the dose or since the dose is already so tiny , to stop levo for the moment .

However as you currently feel well and if you don't want to risk rocking the boat .then i would suggest you ask GP to watch and wait for another 2/3 months on 25mcg and then retest (preferably 24hrs from last dose /early AM test ).

That is what i'd do in your situation ~ If you feel ok, don't ever mess with dose based on just one blood test , wait another couple of months , get retested so you have a clearer picture of what is going on, and then decide.

( see MIDDLE graph (top line) on the picture below for what happens to fT4 levels in the hours after you take a dose .. it does have an effect , but it's not massive , and the highest point is not usually until 2 hrs after swallowing the tablet ~ but it depends how fast your digestion is )

.

[humanbean]

One thing you can do, without needing to discuss with a doctor, is to stop taking your Levo and wait until you feel slightly hypothyroid. You could carry on collecting your prescriptions.

Be ready to start taking Levo again when you feel hypo, possibly at a lower dose than you currently are.

Please note that Levo is a "storage" hormone. The body can "save it up" to a small extent and then will convert it to T3 when the body thinks it needs it. Excess Levo will eventually be excreted if it isn't used up.

So, if you stop taking Levo, then start it again, you might want to only take it five days a week, or a smaller dose seven days of the week, or whatever feels right to you.

Playing around with your dose like this will change your Thyroid Function Tests results, so I wouldn't suggest doing this if you are going to see a doctor regularly, because it could annoy them.

[Pulp88]

Thanks fir the above will see