confused : hi I started on levothyroxine 50mg... - Thyroid UK

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confused

Swifty72 profile image
8 Replies

hi

I started on levothyroxine 50mg in feb22 as I was reallly unwell my TSH then was 35.4 it lowered to 7 then rose to 10 so I went on 75mg followed by 100mg my recent blood test at the beginning of may gave me 0.07 TSH and T4 was 21.1 at this point I was told I’d gone overactive and reduced back to 50mg weekdays and 100mg weekends I’m really confused and just so hungry and tired and suffering really bad depression and anxiety any advice would be massively appreciated thankyou for reading .

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Swifty72 profile image
Swifty72
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8 Replies
Trina64 profile image
Trina64

I am sorry you are going through this. That is a massive decrease. No wonder you feel so awful. There are others more knowledgeable than I to answer your questions, but it doesn't appear that you were overdosed.

Swifty72 profile image
Swifty72 in reply to Trina64

thankyou soo much

tattybogle profile image
tattybogle

Hi .. that last reduction sounds like it was much bigger than necessary .( unless you actually had symptoms of overmedication)

Once taking thyroid hormones the thyroid doesn't become 'overactive '. (the thyroid is 'on holiday') but we can become 'overmedicated' if we take too much . ( same symptoms as overactive / hyperthyroid, but not same cause .. i do wish doctors would use the proper term ,, telling people they have 'gone overactive' just confuses the issue)

You current dose is 64mcg /day ([50 x 5] + [100 x 2] = 450 , divided by 7 )

dropping from 100mcg to 64mcg is a huge drop in dose.

once you are somewhere near the right dose , adjustments should really be as small as possible. not brutally chopped in half just because the TSH is slightly low .

it would probably have been more sensible for GP to reduce dose to to 87.5mcg ( 75 / 100 mcg alternate days).

or perhaps to 75mcg day , depending on whether the fT4 was high in range , or over range.

Do you have the lab range for that fT4 test ? eg [12-22] or [7.9 -14] or [9-21] etc

Swifty72 profile image
Swifty72

thankyou for understand I have no visible symptoms for overactive alls I was told was T4 was 21.1

SlowDragon profile image
SlowDragonAdministrator in reply to Swifty72

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

patients-association.org.uk...

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

SlowDragon profile image
SlowDragonAdministrator

Just testing TSH and Ft4 is completely inadequate

Always test thyroid early morning, ideally just before 9am and last dose levothyroxine 24 hours before test

This gives highest TSH and lowest Ft4 results

You’re only over medicated if Ft3 is over range

Ft3 not even been tested

Never agree to dose reduction without FULL thyroid and vitamin testing

GP has most likely reduced dose far too drastically

How long since you reduced dose

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Do you always get same brand of levothyroxine at each prescription

 

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 and ESPECIALLY after dose reduction in levothyroxine as vitamin levels likely to reduce

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

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

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended 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)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3 and includes BOTH TPO and TG antibodies -£29 

randoxhealth.com/at-home/Th...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test 

healthunlocked.com/thyroidu...

Swifty72 profile image
Swifty72 in reply to SlowDragon

no T3 test done bedn on new dose for 2 weeks he said he’d retest after 10 weeks I can feel my energy and mood decreasing rapidly

SlowDragon profile image
SlowDragonAdministrator in reply to Swifty72

NHS rarely tests T3

Get copies of tests since diagnosis

See if thyroid antibodies and vitamins have been tested

If not

Either

make an appointment with GP and request vitamin levels and thyroid antibodies are tested now

Or

email in requesting these are included at next test. Book early morning test now for 6-8 weeks after reducing dose

or

Test privately thyroid and vitamins after 6 weeks on reduced dose levothyroxine

Come back with new post once you get results

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