Auditory hallucinations triggered by raising Levothyroxine dose.

[Chris321]

hi. This is my first posting here so please forgive any mistakes. My 92 yr old mother has had mildly low thyroid levels diagnosed from blood tests. She was put on 25mg daily which she’s been on for some months now. The most recent blood test indicated she needed to raise the dose so was given 50mg daily. This rise caused her to get auditory hallucinations within a few hours of the dose being raised. We know it’s the Levothyroxine because the hallucinations stopped when dodge dropped to 25mg and started within a few hours of her dose being put up. This happened twice.

Has anyone got any advice? We have a 6 week wait for another GP appointment for her for another blood test. We are keeping her on 25mg but she was more energetic on 50mg.

thanks in anticipation

[RedApple]

Welcome to the forum Chris321,

We really need to see the actual test results that triggered the dose to be raised from 25mcg to 50mcg. If you can, please post them. Ideally this would be TSH, FT4 and FT3 with their accompanying ranges.

Sometimes, levothyroxine is better tolerated by splitting the dose through the day. For example, taking 25mcg first thing in the morning, then the other 25mcg last thing in the evening before bed. Exact timing should be worked around meals and other medications though, as levothyroxine must be taken well away from these.

[Chris321 in reply to RedApple]

thank you. We’ll definitely try splitting her dose. We do not have the test results but I will ask the GP. Thank you for your time replying - appreciated.

[greygoose in reply to Chris321]

Best not to ask the GP for results, they don't always like us having them, even though we are legally entitled to have them. Best to ask for a print-out at reception.

[Chris321 in reply to greygoose]

thx … useful tip.

[greygoose in reply to Chris321]

You're welcome.

[Lalatoot]

Chris I have always had to split my dose as I found it hard to increase (it made me feel sick).

I would use a sharp knife or pill cutter. Give your mother her 25mcg dose morning say and then add in another dose of 12.5mcg either in the afternoon or at bedtime away from any other meds. The 12.5mcg will be a quarter of a 50mcg tablet or half a 25mcg tablet depending on what you have.

If you explain the situation to the doctor that you are splitting the doses ask to have the prescription written as 2 x 25mcg per day. That way the pharmacy will supply tablets you can halve.

Once your mother is okay on the 25mcg and 12.5mcg than up the second dose to 25mcg.

Please also know that not all 25mcg tablets are from the same manufacturer. The 25mcg tablets branded Teva or Northstar do not agree with everyone.

[Chris321 in reply to Lalatoot]

thank you.

[Chris321 in reply to Lalatoot]

thank you - we really appreciate your reply. We’ll definitely try splitting her dose.

[RedApple in reply to Lalatoot]

Lalatoot , As I understand it, there are no levothyroxines re-packaged as Northstar now. (see this post healthunlocked.com/thyroidu... )

[SlowDragon Ambassador]

Which brand of levothyroxine is the 25mcg tablet

Did GP then prescribe 50mcg tablets and were they different brand?

Would agree with suggestions to

A) only initially increase by 12.5mcg

And/or

B) try splitting levothyroxine as 2 doses

Has she had thyroid antibodies tested for autoimmune thyroid disease

Or vitamin D, folate, ferritin and B12

Low vitamin levels are very common when hypothyroid

Low vitamins also extremely common as we get older

Is she currently taking any vitamin supplements?

[Chris321 in reply to SlowDragon]

She isn’t taking any supplements but I think we need to explore that for her. Her meals are pretty good quality but being tired so often makes the whole process of just living and eating is really hard work for her. Getting old is not for sissies…

[SlowDragon Ambassador in reply to Chris321]

ALL hypothyroid patients should have vitamin D, folate, B12 and ferritin levels tested…..but increasingly rare that happens

It’s not how good your diet is….as we get older and/or hypothyroid this results in lower stomach acid and as direct result poor nutrient absorption

[SlowDragon Ambassador in reply to Chris321]

When dose levothyroxine is increased it temporarily can exacerbate vitamin deficiency symptoms

Low B12 can be cause of auditory hallucinations

pubmed.ncbi.nlm.nih.gov/353....

B12 deficiency common in elderly

pubmed.ncbi.nlm.nih.gov/257....

Suggest you get hold of all her blood test results since before starting on levothyroxine until now …..see if any vitamin tests have been done

Optimal vitamin levels are

Vitamin D at least over 80nmol

Serum B12 at least over 500

Folate and ferritin at least half way through range

[Chris321 in reply to SlowDragon]

thank you so much for your reply. It is really helpful and gives us a clearer idea of how to help mum. Really appreciated.

[Angel_of_the_North]

If she takes any allergy meds, I had both auditory and visual hallucinations from one type (can't remember the active ingredient) that came as capsules