Overmedicated extreme brain fog

[Johnfishman22]

I am 23, male, have had hypo since around 15.

I have upped my dosage over the years without really having symptoms that I noticed, especially no brain fog.

I was 200mcg before Nov 24 when I did a full trial off the medication.

Ended up becoming hypo (tsh 224) within 3 weeks so I went back on that SAME dosage (same brand as well, synthroid)

After 7 weeks I started noticing a ton of brain fog, fast heart rate and all hypo symptoms. Ended up with a tsh of 0.04.

Dosage got lowered to 175mcg, tsh hardly moved to 0.05.

Doctor dropped me to 125mcg which is starting dosage for my bodyweight.

He did this 8 weeks ago, my tsh is normal at 2.0 measured 3 weeks ago, and last week 1.85.

I still have intense brain fog, but heart rate and fatigue have improved (still not normal).

Do I just need to wait even longer for this fog to fade? It's been longer than the standard 6 weeks. I just want some reassurance that this fog will eventually go away. This medication worked for me for 8 years very well, I forgot all about hypo because I felt normal. I don't think I am one of those who this doesn't work for.

Any advice/insight is appreciated!

[PurpleNails Administrator]

Why did you trial stop of replacement. Was this recommended by doctor.

Symptoms from being hypo can take long time to recover. Sudden stopping and restarting 200mcg would have caused many issues.

Firstly TSH is not a reliable measure, & takes time to respond to thyroid levels.

Was FT4 & FT3 tested?

[Johnfishman22 in reply to PurpleNails]

Yes, my identical twin brother did and didn't need the medication anymore, so I was told I can try it. FT4 was tested and it is in range as well. FT3 was not, I asked and doctor said it was not needed. How long for symptoms to fade once levels are in range?

[PurpleNails Administrator in reply to Johnfishman22]

FT3 is the active hormone & very important. TSH can be in range and FT4 can be good in range but if the body can’t convert it to FT3 and it’s very low - you can be hypothyroid.

Symptoms can linger & it can take some time to recover if severely hypo.

Most feel well with low TSH eg 1. FT4 top 3rd of range and FT3 at least 50%

Most impove when optimally replaced.

Nutrients folate, ferritin, b12 & vitamin need to be optimal too. These may have crashed when you were hypothyroid. Have them tested.

A starting dose is 50mcg for any weight. An approximation of 1.6mcg per 1kg body weight is a guide only. Adjustments should be by 25mcg at a time - 6 weekly pacing.

Great drops & increases can complicated and worsen the results. Please don’t do that again.

[Lalatoot]

John I hope you didn't come off cold turkey as that would have been an extreme shock to the system. Likewise jumping back in at full dose will not be easy on the system.

The body takes time to adjust and adapt and yours has run into a brick wall so it has a lot of recovery to do.

Dosing by TSH is not the way to go about it. You need to be looking at your thyroid hormone levels ft4 and ft3. TSH isn't reliable when we are hypo and taking levo.

I tapered off my levo and got to 25mcg daily never stopped altogether. It made me very hypo and it was a long journey to recover.

[Johnfishman22 in reply to Lalatoot]

It was cold turkey. Big mistake I know, I learned. My FT4 was also within range. I am hoping my recovery will just come with some time now, can it take longer than 8 weeks?

[Lalatoot in reply to Johnfishman22]

Mine took years - sorry to say. My ft3 ended up out of step with ft4 so I din't recover until I added 7.5 T3 daily into the mix.

[tattybogle]

Hi johnfishman ...if some things have improved already , then yes it's definitely worth waiting more like 12 weeks.. to see how this dose really feels once your body has had a bit more stability on it .

And if you are continuing to feel better after 12 weeks ( even if not perfect) then continue a bit longer ,don't rock the boat if it appears to be going in the right direction .

I've definitely found some improvements are a 'slow build' .

[Johnfishman22 in reply to tattybogle]

Thank you. Things are for sure better than they were. Love that analogy. Will continue to wait, sucks how long T4 takes to work

[greygoose]

Yes, my identical twin brother did and didn't need the medication anymore,

Does your twin brother have Hashi's? Come to that, do you have Hashi's? With Hashi's you can have periods of what we could call 'remission', although it isn't really. Thyroid hormone levels can stay euthyroid for quite a long time, sometimes, inbetween a Hashi's 'hyper' swing, and coming down to hypo again.