Any advice would be appreciated

[dizzy864]

Hi, My latest bloods are:

T3 8.24 ( 3.1 - 6.8 )

T4 21.6 ( 11 - 23 )

TSH has been suppressed for many years. I was finally prescribed liquid levo almost two years ago after a long history of poor absorption of meds. I reduced lio from 60mcg to 47.5mcg and take 125mcg liquid lio. I had my regular blood tests a few weeks ago. My T3 has been over range for the past three or so years. I hoped that this time my T3 would be back in range. Because I wasn't absorbing the meds properly T3 staying in my system and causing high T3 results. My gp had accepted that my T3 was over range and was not unduly worried.

I have no symptoms of being over medicated and was happy with my level of meds. I saw a couple of gps about unrelated problems. They both took my blood pressure. The second was concerned that my blood pressure was 162 and a week previous 161. I had been having long lasting headaches over the past three weeks. I was prescribed blood pressure meds. After ten days, my feet and ankles swelled. I was put on a different med. This time, I became very hypo, very quickly. A Google search told me that thyroid patients should only be given blood pressure meds as a last resort as they block absorption of thyroid meds! I also found that raised T3 can cause high blood pressure. I reduced lio to 45mcg solely to bring my blood pressure down.

For the first two weeks , I was fine with the reduction. However, this third week, I am terrible. I feel very sick all the time, I'm constipated, I have a problem with water retention and I am finding it difficult to pass water. I am really tired inspite of settling half an hour earlier and waking up over an hour later. I am not having any problems with sleeping. I feel "hung over" and really lethargic. I'm not getting anything done! On top of that, I checked my blood pressure this morning. It was the highest I had ever seen it. ( 174 ) I guess it's the stress of feeling so unwell!

Any advice on what to do next would be greatly appreciated. I'm leaning toward putting my meds back to what they were as I can't go on like this.

[GlowCoach Administrator]

Exactly when did you take your last Levo and T3 before this test? To see stable blood levels the timing is recommended to be 24 hours for Levo and 8-12 hours for T3.

Any dose change can take a good 4 -6 weeks before you can assess its effects on you. In the mean time you can feel unwell or just not right which is likely where you are now.

Your T3 dose is pretty high as a combination therapy. Most people with a combo need 5-20mcgs of T3 added to levo.

What supplements are you taking?

What were your latest vitamin results?

No thyroid hormone works well until our key vitamins are at OPTIMAL levels.

[dizzy864 in reply to GlowCoach]

Hi, test was done in accordance with the recommendation here as always. My dose is high because I don't absorb meds properly. I m much better since going on liquid levo hence being able to reduce levo by over 20% but still not absorbing properly, which is why it's so difficult for me. I suppliment with vit D, iron, K2, B12, B complex, zinc and magnesium. Doctor forgot to test them this time. I was going to ask when I retest thyroid. They are, as always a work in progress! But nothing more I can do to improve them.I feel well beyond " not right," I can't take feeling like this much longer. I m also very hungry and eating a lot more which is Def not good for my weight.

[GlowCoach Administrator in reply to dizzy864]

Judging by your blood results you are absorbing very well.

Speaking for myself I would feel very unwell with those blood results so you may well need to drop your dose further but see how it goes with the next blood test.

Eating a lot more is something I have done when my metabolism is running too fast and over replaced.

[dizzy864 in reply to GlowCoach]

Hi, I m glad you re not my doctor! The problem I ve had for years is that my T3 bloods have been consistently high. Taken in isolation as you are, I m clearly over medicated. But taking symptoms in to account, which clearly they should be, I ve been very hypo for years. - hair loss being the most visible symptom.Years ago, I was very hypo on 20mcg lio. I saw a newly qualified endo who increased lio to 60mcg. No internet then and I knew no different. I don't think anyone could cope with a three fold increase from 20mcg to 60mcg in one go. I not only did but was well for the first time in years!!

Clearly, I could only do so because I wasn't absorbing all of the increase. I ve heard various theories on my situation over the years but the bottom line is I react to meds different to most and it's a nightmare for me and to be fair for doctors too.

I have been a lot better on liquid levo but I am still not completely right.

[GlowCoach Administrator in reply to dizzy864]

Hair loss is often low iron/ferritin. Would recommend you get that checked as is very common to be low with hypo.

[dizzy864 in reply to GlowCoach]

I m hoping to get all vits checked when thyroid levels are rechecked. From previous tests iron is lower than I would like. I am doing my best to raise it.The first signs of being hypo with me is bladder problems, constipation and then my appetite goes through the roof.

On the rare occasions I ve been hyper, I lose my appetite - I don't want to eat.

[greygoose]

So, you're saying that you don't absorb thyroid hormone at a cellular level? Bit of confusion there because it has to be absorbed in the gut, first, then into the cells. A lot of people have trouble absorbing in the gut.

So, how do you take your T3? Do you take it all in one go? Or do you split it into two or three doses?

[dizzy864 in reply to greygoose]

My previous GP, used to work with an endo so knew more than most GPs. She told me that thyroid meds attached to lots of cells throughout the body. In my case she said it was not attaching to some cells and only partially to others, whilst at the same time attaching completely to some. Unused meds go into the blood stream and show as thyroid levels. In this case, the less meds that are used, the higher the blood test results. In my case showing me as over medicated when in fact I m under medicated. She told me that this condition was rare but known. Unfortunately she took early retirement 18 months ago. Many of the doctors at my surgery have now left, and the surgery runs on registrar's, trainees, nurse practitioners and pharmacy personnel. I haven't had a regular doctor since my GP retired. I take lio in three doses. I tried it in one go but after four hours I was running down and felt hypo after six hours. I find splitting it into three I don't get the peaks and troughs.

[greygoose in reply to dizzy864]

Not nearly as rare as doctors think!

Unused meds go into the blood stream and show as thyroid levels.

They're already in the blood stream. They go from the gut into the blood and are carried round the boy in the blood.

And, anybody with this condition tests over-medicated, which makes it difficult for them to get the treatment they need. That is my problem. Doctors do not like my high dose of T3 and are always trying to reduce it. So, I self-treat.

Taking your T3 all in one go saturates the receptors and gets more into the cells than taking it in several doses. The difficulty is that the uptake is not equal in all cells, so some get too much and others don't get enough.

Usually, with this condition, people don't notice the peaks and troughs. You only notice them if it gets into the cells. Thyroid hormone does nothing in the blood, and that is where the peaks occur.

[Sneedle]

Hi there,Without recent blood results for the co factors iron, b12 and folate etc. you won't know if you're over or under supplementing for any given substance.

And these can all cause their own issues. And affect your thyroid as a knock on.

So changing your thyroid meds may or may not help. Blood tests for co-factors will rule them in or out as causing problems. Another part of the puzzle.

If all are at optimal levels as suggested on this group, then you know it's not that.

Especially as you're taking iron (iron overload needs to be ruled out).

Best of luck getting some clarity, and feeling better soon.

[dizzy864 in reply to Sneedle]

My iron will always be low as I ve been Vege for over 40 years. The others I try to boost with supplements but only vit D is where it should be. Hopefully I can get them checked when my thyroid bloods are repeated.

[Sneedle in reply to dizzy864]

That would be really good to ask for them to be done. An important part of the picture. I know for myself I've made assumptions in the past about my intake and had a surprise when the results came back the opposite of what I expected!

[Hidden]

A 12.5mcg reduction of t3 in one go is quite a bit, I do think reducing the t3 is probs a good idea for your BP, but i’d reduce it at the rate that I increased it - so 2.5mcg weekly. Can you go back up and then re-reduce it much more slowly? Sounds like your system is just panicking at the sudden drop in available T3?

it takes about 2 weeks for lio to completely leave the body, so this explains why you felt Ok initially and now are noticing a rise in hypo symptopms.

[dizzy864 in reply to Hidden]

I reduced the 12.5mcg over a couple of months after starting liquid levo. I did it quickly because I became very over medicated as I was now absorbing far more of the levo than I was on tablets. I really had no choice. This time I have reduced lio by 2.5mcg and it is too much. I couldn't stay awake this afternoon and had a 2 hour nap. This clearly isn't working.I m going to try taking 2.5mcg less every alternate night. I know this isn't ideal but I only have 20mcg tablets and can't cut them up any more so I take the same every day. I ll see how I feel over the next few days.

[Hidden in reply to dizzy864]

ah OK, sorry I don’t think I grasped your situation entirely. Good luck, hope it goes well for you 🙂

[SeasideSusie Remembering]

dizzy864

How many different blood pressure meds has your GP tried? I know that some people don't get on with some that others find OK, it's a case of finding the right one for you. I was on Amlodipine for quite some time, some people have problems with it but I didn't I was fine, and it didn't affect my thyroid levels and I took Amlodipine at bedtime with thyroid meds in the morning.

A Google search hasn't thrown anything up for me that BP meds block absorption of thyroid meds for hypothyroidism, do you have a link to what you've found?

[Gingernut44]

Maybe DippyDame will have some advice for you, she has thyroid hormone resistance.