Feeling depressed and fatigued since lowering dose of levothyroxine

[Zazbag]

Hello everyone,

I've been on 175 mcg levo and 25 mcg T3 for about a year, which was definitely too much, but 150 mcg and 25 mcg wasn't enough (I had hypo symptoms and free T3 had dropped to 5.1 (3.1–6.8) which isn't enough for me), and I tried increasing T3 which made me feel worse, so the only thing left to try was 175 mcg levo and then I struggled to be seen by a doctor since then even though I knew I was overmedicated (I increased the dose to 175 mcg myself because my endo wasn't listening to me and his advice of increasing my T3 to 50 mcg was insane and made me a bit of a psychopath).

Anyway I finally spoke to an endo about a month ago who actually took the time to listen. I knew I was overmedicated and I had a blood test which backed this up (T3: 7.7 (3.1–6.8) and T4: 20.2 (12–22). I told her when I tried to lower back to 150 mcg by making the sudden reduction from 175 to 150 I felt terrible so I put it back up. I asked her for a dosing schedule to gradually titrate down the dose. The first week I took 150 on one day, the second week I took 150 on two days, the third week I took 150 on three days. During the third week I noticed I was feeling depressed for the first time since winter last year. I am a bit stressed right now but I don't think that's the reason for the depression. Now over the weekend I felt even more depressed, difficult to get out of bed, didn't want to move, didn't even have the energy to shower for two days.

The endo said once you have lowered the dose to a level where you feel good and not overmedicated, keep it there for 3–4 weeks and then have another blood test.

I don't want to lower the dose anymore than this, because I think it the reason for the depression and fatigue, but I'm also wondering if I've lowered it by too much and should increase it back to the level of week 2 (2 days of 150 and 5 days of 175). I felt decent that week and I could tell that the lowered dose was beneficial because my sleep improved and I felt less wound up inside, also my resting heart rate was a bit lower.

However I'm not sure whether this fatigue and depression and temporary and I just need to stick to this dose and wait things out. I find it hard to get anything done including work when I feel like this and just want to sleep all the time.

Would appreciate any advice and hope this all made sense (I'm feeling a bit fuzzy right now).

[SlowDragon Administrator]

You’re changing dose too fast

Reduce dose slowly

Eg

175mcg 5 days a week 167.5mcg 2 days week

Wait 8 weeks retest

Assuming you need to reduce further

167.5mcg 4 days a week and 175mcg 3 days a week

Wait 8 weeks retest

Essential to maintain and retest vitamin levels while reducing dose

[Zazbag in reply to SlowDragon]

Thanks so much for this SlowDragon!

I will try what you suggested instead and keep taking my vitamins too.

[arTistapple]

I agree wholeheartedly with SlowDragon . At first nothing seems to be happening when you do something to your dose, so it feels ok to go on changing it. Big mistake. I have done it and probably many others on the forum can attest to it. The body needs time to catch up with the change you already made in the first place! Just saying she is so right! I really wish endos and doctors knew something (anything) about dosing and timing, or indeed anything about the lived experience of hypothyroidism.