increase meds and symptoms : just wondering if... - Thyroid UK

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increase meds and symptoms

Ajva profile image
Ajva
13 Replies

just wondering if anyone else finds when they increase their medication (only by the usual 25mcg) they have an increase in hypo symptoms. I increased from 75mcg to 100mcg of t4 tirosint a few days ago and the fatigue/ body aches and weakness and hunger has hit me.

Is this a common thing whilst your body adapts to the new dose?

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Ajva profile image
Ajva
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13 Replies
helvella profile image
helvellaAdministrator

Many of us find that as we approach our best dose, or if we have gone slightly over, actually need to adjust by a smaller amount than 25 micrograms.

75 to 100 is a 33% increase.

100 to 75 is a 25% decrease.

I realise it might be a problem with Tirosint, but 88 micrograms a day might have been a better choice. If you have 75 and 100 available, you could try alternating 75 and 100 day by day.

Ajva profile image
Ajva in reply tohelvella

Yes that’s a good idea. I have actually decided (as I self medicate) to do over the weekend 100mcg and in the week 75mcg. Do bloods in 6 weeks and see where I am at. As you can see with my bloods t3 and tsh are ok but t4 is dropping quite low for me.

I am also on 1 grain armour along side. Unfortunately can not increase armour as t3 goes over range even with a 1/4 grain increase.

Grey
helvella profile image
helvellaAdministrator in reply toAjva

Trouble with that is you are taking the higher dose two days running.

I know it can help for remembering what you need to take each day!

But I think I'd go for alternate days, or even two days 75 one 100, rather than putting the 100 doses together. It doesn't have to match a week! That is, a three-day cycle will drift by day of week, but there is nothing intrinsically wrong in doing so.

Ajva profile image
Ajva in reply tohelvella

I completely agree I think spacing out rather than taking a larger dose all weekend. I find if I take 100mcg daily I go over range slightly and the 75mcg isn’t enough. You’re right I do need the 88mg but they only stock 25mcg, 50mcg and 100mcg in tirisont. So I have 50s and 25s so does allow me to play around with doses a bit.

Also use a pill organiser so can remember to increase on week days.

Just to get your opinions on my bloods does my t4 look a bit low? I usually use medichecks and the ranges are different with the nhs. So finding it harder to work out

helvella profile image
helvellaAdministrator in reply toAjva

I don't feel I know enough about FT4 levels when combining desiccated thyroid and levothyroxine to make an informed comment.

It would be better if someone with experience replies!

waveylines profile image
waveylines

So to be clear Armour contains 38mcg of T4 and 9mcg of T3. And you are currently also taking 75mcg of Levothyroxine.But you are looking at a further increase upping to 100mcg of levothyroxine twice per week as you found increasing to a 100mcg daily too much and you didn't feel well?

Your ft4 is on the low side I agreebut remember it is a storage for and the key is sufficient T3.

How do you currently feel on your current dose? Are your B12, vit D, folate and ferritin optimal? Do you take any supplements?

Blood tests tell us only so much but the key thing is how you feel - do you have any symptoms?

I always find it useful as well to check my temperature/ pulse first thing before rising as another indicator. For example I was on a good wack of NDT but my temperature was still quite low. 36C. Maybe it's my norm thought I. Once I addressed my b12 issue and went GF my temp rose to 36.8C and in the end I was able to reduce my Armour by 1/4grain.

Ajva profile image
Ajva in reply towaveylines

Thank you for replying to my post.

Yes that it correct 1 grain armour daily and 75mcg of tirosint with an increase to 100mcg per day. I was originally a few months ago on 1 grain armour with 75mcg of tiro daily for 6 months. Then all my hypo symptoms slowly started returning and creeping in (extreme fatigue, muscle aches and weakness, hair loss, brain fog, irritability, bad periods). For some reason I thought I was slightly hyper so I decreased meds and took out 75mcg per week. So was on 75mcg 6 days and 1 day without. Have gone more down hill since.

So just to clarify the blood test in the picture was on the 1 grain armour and 75mcg 6 days.

Body temperature is difficult and so is heart rate as I have Pots, orthostatic hypertension/ intolerance, possible addisons (keep being tested as cortisol low).

I am currently taking three arrows iron, b complex thornes and probiotic, COQ10, magnesium , vit D, 3 electolyte drinks a day. All my iron and vits are very low . I am gluten free as well.

The fatigue is one of my worst symptoms. I was diagnosed with ME but I still believe the fatigue is cortisol, iron and thyroid related.

waveylines profile image
waveylines in reply toAjva

Ahhh low cortisol may affect your uptake of thyroid hormones. Shame you lowered the levo. I'd put that 75mcg back in so ure back to where you were. We've all done it gone in the wrong direction! I did several times.... Frustrating! Then when uve settled try adding the two 100mcg but split apart.You really need to get your cortisol levels up though. Are you taking anything to support your adrenals?

I was also diagnosed with ME/CFS.... but luckily NDT sorted things for me after much trial and error of all sorts. I took a Dessicated Thyroid extract for my adrenals for two years but my adrenals were only mildly affected.

I don't know if this is true for you but you may need to go slowly with gentle increases..... case of the tortoise wins the race.... But you will know this am sure... Lol. Xx

Ajva profile image
Ajva in reply towaveylines

yes your right I will go back to my normal dose and slowly increase. It has been a head ache getting my levels right for 3 years. I have never been in a stable dose, also switched to separate compounded t3 and and tiro for about 8 months and felt as if I was going to die of fatigue. It has been a long road, and it is a shame I can’t tolerate a higher dose of NDT due to the t3 going over range and hyper symptoms after a few days. I have attempted it a few times. Seems my body does not like to go over the 1 grain.

I have brought some adrenal cortex so will start that soon once meds have settled. Have only just added the three arrows in so trying to add things in slowly. Thank you for your help!

waveylines profile image
waveylines in reply toAjva

No probs hope the adrenal cortex helps. You will struggle to increase if the adrenals are not addressed.And you're wise to add slowly. It can be a frustrating process.... I know I found it so. I guessing you've checked the other factors: B12, vit D, Folate & Ferritin? Commonly low in hypothyroidism.

groovylady2017 profile image
groovylady2017

Hi Ajva, I take 75mcg of Tirosint daily for five days then nothing on Saturday and Sunday. No T3 needed. I am also based in California. This is been ongoing for over six months and no crazy fatigue like before. I too fluctuate between 75 and 100mcgs like twice a year…my vitamins are for crap right now (This dual strike in Hollywood has affected me too and things are tough)but they have been real good up until May. I also practice Trandscental Meditation and it seems to help me greatly. The key I know for sure, is the same time daily. Never believed until I actually paid close attention. Hope this helps.

Sophie4506 profile image
Sophie4506

Hi,

I'm quite surprised of this high increase. What about a lower increase ? from 75 to 88 ? Have you testing your TSH/T4/T3 levels since ? How do you feel ?

On my side, when I increased Tirosint dosage, I noticed fatigue (not as in hypo, where I literally could sleep the whole day), as I have more energy probably, and feeling restless, tachychardy and insomnia the first few weeks. But on my case, even a slight increase (+1,9microgram per week) leads to hyperthyroidism symptom ...

Ajva profile image
Ajva in reply toSophie4506

The pharmacy in uk only stock 75mcg or 100mcg of tiro. I am now taking 75mcg daily and 1x a week take 100mcg. Added into my 1 1/4 grains of armour

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