Accidental double dose Levo

[Girtonian]

Hi all, looking for some advice after taking too much Levothyroxine today, mainly how to get back to usual dosing again?

I’m supposed to take 75mcg Levo in the morning and 5 mcg T3 morning and evening. Popped upstairs to take my 5pm dose of T3 today and realised afterwards, to my horror, I’d just absent-mindedly taken my Levo again as well! So I’m not sure whether to skip tomorrow’s Levo dose completely, or take it later in the day, or take a bit less… what do you folks advise? I think I can carry on as normal with the T3 as its half life is so short. I’m currently feeling ok apart from my tinnitus has ramped up a notch.

I really want to be on good form on Sunday as I’ll be leading a labyrinth workshop for a church all-age service.

any suggestions gratefully received!

[Anthea55]

Easily done!

T3 needs to be taken regularly, so no change there.

Levo / T4 is a storage hormone which you take and then stays waiting for you to need it and convert it into T3. I think of it as being like your petrol tank where you fill up when convenient. So do whatever works for you - you could take 25mcg less tomorrow and next 2 days or just skip tomorrow morning's dose. Just so that you end up with the expected total.

I'm sure you will be fine.

[Girtonian in reply to Anthea55]

Thanks Anthea55, that is reassuring and makes good sense. The double dose was yesterday now. I suppose another way to do it would be to take 25 mcg T4 today and 50 mcg tomorrow… or skip today and back to normal 75 mcg tomorrow. And of course will take the T3 as normal.

[Jaydee1507 Administrator]

You could do several things. Either skip tomorrows dose and then its sorted, or take a half dose (not easy on your dose) for the next 2 days.

Either way, Levo is a storage hormone so the effects of today and whatever you do tomorrow won't be felt for a few weeks so you should be fine at the weekend.

[Girtonian in reply to Jaydee1507]

Thank you so much Jaydee, that’s very reassuring. I was worried I’d crash tomorrow.

[radd]

Girtonian,

T4 has a long half life and such is the slow buildup, there are records of people taking a weeks worth of Levo in one go!

I myself can't imagine this to be conducive to achieving/maintaining good health, especially when many with hypo have adrenals issues, but my point is you will be fine with only a double dose. Just leave off the next days dose to get back to your usual daily dosing regime.

[Girtonian in reply to radd]

Thanks, that’s reassuring!

[Entropy0101 in reply to Girtonian]

Like others have said, no need to worry.

As T4 has such a long half life, there is no concern. Just drop tomorrow's dose and you're all good. Your body will not even notice the error.

Be more careful with T3 which is the active form of T4, that you don't want to be double dosing!

[Girtonian in reply to Entropy0101]

Thanks. I had a bit of a panic! But reassured now. I'm normally so careful, but was distracted and went on to complete autopilot. A good reminder to be mindful of what I'm doing and not get complacent!

[Fruitandnutcase in reply to Girtonian]

Why don’t you buy a weekly pill box and fill it at the start of every week - that way - if it’s not in its space then you’ve taken it - provided you fill the box every week.

[Lottyplum in reply to radd]

An Endo I saw once a year ago said I could take a week's worth of levo@once! Thought she'd lost her marbles!!🥴 And we're supposed to have confidence in the medical profession!

[radd in reply to Lottyplum]

Lottyplum,

There are lots of studies if you search but they all patronisingly talk about patient non-compliance forcing the need to medicate weekly. I suspect it also suits some care-givers.

On paper it looks fine as in the peripheral tissue there is regulation by deiodinases (thyroid activating and deactivating enzymes) and protein transporters for the conversion of T4 to T3 which increases at a low T4 level and decreases at a higher T4 level. But the reality is these studies fail to connect any influence on the HPA (adrenals) and HPG (gonads- sex hormones).

The fact that some members are so sensitive to increases of Levo it has to be raised by only 12.5mcg must indicate Levo directly effects so much more.

[Lottyplum in reply to radd]

I’ve heard such nonsensical things coming out of the mouth of some medical professionals that it beggars belief! Is it any wonder that so many do not trust doctors? If only they would listen to their patients. It would address so much distress on our side - as well as physical and emotional pain. That’s why I am forever grateful to finding this community at Thyroid U.K.

[Bob00752]

Just skip the next day and it should sort itself out in a day or two. The half life of T4 in the body is around 5 to 6 days (so it is assumed that T4 as levo has a similar half life).

So if your consecutive daily doses are" 2, 0, 1" you've taken 3 doses over 3 days, which was what was wanted - if you try "2, 0.5, 0.5" instead you have also taken 3 doses over 3 days (however if you halve a Levo you'll probably lose some on the cutting board!). so no worries as some of the others say.