Dose increase - worse anxiety

[Dahliasanddaisies]

I'm nearly at 4 weeks of a dose increase. From 75 to 75/100 alternating. I got a new brand (aristo) last week and I've been taking them for 3 days.

Anxiety has been a constant for me for years now but it's got really awful in the past few days, much worse physically. Breathless, tight chest, can't swallow etc. I'll be okay for hours then the anxiety will just come out of nowhere.

I think I'll go back to my old brand to see if its that but has anyone else found anxiety got worse in the transition upwards? I'm assuming it's not over medication as it's not been long (last results in my bio).

Thank you

[Jaydee1507 Administrator]

Looking at your last results its highly unlikely to be overmedication causing your symptoms. Just low FT3, also low FT4 and changes in levels.

8,000iu vit D is a high dose.How did you work out you need that much?

Your B12 wasn't great on last test. Most people need a B complex.

How was your ferritin?

[Dahliasanddaisies in reply to Jaydee1507]

Hi Jaydee, thanks. The Thyroid Clinic advised 8000 vit d but I've not started it yet. Only taking 4000 currently. Do you think that might be a reason? I'll stop it for a few days. Taking ingenus vit B complex as b12 was 500ish. Ferritin was 80 in Feb, I've been taking 5mg supplement. This has been enough to raise it from 60 last year.

[Dahliasanddaisies in reply to Dahliasanddaisies]

Vit D was 68 on 1st March

[Jaydee1507 Administrator in reply to Dahliasanddaisies]

Ah, your profile doesn't mention that you take a B complex.

If you're only taking 1 of the ingennus you probably need to take the full dose of 2 as your B12 isnt optimal yet. That wont be helping anything.

What was your test result on 4,000iu vit D? Theres a calculator here so you can work out how much you need to take to get to 100-150 which is said to be optimal. grassrootshealth.net/projec...

[Dahliasanddaisies in reply to Jaydee1507]

Thanks Jaydee, I was taking the Thorne basic B for a few months but swapped to the ingennus a few weeks ago.

Vitamin D was 68 in March

[Jaydee1507 Administrator in reply to Dahliasanddaisies]

Use the calculator I posted to work out what you need to take to get you to around the 100 level.

Retest vitamins 3-4 months after you started supplements to make sure you're taking enough. Same goes for vit D.

[Buddy195 Administrator]

My anxiety is worse if I adjust too quickly, (either increases or decreases in Levo). I now only adjust by 12.5mcg Levo alternate days at first until well tolerated. When adjusting, I’m definitely more tortoise than hare, as this really helps stop anxiety spikes.

I’ve also found some brands of thyroid medication make my anxiety worse, so GP has agreed to state the brands I can tolerate on my prescription.

I’ve ended up in A and E with tight chest, palpitations, fast pulse etc from anxiety flares linked to thyroid medication not been optimal/ or adjusted too quickly. Low and slow is definitely my new mantra!

Have you trialled a GF diet? I really find this helps both physically & mentally. As Jaydee1507 has advised, optimising key vitamins really supports thyroid health (mental & physical). Taking magnesium early evening also helps me relax/ unwind.

[Dahliasanddaisies in reply to Buddy195]

Thanks buddy, good to know! I'm loathe to change the dose back down now, I'll try to get through the next week and see how I am. Defo.go.low and slow next time!

[McPammy]

can I ask why did you increase your dose. Your previous TSH looked good along with your levels. Your symptoms sound like over medication.

[Dahliasanddaisies in reply to McPammy]

? Thought TSH was the least important factor (from everything I've read on here) as you've read it my profile, I'm housebound at the moment and can't look after my child so I'm doing anything possible to get better.

[Buddy195 Administrator in reply to Dahliasanddaisies]

You are correct in taking steps to address your less than optimal FT3/ FT4. Many members have suppressed TSH, so very important to look at the complete picture. I hope the dairy free Levo is suiting you better.

[Zephyrbear in reply to Dahliasanddaisies]

TSH is the least important! FT3 and FT4 are which is why most of us go for private blood tests rather than rely on the tests done by the NHS!

[McPammy in reply to Dahliasanddaisies]

I personally would not say TSH is the least important factor. I always monitor my bloods by my TSH alongside T4 and T3 levels. Lots of people cannot cope with a suppressed TSH meaning over medication either T4 or T3 or both. My TSH has swung in the past from suppressed to too high. Either way if my TSH is not in range I get awful symptoms. What we should be aiming for is to mirror a healthy persons thyroid blood results. And that is a TSH between 1.0-2.0. To achieve that you must keep your T4 and T3 levels within range including times when those levels spike after taking your medications. It’s all about balance and copying a healthy persons result. A healthy persons thyroid wouldn’t go over or under range and their TSH wouldn’t either. T4 or t3 meds are hormone replacements so we need to replace not flood our bodies. I keep with my levels and my TSH last week was 1.09 (0.35-5.50). More importantly I feel symptom free and have no issues. I’m energised and exercise regularly and happy I take T3 and T4 medications and keep within range

If you want to be symptom free keep within ranges. I feel you are over medicated and suffering the results of that. I’m no Dr but I do have 25 years experience of this disease. I had no clue to begin with and nor did my Dr. It’s been trail and error. My error was not understanding the importance of keeping levels optimal and not over or under range. I’d lower your dose if I was you and wait and see how you feel over the next few weeks. It can take a few weeks to settle down. Go off how you feel then get your bloods done again.

[Dahliasanddaisies in reply to McPammy]

Thank you for your imput. I wish I was symptom free but I haven't been for 4 years and after 12 months on Levo I feel worse than ever. I'll pull back and check my bloods in a few weeks

[McPammy in reply to Dahliasanddaisies]

I think that’s wise. Don’t over do it.

[Judithdalston in reply to McPammy]

Curious, you mention while getting your TSH c.1 you are keeping your FT4/3 in range, but also keeping levels optimal…are these the same or is the latter a smaller range?

[McPammy in reply to Judithdalston]

I had my bloods checked a few days ago. My TSH was 1.09(0.35-5.50). T3 was 5.6 (3.7-6.0) and my T4 was 9.6 (7.6 - 14.41).

I take my T3 2 hours before the 9am blood draw. I don’t take any levo T4 before hand.

I take 5mcg T3 twice a day 8hrs apart

My last T4 dose was 16 hours prior. I take my T4 with splitting my dose routinely 12 noon and 5pm.

[Judithdalston in reply to McPammy]

ok, you are fortunate that you can get your Ft3 at 83% thru range yet still have a TSH at 1 and nicely in ‘dr’s range’ too. When my TSH was last c.1 twenty or so years ago on 150 levo. my FT3 barely registered. Now on a T4/3 ( 100/ 15) combo I get FT3 in a rather abysmal 40+% and FT4 about 50%…but whatever I do to juggle the dosage the TSH is stuck at 0.02 ish! I have numerous other ailments ( including type 3 diabetes, fibromyalgia and Long Covid BP/HR problems…) that make it impossible to adjust thyroid meds by how I feel, but surely lowish Free T4 and T3 could not be viewed as ‘overdoing it’ even if extremely low TSH?

[McPammy in reply to Judithdalston]

I understand what you’re saying.

Have you tried testing t3 2/4hrs after taking it to see where it gets to at its highest, if you haven’t already of course.

My T4 is fairly low 16hrs after taking it on the blood test. So I think that’s ok and importantly I feel good. Your T4 is pretty high if I had mine that high my TSH would be suppressed I never alter my at3 dose but I do reduce my levothyroxine at times I was on 75mcg, then 68mcg now I’m on 64mcg per day i take liquid levels it’s easy to adjust and it absorbs much better than tablets. I also split my levothyroxine dose That avoids spikes and can help TSH from not being suppressed too. Maybe the liquid levo is my key to success as it converts better too I’ve been informed

[Judithdalston in reply to McPammy]

Hi, yes in a rather haphazard way over the years I have taken t4/t3 at different times in relation to blood tests…not so much by intention but the not knowing the recommended Forum suggestion of leaving 24/12 hours between taking pills and blood draw, nor having the test at 8.30-9 am. But I had recorded when taken pills/ done blood draw so could look back at previous results. It was my private endo who upped my levo back from 75 mcg as it was under 10% in range.; he was reasonably happy with the very low TSH caused by T3 because he could see it was needed to get FT3 off the bottom of the range. He does however cover himself by telling any dr. ‘The patient is aware of ‘ possible problems with bones/ heart! It is probably much easier with liquid hormone fine juggling dosage than wretched pill cutter!

[McPammy in reply to Judithdalston]

Have you tried a scalpel. I find using one is much better than a pill cutter. EBay or Amazon for a few pounds.