Advice needed please

[Jefner]

healthunlocked.com/thyroidu...

am in a muddle since finding out I am over range with my T4 and suffering badly because of it with all the nasty symptoms, it's like a double whammy of deblitating anxiety at the moment. Never been down this road before and my poor brain is so muddled at the moment.

ok thinking out loud here for a moment if I can explain myself properly with all this brain fog. "Levothyroxine levels in the body start to drop significantly after about 6 or 7 days" so since my results last Thursday, being on 125mcg I tinkered with my Levo from last Friday to try and get my levels down a little to try and free myself of some of these awful symptoms before moving to a new dose of 112mcg.

Friday 25mcg..Saturday - nothing......Sunday 25mcg....Monday 100....Tuesday 100....so that is a total of 5 days that I have effectively had much less than normal. If I had taken my usual dose of 125mcg I would have taken a total of 625mcg during those 5 days BUT instead I have only taken a total of 250mcg so in theory there should be a drop in my T4 levels? As it says "levels can drop significantly after about 6-7 days". I did feel slightly better on Sunday with the lessened T4 intake but after taking 100 on Monday and Tuesday, had a really bad day today with all the crappy symptoms.

At this point I am at a total loss in what to do. As anxiety is a big part of my miserable life, it's usually pretty bad on waking and throughout part of the day but eases off in the evening to where I actually feel OK but am not feeling OK in the evenings with the anxiety still there, fatigue, palps. Kinda feels like I am still overmedicated

If I miss any more doses or have small ones then I am likely to go hypo after lessening it for those 5 days ? Trying to think logically here. So as difficult as it could be, still with all these symptoms, in theory my T4 should have dropped a little in those 5 days and maybe I should now carry on with 100mcg for around a week and then up it to where I probably need to be at 112mcg as 125 is too high for me and 100 too low.......or go 75mcg for a couple of days, then 100mcg for a few days and then up to 112mcg?

[Buddy195 Administrator]

As I’ve recommended before, I go low & slow when making adjustments in thyroid medication, either increasing or decreasing. 112mcg Levo daily is a sensible first step in reduction, as long term if us not advisable to have over range FT4. My anxiety levels massively spike if I make changes too quickly & I think this could be at play for you too.

I didn’t find my thyroid levels changed in the short term; that’s why I personally prefer to wait the full 8 weeks on a consistent dose before rechecking levels.

[Jefner in reply to Buddy195]

since tinkering with my Levo from Friday - Tuesday ie. Friday 25mcg..Saturday - nothing......Sunday 25mcg....Monday 100....Tuesday 100...today 25mcg.......so that is a total of 6 days that I have significantly reduced my dose. I took only 25mcg today because of taking the 100 Monday and Tuesday my symptoms were very bad again yesterday and it felt like I was just topping the T4 up. .....So taking into account the above doses I have had the last 6 days to try and get my T4 down a little, it still feels like there is still too much in my system so at this point where is my starting point on properly dosing please and at what dose? I clearly need to get to 112mcg as the 100 is a little too low and the 125 too high for me?

[radd]

Jefner,

* Free T4 H 22.7 ........... (12.0 - 22.0 pmol/L) - 107%

* Free T3 5.2 ..................3.1 - 6.8 pmol/L - 46.43%

I'm sorry to hear you are still feeling so unwell but my response remains the same as when I replied to you a year ago and may be read here .... healthunlocked.com/thyroidu...

In a nut shell over range FT4 makes many members feel horrible, and through bodily safety mechanisms is likely to inhibit a proportion of future meds from working properly.

Many members (including myself) have found reducing high levels of FT4 meds has eventually improved FT3 levels.

Getting meds right will reduce the burden on the adrenal glands and cortisol and anxiety should improve.

Thyroid hormones drive everything and you have been overmedicating for a long time. This will require many months of a reduced dose and likely further testing and dose adjustments to reverse all the layers that have been influenced by over medication .

Each dose change must be left for 6 weeks before testing and further assessment as this is the least time is takes for most change to be seen/felt.

[Jefner in reply to radd]

@radd since my results last Thursday, being on 125mcg I tinkered with my Levo from Friday - Tuesday ie. Friday 25mcg..Saturday - nothing......Sunday 25mcg....Monday 100....Tuesday 100...today 25mcg.so that is a total of 6 days that I have significantly reduced my dose. I took only 25mcg today because of taking the 100 Monday and Tuesday my symptoms were very bad again yesterday and it felt like I was just topping the T4 up. .....So taking into account the above doses I have had the last 6 days to try and get my T4 down a little, it still feels like there is still too much in my system so what if I stayed off completely for a couple of days and then start redosing and if so, where is my starting point on properly dosing please?

You say many members have found reducing high levels of FT4 has eventually improved FT3 levels......that has never been the case for me. From all the past results, even with the small dose T3, my levels have always stayed at the bottom of the range. The reason it's high at the moment is due to my T4 being high. Tbh, and I have always said it, I don't think I tolerate T3 well which is why I never upped it because someone else mentioned it could be driving my anxiety which I strongly believe as I used to take my first split dose on waking and my anxiety was still severe so I moved first dose to later in the day and I did notice that it wasn't quite so severe on waking. When the subject of me needing some T3 was suggested on here some years back I spoke with my then Endo about it and he wouldn't prescibe it to me because of my anxiety levels and said it could heighten it, maybe he was right after all and I should have just left off it because I haven't felt any benefit from it at all as I am quite sensitive to it

Thyroid hormones drive everything and you have been overmedicating for a long time. This will require many months of a reduced dose and likely further testing and dose adjustments to reverse all the layers that have been influenced by over medication .....that's the problem I really don't know how long I have been overmedicated but with the cockups by pharmacies and not being able to test the end of last year and having to wait to stabilise to now, then it could be a few months but tbh with my already present anxiety it's difficult to tell. Thinking back first sign for me might be the unexpected weight loss which started around a couple of months ago. I remember last year when I was on a lower dose ie 100mcg I gained a little weight and testing last summer it came back that 100 wasn't quite enough which is why I went back on 125

[jgelliss in reply to Jefner]

From my own experiences with thyroid meds if nutrients are not up to par the thyroid meds won't work to it's fullest. This is something that Dr's don't tell us . Either they don't learn it in Medical Academia or they are just ignorant and don't share.Best wishes while your sorting yourself out.