Hi. Doctor suggested I reduce levo as over 60 years now and surpressed TSH risk for osteoporosis. Like a fool, I agreed to a reduction of 25mcgs every other day even though I felt very well for the last seven years on my dose.
After 3 weeks terrible heart palpitations mainly after eating. Slowed digestion with bloating. Dry skin and eyes and just feeling low and anxious. Increased does a week later and just can't get rid of the palps. Digestion improving and feeling better in myself. But why the palps? Had them prior to getting on correct dose all those years ago. Wonder if anyone had similar.
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As it’s a couple of years since your last post, can you share your thyroid blood test results with us. Was FT3 and FT4 tested, or just TSH? For a complete picture of your thyroid health, it’s advisable to have all tested.
Highly likely your adverse symptoms are linked to thyroid medication not being optimal. I’ve had palpitations when both under and over medicated thyroid wise,
When was the last time ferritin, folate, B12 and Vit D levels were checked? These key vitamins support thyroid health.
Hi, I have never had my Ferratin, Folate, B12 and Vit D checked - the GP has tried but the labs won't do it unless an Endo requests it, and it has never been done when I have an Endo appt at the Hospital,
I attended the hospital and there it was decided to lower my T3 by switching from the 10 mcg per dayI was taking to taking 10mcg and 5 mcg on alternate days. I was then sent for Thyroid blood screen after the consultation.
I was then sent a "follow up " letter, but although I specifically requested a copy of the full result all I got was this in the letter -
"....your TSH is 0.01 with a free T4 of 16.5,your Free T3 is slightly on the high side at 8.5. Ideally I would like the supressed TSH to be over 0.1 and FreeT3 a bit lower so I have decided that your Liothyronine should be reduced to 10mcg and 5mcg on alternate days and you will contine with yourLevothyroxine at 75mcg daily"
He also said that -
"...unfortunately lowering your T3 will make you feel a lot worse..."
To knowingly do that is against the Hippocratic oath of "...first, do NO harm"
So that is all the info I got. I have no thyroid at all, and understand that Liothyrone 10mcg and 5mcg on alternate days as he suggested is an absolute NO.
I had taken my thyroid medication with my breakfast, ( about 8am I think and was seen at the clinic on 9th May at 9:45. ( I was not aware that I should have withheld my T3 at that time, but I am now)
So would taking 5mcg twice a day give an accurate FreeT3 reading and not taking my T3 before having my Thyroid bloods taken give a different (ie lower) result as I just can't cope with the 10mcg and 5 mcg on altenate days, I am fine on m 10cg, but on the days I take the 5mcg I feel awful, brain fog, weepy ,exhausted,freezing hands and feet....falling asleep in the afternoon etc. .I can relate to this as being symptoms of Hypothyroid.
So how can I get this sorted? What do I tell my Endo without him taking offence?THere must be some research articles about the spike in T3 after taking it, and about the reason that doing this "alternate" days of 10mcg/ 5mcg simply doesn't work as the Free T3 is not stable in the body
So if anyone can provide information/articles, etc that I can send to my Endo on the above I would be so grateful to you!
HilaryWB, please do put this information in your own post, as per forum guidelines. Otherwise it is confusing for members trying to advise the original poster.
GP will only test TSH and the one in April that triggered the reduction in Levo was 0.02 (0.4 - 5.5).
My last private test via Medichecks was on 11 May 2023 was as follows and I was taking 125mcgs four times a week and 100mcgs three times a week:
TSH 0.33 (0.27 - 4.2)
FT4 18.6 (12 - 22)
FT3 4 (3.1 - 6.8)
I know I am not good at converting and my ft3 has never gone above 4.32 but I felt well then. Vitamins haven't been checked for ages. I have had a tendency in the past to be low in ferritin and folate but being post-menopausal I haven't had iron checked lately.
What are your most recent results from BEFORE reducing dose
TSH, Ft4 and Ft3
Plus vitamin D, folate, ferritin and B12 results
What vitamin supplements are you taking
Do you always get same brand levothyroxine
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
TSH does not affect bones in someone on replacement thyroid hormones
…it’s essential to test and maintain optimal Ft3 especially…..and good vitamin levels especially vitamin D and magnesium
GP will only test TSH and the one in April that triggered the reduction in Levo was 0.02 (0.4 - 5.5).
My last private test via Medichecks was on 11 May 2023 was as follows and I was taking 125mcgs four times a week and 100mcgs three times a week:
TSH 0.33 (0.27 - 4.2)
FT4 18.6 (12 - 22)
FT3 4 (3.1 - 6.8)
I know I am not good at converting and my ft3 has never gone above 4.32 but I felt well then. Vitamins haven't been checked for ages. I have had a tendency in the past to be low in ferritin and folate but being post-menopausal I haven't had iron checked lately.
I always take Eltroxin and have this written on my prescription. I always have my blood tests done first thing and never take my Levo before.
Not taking anything at present. I think I will get the full works from medichecks to include vitamins but will wait a couple of weeks until I've been back on my original dose for six weeks. Does that make sense?
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
There's lots of reasons for palpitations (caffeine, booze, that pesky thyroid, etc) but one of them is Atrial Fibrillation which is common and should be treated because of the risk of a stroke. I have AF.
Suggest that you contact your GP (sounds easy!) and ask for an ECG. There's a gadget called Kardia which works with a smartphone to produce an ECG costs about £100. I think there's a recent thread about it on here.
Suppressed TSH is not a risk for osteoperosis.....
TSH is a pituitary, not a thyroid hormone, It's a messenger from the pituitary to the thyroid to increase or decrease hormone production....it indicate thyroid hormone levels. High TSH/ low hormone: low TSH high hormone. The problem starts if the HPT axis is faulty and the 'signals' are no longer reliable.
For this reason we should rely on FT3 followed by FT4 for monitoring thyroid status and dose
You were NOT a fool....you trusted your GP as we should be able to do (that's their role!)....his foolish lack of knowledge let you down!
Medics are supposed to consider symptoms....if you were well on your previous dose he should have left well alone instead of making a change and causing you problems....I expect he'll have some spurious excuse as to why you now feel unwell. You are now undermedicated!
Palpitations are symptoms of both over and undermedication
Suggest you go back to GP and ask to have your previous dose reinstated and point out that you had palps prior to getting on correct dose all those years ago.
That speaks volumes!
Also suggest he tests TSH, FT4 and FT3....so long as FT3 is in range you will not be overmedicated.... which he appears to wrongly blaming for your palps
If he still insists it's low TSH request a ECG test!
The level of ignorance amongst medics about thyroid diagnosis and treatment is appalling....and potentially dangerous!
Being hypothyroid/undermedicated is the problem here...not suppressed TSH
It will take time for an increased dose to settle again after the system has been disrupted....give it the time and have a full thyroid test after you've been on a steady dose for 6/8 weeks
Thankfully she has agreed to increase my dose to the previous level. I am planning a re-test after 8 weeks as you suggest and I will include vitamins this time I think. Just so concerned because these damn palps keep coming (although touchwood, not today so far) so I'm hoping things might be settling down.
Hi there, I had the very same problem a few years back when GP insisted to reduce my levo every other day, as my TSH was suppressed. Made me sick as a dog and I also had palpitations like you, I also had anxiety, hair loss, lack of energy and low mood. Needless to say TSH did not go up one bit at all. After feeling lousy for about 3 months, I decided to tell the GP where he could stuff his reduction and never looked back. I supplement with Mg, Vit B complex, Vit D3&K2. I am not gluten free and an absolute dairy lover, and this suits me very well.
The palpitations take a while to settle down and these will probably have been the result of the unnecessary reduction, so I would give it a while for the meds to get things on an even keel again. However, if it persists, do get it checked out. 😉
thanks, very useful info! I have had x2 of 12 lead ECG's in the last 2 years - and there is absolutely nothing wrong with my heart yet my Endo was telling me I was at risk of Cardiac problems as my TSH was "supressed".....and I am "elderly" .... at 75!! apparently that was his reason for lowering my T3! What planet are these Endos on?
Stuff and nonsense....I'm almost 79 and a fairly recent ECG showed a healthy heart ....despite taking high dose T3-only for several years which suppresses TSH naturally
And...T3 must be taken in a constant daily dose as you clearly understand....unlike that clown of an endo!!
Thanks, you are a breath of fresh air! I will ask the endo to let me take my T3 not as one dose of 10mcg but split into 5mcg twice a day,and if necessary send him some articles that state that taking 10 and 5 mcg on alternate days is NOT recommended!
Hi, my endo reduced my Levo to 75mcg OD which brought my free t4 waaay down which he thought was ok. Despite the effects on my body. I spoke to my practice and it was increased to 100ncg to lift the levels to the optimal level.
Now I’m having the same problem with free t3 so yet again we are correcting it but not after I was pushed into hyperthyroidism
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