over medicated new dosage help!

[Racheeeel78]

hi lovely people,

over the past 18 months I’ve slowly lost 21lbs. Over the past week I have noticed I am having over medicated symptoms (I have been overmedicated before so know what to look out for).

I am currently on 100mcg levo and 10mcg lio.

Do you think I would be better taking 75mcg levo with 20mcg lio or 10mcg lio to reduce the symptoms. I don’t want to reduce too much and end up going the other way.

my last bloods were:

TSH 0.12

T4 18

T3 3.7

My gp obviously doesn’t work with my t3 and I can’t see my endo until august!

thanks in advance 🙏

[Jaydee1507 Administrator]

2 months ago you were'nt taking enough Levo. Those effects are going to last for a while.

You're certainly not over replaced with those results although you haven't given the reference ranges which are important as they vary between labs.

How did you take this test?

What time of day was it?

When was your last dose of Levo & T3 prior to the test?

If anything you're under replaced. On T3 most peoples TSH is below range or suppressed.

How are your vitamin levels looking?

What are you supplementing with?

[Racheeeel78 in reply to Jaydee1507]

hello,

Yes 2 months ago I accidentally took 50mcg with my 10mcg lio. My T4 dropped to 11.

I’ve been back on course with my usual dose for 6 weeks. I realised when they did bloods to diagnose my whooping cough then did my thyroid and it was way off !

Last bloods:

TSh 0.12

Normal range: 0.27 to 4.2

t4 18.5

normal range 10.8 to 24

T3 3.7

Normal range 3.8 - 6.8

Blood taken fasted first thing 24 hours (I didn’t take half t3 before blood as I auto pilot took the full dose).

My tSh is below range and suppressed, I assumed that’s okay as t3 can suppress both tSh and t4. I’m basing on how I’m feeling more than anything…

All vitamins all fine- I had low ferritin but got that up to 80 now.

Vit d is 125

B12 is 750

I take vit d, iron, folate, hair vitamins, zinc, selenium, vit c, fish oil, collagen, mct bone broth… cost a small fortune!

No gluten, no issues with diary…

[Jaydee1507 Administrator in reply to Racheeeel78]

It can be very confusing as the symptoms of too much and not enough thyroid hormone have a big crossover.

So FT3 is a false low. You would need to retest that with an 8-12hr spacing for last dose for an accurate result.

FT4 is only 58% of its range and needs to be around 70% on combination therapy.

Your TSH is not suppressed. If it were suppressed it would be 0.01. Its just below range and completely to be expected on T3.

On combination therapy you need to look at both FT4 & FT3 and disregard TSH.

For now you could raise Levo by 25mcgs. 75mcg Levo on combi therapy is a low dose and your level could do with being higher.

Well done on the vitamin levels.

[Racheeeel78 in reply to Jaydee1507]

Thanks for the detailed reply Jaydee!

I will not reduce meds, and will monitor my symptoms!

I was worried that loosing a stone could be the reason feeling jittery!

Thanks again for your help

[Jaydee1507 Administrator in reply to Racheeeel78]

A minority of people lose weight when hypo and under replaced.

[Racheeeel78 in reply to Jaydee1507]

I’ve been following a low carb unprocessed diet, it’s been very slow and steady so think more like do to that over meds. I was told some people need to lower dosage with weight loss?

[Jaydee1507 Administrator in reply to Racheeeel78]

Going by your blood results you probably weren't on enough in the first place and definitely aren't on enough now.

[Racheeeel78 in reply to Jaydee1507]

I was previously on 125mcg and felt awful, couldn’t climb the stairs without palpitations. I’ve felt lots better on 100mcg. Could I up the lio to 20mcg instead of levo?

[Jaydee1507 Administrator in reply to Racheeeel78]

Try going up just 5mcg T3. You wouldnt want to go up too much all at once anyway.

[Racheeeel78 in reply to Jaydee1507]

Great thanks, I’ll try that!

Thanks for help!

[Jaydee1507 Administrator in reply to Racheeeel78]

To make the T3 last you throughout the day take it in 3 split doses.

5mcgs morning, 5mcgs late afternoon, 5mcgs bed time.

[Racheeeel78 in reply to Jaydee1507]

Will do, thank you!

[Transalp in reply to Racheeeel78]

you might consider doing a resting metabolic rate (RMR) test as another way of looking at your medication levels.

Takes around 15-20 mins sitting motionless with a mask to a gas analyser. They then compare your actual results to the standard predicted results for you and you can see if you’re hypo or hyper.

My first RMR I was 37% below expected, I have slowly improved medication (combo) and I am now higher up in the FT3/FT4 range and last RMR had me 2% above expected.

In the UK costs around £100.

[Racheeeel78 in reply to Transalp]

Wow, I’ve never heard of this!

Definitely something I’ll look into, thank you!

[Shelleyblue]

Hi. Looking at your test results it looks like you are having trouble converting T4 to T3. :/ but if you feel you are over replaced then I would try 75mcg with 10mcg of lio first. If you are not feeling good in 8 weeks time then I would try adding 10mcg so you are taking 75mcg levothyroxine and 20mcg liothyronine daily. I would take the 20mcg in 2 split doses of 10mcg each dose. IF you don't feel well after that then do a blood test after 4 weeks of new dose and don't take any meds 20 hours before blood tests. Sometimes we can lose weight and it releases stored up thyroid hormones from our fat as we lose weight. So it could be a short lived thing and then you might start to gain weight again and feel hypothyroid symptoms instead. :/ Catch 22 situation. :/

[Racheeeel78 in reply to Shelleyblue]

Hi shelleyblue, thank you so much for advice!

It’s such a balancing act isn’t it! 😰