Overmedicated symptoms?

[ShiningStar77]

How would I know if I was overmedicated?

I have recently started taking NDT and had some pretty severe symptoms.

Started taking one grain last Tuesday AM after doctors appt on the Monday. I'd had the meds for a while but was not sure if I wanted to be medicated although I've had symptoms that have waxed and waned in severity for years.

Anyway had been taking 1 grain every day from last Tuesday to this Tuesday at about 6 am every morning. By the weekend I had such a severe cloud of depression like nothing I had ever felt before. Ive had bouts of mild depression before but this reaction was off the scale and had me really questioning my existence.

On the Wednesday (yesterday) for whatever reason I decided I would stop taking the NDT and instantly felt better and was able to function. The feeling was like night and day. Today I felt even better and I had energy that I don't usually have - I cleaned the house (which I usually drag my feet to do).

So my suspicion is that I need some medication but that potentially I have been overdosed this past week.

My only question is if the dark cloud of depression is a symptom of overmedication as my understanding is that depression is a symptom of being under-medicated, although to be clear I do not have any depression at present and have not felt depressed for quite some time.

I also had a similar episode in June/ July this year but myself and doctor chalked it up to taking oral bio-identical progesterone and did not suspect that attempt at trying thyroid meds. I now suspect that I was also over-medicated then. The funny thing is that my tests @ 2-3 weeks after that attempt showed a rapid improvement in my T3 (near top of range) although my TSH was still marginally hight at about 3?

So I conclusion is that I need meds but that 1 grain seems too much ?

[GlowCoach Administrator]

Looking back on your previous results your vitamin levels were terrible, particularly folate & ferritin.

Have you raised these levels since this test?

Low vitamin levels can cause intolerance of thyroid hormones.

TSH - 3.78 (0.27 - 4.2)

FT4 - 18.4 (12 - 22)

FT3 - 6.3 (3.1 - 6.8)

Cortisol (7:45 am) - 242 (133-537)

DHEA 2.5 (0.26-11)

Prolactin - 586 (102 - 496)**

Vit D - 120 (50 - 200)

B12 - 121 (25.1 - 165)

Folate 3.5 (2.9 - 14.5)

Iron - 22.6 (6-26)

Ferritin - 19 (13 - 150)

TIBC - 53 (41-77)

Saturation - 43% (20-55)

1 grain of NDT is very unlikely to have sent you over replaced in a week. More likely you need to raise the low vitamin levels before attempting to take NDT.

[ShiningStar77 in reply to GlowCoach]

Thanks GlowCoach - these are the results I was referring to after the last attempt at taking thyroid meds - as you can see T3 and T4 look great but TSH is still sightly high.

I have been taking supplements to address Iron and Folate since July ((1)Thorne Multi, (2) Thorne Methyl guard (B2, B6, B9 & B12) and (3) Heme Iron). I feel much better and fatigue is significantly better. I also take 10,000 iu of Vit D2 and 100mcg of K2 5 days a week. I also take Magnesium twice a day.

Can I ask which vitamins in particular can lead to Thyroid hormone intolerance apart from Iron/ Folate.

[GlowCoach Administrator in reply to ShiningStar77]

I'd recommend getting all vitamins to optimal before thinking about adding any thyroid hormones at all.

It will likely take well over a year to raise your ferritin off the floor.

Take iron 4 hours away from anything else as it affects absorption of other things.

Take iron with vitC or orange juice to help absorption.

10,000iu vitD is a lot even 5 days a week. Suggest you restest in 4 months from starting it to make sure youre not taking too much, which is a bad thing.

You could swap the mthyl guard for Thorne Basic B which isnt always easy to find but its very good. Probably you dont need the multi then anyway.

Magnesium is another thing that can affect absorption of other things. Best taken 2-4 hours apart from anything else.

Probably your low ferritin thats causing intolerance, but hard to say for sure, they all play a part.

[Jazzw]

I have a feeling you may have tried to go too fast. If you’ve been unmedicated for a while, your body’s got used to managing on low levels of thyroid hormones. A grain a day will have seemed a significant increase. The T3 in particular will have been a bit of a shock to your system. And though it may seem strange, over-medicated symptoms can be very similar to undermedicated symptoms.

Low and slow is the way to go. When you’re ready to give it another go, take half a grain a day for the first 2 weeks. If that seems to be going ok, you can then experiment with raising to a grain.

[ShiningStar77 in reply to Jazzw]

Thank you so much Jazzw I am planning to back off for another week or so and then reintroduce slowly.

My Dr has suggested 1/2 a grain a few times a week and then gradually increasing slowly till I can take 1/2 a grain the whole week.

By which point I will then ask her to re-test and then see if I need to up my dosage again.

[greygoose]

On the Wednesday (yesterday) for whatever reason I decided I would stop taking the NDT and instantly felt better and was able to function. The feeling was like night and day. Today I felt even better and I had energy that I don't usually have - I cleaned the house (which I usually drag my feet to do).

So my suspicion is that I need some medication but that potentially I have been overdosed this past week.

That is a perfectly normal reaction to stopping thyroid hormone replacement of any kind, and any amount. It always dose that but it doesn't mean anything, not that you don't need it, not that you were over-replaced, nothing. It's just some sort of bodily reaction that nobody understands - we don't know why it happens.

That said, whilst starting on one grain a day was more than likely too much - it's usually recommended to start on half a grain, or even a quarter - it's unlikely that one grain would cause over-medication in the long-run. It's quite a small dose. Just too large to start on. All hormones need to be started low and increased slowly.

The funny thing is that my tests @ 2-3 weeks after that attempt showed a rapid improvement in my T3 (near top of range) although my TSH was still marginally hight at about 3?

That, too, is perfectly normal. The TSH is slow to react. It moves far more slowly than the Free levels. And that's just one of the reasons that the TSH is a poor indicator of thyroid status. The most important number is the FT3.

[ShiningStar77 in reply to greygoose]

Thanks greygoose this is very helpful - yes plan to take a break for a while and then restart very slowly as you suggest.

I didn't experience those symptoms the first few days so thought I was ok - but now realising that T4 has a long half life so was likely building up in my system !

[greygoose in reply to ShiningStar77]

You're welcome.

[ZeilaJee]

I take NDT Armour for hashi and have done for c 10 years. My advice: start with 1/4 grain per day for 2 weeks, then move to 1/2 grain for a month, then advance very very slowly until you get to your optimal dose. It takes the body a long time to adjust - in my case. I’m now on 1.5 grains. It should all settle down nicely.

[ShiningStar77 in reply to ZeilaJee]

thanks ZeilaJee can I ask what the equivalent of 1.5 grains is compared to Levothyroxine ?

[Jazzw in reply to ShiningStar77]

It’s not an exact equivalent because NDT contains both T4 and T4, but broadly, 1 grain of NDT is roughly equivalent to between 75mcg and 90mcg levothyroxine (some say 100mcg but I don’t tend to find that very accurate).

I take 2 and a half grains (1.5 grains in the morning, 1 grain in the evening).

[ShiningStar77 in reply to Jazzw]

Thanks this makes sense and now I can see it was a huge starting dose.

[humanbean]

How would I know if I was overmedicated?

A quick way is to take your basal body temperature. This means that you must have a thermometer available on your bedside table, and you take your temperature the instant you wake up in the morning. Don't even sit up or drink anything. And keep records.

"Normal" body temperature is discussed in this link :

en.wikipedia.org/wiki/Human...

If your body temperature first thing in the morning is low then you are under-medicated for hypothyroidism. If your body temperature is high then you are over-medicated for hypothyroidism.

In hyperthyroidism basal temperature would be high in range or over the range.

Note as well that in menstruating women their body temperature varies across their menstrual cycle, and ovulation causes a big change.

.

Although I've never tried it myself, I have seen some reports that this link is helpful :

drrind.com/metabolic-temper...

Allegedly, it helps to determine if the problem(s) you have are more related to thyroid or adrenals.

[ShiningStar77 in reply to humanbean]

This is very useful humanbean thank you so much !

Agreed re the body temps I have one by my bed, just need to remember and get into the habit of using it.

[Britpol]

Hello,

I am sorry to hear about your experience. I had something similar happening when I was Levothyroxine and, for convenience , and listening to the doctor took the whole daily dose in one go, instead of a split dose. I am on Armour thyroid but had to introduce it very slowly to build up to almost two grains a day over a period of 9 months. Since being on Armour thyroid, my eyesight and my hearing have improved. I would recommend splitting your dose by halving your 1 grain and taking it twice a day. Taking other hormones as well complicates the picture but nay be you can take some of the medication at night , away from thyroid replacement hormone. It may well be that you need to take 3/4 grain a day to start with. Then, depending on your symptoms, you stay on that dose or increase very slowly but a split dose might work. You can split 1 grain tablets using your thumbs to avoid them crumbling in a pill cutter , but need to leave them out of the bottle for a while so that they soften a little and become easier to break. You can order half grain tablets but they are just as expensive as one grain Good luck!

[ShiningStar77 in reply to Britpol]

Wow I am just realising that I clearly went to fast if it took you 9 months to build up to 2 grains - OMG

Ok so I will do what my Dr said and drop down to 1/2 a grain a few times a week, slowly adding a day.

[Britpol in reply to ShiningStar77]

Hi

I meant try half a grain twice a day

or half a grain and then a quarter grain as a second dose so that you are on three quarters of a grain a day. Stay on it for 1, 2 or 3 weeks and increase by a quarter to one and quarter grain a day or one grain a day if start feeling very tired . Good luck