hello and thank you for reading I have asked my dr 4 times in last year for blood tests as I feel over medicated on 100 levo a day, I had tests done and all came back not over medicated and stay on 100. Today I got Medichecks results and Drs report says if I feel hyperthyroid I should ask my dr to reduce as my tsh is low the truth is I feel wiped out, fatigue crippling me can’t get off the sofa and brain fog so bad it’s scary. I get racing palpitations especially at night too. I do have ectopic heart problems and heart failure which I’m seeing my cardiologist tomorrow. I have m.e. Cfs fibromyalgia osteoarthritis and recently I have a frozen shoulder which I read is caused by autoimmune which I have hashimoto. Please advise on reducing my dose please and will it help with fatigue and brain fog. Sincerely thank you for reading this. Just to add I did test at home 8am before meds, also no b complex or anything 5 days before as wanted accurate results. I was due to have gallbladder removed but had to ring the hospital and ask to put it on hold as I feel too unwell to through the operation at the moment.
advice please on Medichecks results should I re... - Thyroid UK
advice please on Medichecks results should I reduce my levo?
Well, it might be a good idea to reduce your levo because your FT4 is very high, and that's not good long-term. Especially if you have hyper symptoms. But if you do do it, do it because of the high FT4, not the low TSH. TSH is a very poor indicator of thyroid status and can be low even if your Frees are also low.
However, might be a good idea to do it by yourself and not involve your doctor because you have Hashi's, which means that the high FT4 might be due to a Hashi's 'hyper' swing and have nothing to do with your dose - which at 100 mcg is not even very high. But, doctors don't understand that and are usually reluctant to put your dose back up again when you need it - which you will if this is a Hashi's swing.
You said a recent test came back good, so it's unlikely that your FT4 is suddenly going to get too high without changing your dose.
As for whether or not it will make you feel better to reduce your dose, only time wiil tell. So try reducing it, but with caution.
How are they planning to remove your gallbladder? Keyhole surgery? I had that, it's an absolute walk in the park. I was only in for two nights - one before early morning surgery and one after. The next morning I went home. No pain, nothing. A piece of cake. 
Your reply means alot to me and gives me more understanding thank you so much greygoose. Does everyone get these hashi flares please can you tell me how long they can last? Sorry for questions but do I reduce by taking a 100 every other day, is that good thing to do? I am not a bright spark and would be so grateful for some guidance please if you could to help me. Yes keyhole surgery home same day if all goes well they said but I am very scared to have surgery feeling so unwell. Thank you again
I think it would probably be better to cut your pill in half and take 50 every day. It's usually better if you can take the same amount every day.
I don't think there's anything to be afraid of. They will take good care of you during the surgery. If they agree to do it, it means they don't think there's any cause for concern.
Thank you really appreciate your reply I will do that thank you again
you're welcome.
I think your results show just how different we all are. I had some similar ones 5 years ago and felt very well but then again I am not taking any Levothyroxine.
Here is a link to my thread about them
your t3 is very low, the crushing fatigue is more likely to be due to that. Is adding liothyronine (t3) an option for you?
thank you for your reply I don’t think I could do t3 on my own, I would if Dr would prescribe but I was told 2 years ago my t3 is fine (but I do agree it’s low like you say) thanks again for replying to me
No worries. I would really strongly encourage you to find a doctor who will treat you based on symptoms and is willing to trial t3 for you to see if it improves things. Personally for me a t3 that low would mean I couldn’t really function properly, I would really be feeling rubbish. Could you afford to get one or two private consultations? This is what I did. I see the private endo once or twice a year now at a cost of £185 a time. A lot of money I know but worth it for me.
I would check other vits too - vit d etc as that made me feel a lot better to. Good luck.
I am going to look into finding a Dr because of what you said how much it has helped you I have to try and do this. Thank you Arlie
Free T4 (fT4) 22 pmol/L (12 - 22) 100.0%
Free T3 (fT3) 4.6 pmol/L (3.1 - 6.8) 40.5%
Was test done as recommended, early morning, ideally before 9am, only drinking water between waking and test and last dose Levo 24 hours before test
Do you always get same brand levothyroxine at each prescription
If yes…..Which brand
Do you normally take levothyroxine waking or bedtime
Ft4 is rather high
But Ft3 is low
So you will be feeling a mix of hyper due to high Ft4 and hypo due to low Ft3
ideal aiming for both about 70% through range
For good conversion of Ft4 to Ft3 we need GOOD vitamin levels
when did you last test vitamin D, folate, B12 and ferritin
Exactly what vitamin supplements are you taking?
Suggest you reduce dose Levo by 25mcg PER WEEK initially
Retest in 6-8 weeks including vitamin levels
As you have Hashimoto’s are you on gluten free and/or dairy free diet
yes . a slightly reduce dose is a good idea to try given some of your symptoms ,, and the high end fT4 / very low TSH.... the only way to know if it improves your symptoms is to try it for at least 6 wks .... you may well feel undermedicated for the first week or so ,but then thing can start to settle down , so don't make your mind up about how a lower dose feels until at least wk 5 /6 onwards
personally i'd reduce by 12.5mcg to 87.5mcg daily , but depends what tablet sizes you have.
if you've only got 100's you could half one and take 100mcg for 6 days a week , and 50mcg the other day. this equates to 92mcg / day
or 5 days @ 100mcg / 2 days @ 50mcg equates to 85mcg/day
or you can ask GP to prescribe lower dose using 50's and 25's ie. 75mcg one day /100mcg the next , alternating. gives 87.5mcg /day
some poeple don;t notice the difference between days of different doses ... some of us do notice and find it unsettling ... so we cut 25's in half to take same dose each day.
12.5mcg tablets are available, but stupidly expensive compared to other sizes, so not often prescribed .
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on a separate issue ... it's possible you op might have been cancelled when you got to pre op stages anyway , due to your low TSH ..... see replies to a post this morning : healthunlocked.com/thyroidu...
so that's another reason to try a lower dose, to get your TSH into range for op.
I am so grateful for your guidance on how to proceed with reducing my dose thank you so much. I will ask my gp to prescribe for me. Please can you tell me am I asking for 50s and 25s? I have lots of 100 left I’m a bit confused what to ask my dr for sorry to keep asking
ideally , it's best to stick to the same brand of levo you are usually getting if possible , that way you can tell if it's the dose change affecting how you feel ,, if you get a different brand at the same time as changing dose , it can muddy the waters .
The only problem with asking GP to lower dose officially when you have a very low TSH is that it can then be very difficult to get them to agree to put it back up if it turns out you don't feel so well on the lower dose.
personally , i'd just lower it a bit it myself with whatever tablet i had to hand , and keep the prescription at 100 officially. that way i can put it back up when i want to rather than having that neverending 'TSH argument' with the GP again
but yes, if you want lower dose tablets , they can prescribe a combination of 50's and 25's .. there is also one (or maybe 2 ?) that do a 75mcg size,, but one of them is teva brand which some of us don't get on with.
So it's up to you really .. decide whether it's too much faff to get the dose you want from 100's for a few wks till you get the op agreed , or whether you are prepared to risk getting stuck on lower dose for ages .
if you try the lower dose using 100's and it does feel ok to you , then at that point ,get GP to give the smaller tablets to make it a bit less faff.
Tattybogle please help me as I saw a medical practitioner today at my Drs surgery regards my Medichecks results and told her a felt I needed dose reduced and she flawed me, raising her voice and speaking down to me it was a awful consultation which in the end she said will reduce to 75 not 87.5 as I asked. Retest 6 weeks at the surgery and go from there. I feel so very ill and Xmas has a 18 hour spinning dizziness very scary was also vomiting. I don’t even want to consider my gallbladder opp feeling so ill the hospital are keeping me on the list till May then I’ll be removed they said. The medical practitioner lady said my t4 isn’t high and made me feel I was just waisting her time. I feel I can’t do this constant battle anymore but I will have to won’t I. She is sending 50s and 25s prescription tomorrow but I will be taking 87.5 as you suggested. I’ve lost a stone since November so don’t need as much levo I’m now dropped from 9stone 7lb to 8 stone. Too I’ll to eat most days just soup. Orders a pill cutter as well today. Any advice how to move forward on lower dose please thank you I appreciate you
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