Over medicated?

hi all

So the past few days I’ve been having symptoms of over medicated - hot flushed, sweating, not being able to sleep AT ALL, palpitations and just generalised jitteriness.

my results 2nd December were:

TSH 0.77 (0.35-4.94)

T3 5 (3.1-6.8)

T4 13 (9-19)

Increased to 100mcg levo from 75mcg 10 weeks ago.

another thing to add, my TPO antibodies were in range and my TG antibodies were high in the 500’s. The GP didn’t test the TG just the TPO and said I don’t have autoimmune because the TPO is negative! I know that’s a load of rubbish though!!

thanks in advance!

[TiggerMe Ambassador]

Looking back at your previous results...

so I had private bloods done and got the results last week:

TSH 1.89 (0.27-4.2) T4 taken before test

T3 5 (3.1-6.8)

T4 25.6 (12-22)

The very next day the GP did the TSH and T4 again and the results are below

TSH 0.77 (0.35-4.94) T4 taken after test

T4 13 (9-19)

Seems you have a quick uptake of T4 and probably 87.5mcg would be a better dose to trial if able to cut pills, you could even split it into two doses a day to see if that helps smooth things out, let things settle for 6-8 weeks before retesting at 9am fasted last dose 24 hours before

How are your vitamin levels looking now? I see previously your Vit D and folate were a little low

[Hidden in reply to TiggerMe]

Thank you for your reply.

Interestingly I felt so much better before I started taking levothyroxine, ever since I’ve taken it I just feel awful. I was first diagnosed as ‘sub clinical’ so perhaps I’ve been taking too much? X

[TiggerMe Ambassador in reply to Hidden]

It doesn't work that way, once you take the replacement hormone your thyroid stops producing so you need to take a full replacement dose... but finding just what works is a little bit of trial and error and needs smaller dose changes as you get closer to your sweet spot

[Hidden in reply to TiggerMe]

Would you recommend re testing before adjusting dosage x

[TiggerMe Ambassador in reply to Hidden]

No, I'd say your symptoms along with previous results are telling you that you have jumped your sweet spot and hopefully you will notice the difference when you drop your dose just a little

[Hidden in reply to TiggerMe]

I don’t have a pill cutter so do you think it would work if I did 50 one day 100 the next?

[TiggerMe Ambassador in reply to Hidden]

The fact your level bobs up and down rapidly I'd say investing a couple of pounds in a cutter a wise investment but you can do it with a sharp knife and keep them in a pot

Generally levels of fT4 are quite slow to change, some people are sensitive changing doses daily

[Hidden in reply to TiggerMe]

I just don’t feel any better after 9 months on levo on various doses so not sure where to go from here as my levels are clearly optimal! X

[TiggerMe Ambassador in reply to Hidden]

No, your levels aren't optimal for you...as your fT3 was a little low on 75mcg and then jumping up to 100mcg has pushed your fT4 possibly a little too high and TSH too low which again can lower conversion to fT3

25mcg is too big a change so something in between is worth trying

[Hidden in reply to TiggerMe]

Ok, I think I’m going to try 82mcg for 6 weeks and re test in 6 weeks. Do you think I need to add any t3 in (privately) and can suppressed tsh and high t4 cause symptoms of fatigue too?

[TiggerMe Ambassador in reply to TiggerMe]

The results you have posted seem to be a mash up of the private and NHS results so not really much use

[Hidden in reply to TiggerMe]

It’s because for the private results I took my t4 the night before the test in the morning. These results above are from the NHS after not taking the t4 beforehand

[TiggerMe Ambassador in reply to Hidden]

The NHS tested your fT3?

[Hidden in reply to TiggerMe]

Yep x

[TiggerMe Ambassador in reply to Hidden]

and it came out exactly the same as your private test result under different conditions?

You didn't previously post a fT3 result with your NHS test?

[Hidden in reply to TiggerMe]

Sorry no, I got confused the NHS was only t4 and tsh which are the results above, the t3 is from the private test the day before

[TiggerMe Ambassador in reply to Hidden]

This is what I mean, you can't mix and match results from different tests as they are meaningless

[Hidden in reply to TiggerMe]

Oh ok. So do you suggest I stay on current dose and re test so I have all 3 results from the same time/place?

Any idea in regards to the antibodies? My TPO is in range and TG was high but GP said it’s not autoimmune and it was triggered by pregnancy!

[TiggerMe Ambassador in reply to Hidden]

Chances are pregnancy did trigger the auto immune reaction which is common, the trouble is the NHS only test TPO which are low but the TPA result shows you have Hashimoto's

You can either give this dose a little longer to see if it settles or drop it down a little and introduce the increase from 75 -100mcg more slowly which might give you a smoother ride and help with the symptoms you are suffering with

You are going to have to educate your GP... ask them to Google TPA results! 😳

[Hidden in reply to TiggerMe]

Thank you, do antibodies ever settle on their on or decrease? X

[TiggerMe Ambassador in reply to Hidden]

They do tend to fluctuate, gluten free diet often help as the body can get confused by gluten and for others cutting out dairy can help and for some both

Only results from the same test are any good, 24 hours after last dose of levo, pre 9am, fasted (water only before) if you always follow the same pattern then results are comparable

[SlowDragon Administrator in reply to Hidden]

common to initially feel a bit hyper as dose increases

It may settle

But if not …If going to reduce dose

Initially only reduce a LITTLE

Eg 100mcg 4 days a week

And 87.5mcg 3 days

Or if going to trial splitting current 100mcg dose as half waking and half at bedtime

Get a weekly pill dispenser and a pill cutter

Or sharp scalpel

hobbycraft.co.uk/swann-mort...

[Hidden in reply to SlowDragon]

Thank you! Do my levels look optimal to you?

[SlowDragon Administrator in reply to Hidden]

2nd December:

TSH 0.77 (0.35-4.94)

T3 5 (3.1-6.8)

T4 13 (9-19)

Are these the most recent results ?

Reading replies above …..possibly not?

Sorry no, I got confused the NHS was only t4 and tsh which are the results above, the t3 is from the private test the day before

TSH, Ft4 and Ft3 should be tested together, early morning and last dose levothyroxine 24 hours before test

If they are correct results

Free T4 (fT4) 13 pmol/L (9 - 19)

Ft4  only 40.0% through range

Free T3 (fT3) 5 pmol/L (3.1 - 6.8) 

Ft3 a bit higher at 51.4% through range

So definitely not taking too much Levo

[connyankee in reply to SlowDragon]

What if an increase of Armour from 105 to 120mgs produced pains and slight pressure in middle of chest for a couple of days? Go back to 105mgs?

[FoggyThinker in reply to connyankee]

connyankee suggest you start a new thread to ask your question as it won't be seen by many people in the middle of this thread and could cause confusion for the Original Poster

[Magyarkeszi in reply to Hidden]

Pill cutters are cheap and it keeps your dose more even.

[Lavellekelly in reply to Hidden]

I came off my tablets for 18 months and didn't feel any worse ,sugars raised a bit so went back on it

[Hidden in reply to Lavellekelly]

Can I ask what was the reason you came off x

[SlowDragon Administrator]

was test done as recommended, early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

what brand is Levo currently

Do you always get same brand

when did you last test Vitamin D, folate, ferritin and B12

What vitamin supplements are you taking

[Hidden in reply to SlowDragon]

Yes it was done as recommended.

I always get accord (pharmacist has it on the system)

I take iron and vitamin D along with Sertraline to treat anxiety. That’s the only medication I take (as well as Levo)

When I was first diagnosed it was classed as sub clinical so I’m not sure if I’ve just been taking too much? X

[SlowDragon Administrator in reply to Hidden]

Are you taking levothyroxine at least 4 hours away from iron supplements and vitamin D tablets or gels

Iron supplements at least 2 hours away from other supplements and medications

Vitamin D mouth spray only need be an hour away from Levo

how low was vitamin D

How much are you taking

Are you taking separate magnesium at bedtime (or early evening if taking levothyroxine at bedtime)

When were B12 and folate last tested?

Suggest you try splitting Levo

Initially

Take half waking and half at bedtime

[McPammy]

Looking at the two different blood results when taking T4 prior to test and secondly not taking T4 prior to test it would seem that you’re taking too much currently. Even though your TSH is just in range it’s clear you’re taking too much in one go with those results. I was in a similar situation and what I did was reduce slightly and split my t4 dose to twice a day taking half then the other half later on in the day. I’m take liquid levothyroxine which makes it easier to split accurately. But you don’t have to split exactly as long as you’re getting the right dose inside you within each 24 hr period. That way you’re getting the right amount daily but your t4 shouldn’t then go over range. It made a big difference to me when I split my t4. I’m on T3 medication which I also split. I’m symptom free now

[Hidden in reply to McPammy]

Amazing thank you so much. The GP said to continue on this current dose for another 6 weeks to see if it levels out because it could of been a hashis swing after some stress, however I might do what you suggested and half the 100 in to two morning and night to see if that makes any difference x

[McPammy in reply to Hidden]

Yes, try taking 50 in the morning and 50 later on. I take mine at midday and second half at 5pm. It doesn’t matter when as long as you avoid food when taking tablet form. After all your body naturally wouldn’t make t4 in one hit daily. It’d do it as required and gradually over the course of the day/night I’d imagine. As I’m taking liquid form I don’t need to avoid food. It might be worth requesting a trial on liquid going forward as it makes life so much easier and it’s absorbed much better than tablets too. It’s more expensive than tablet form so you might get some pushback from your gp.

[Hidden in reply to McPammy]

Just to add, I don’t think I need added t3 at this point do you agree? I have anxiety too so sometimes the symptoms cross over each other x

[McPammy in reply to Hidden]

You might be feeling anxiety when the t4 level goes over range. Start splitting today and see how you feel by the weekend. You might notice an improvement in anxiety. Thing is though I find taking T4 going to bed not good for me. You might be ok though. I worked out leaving a few hours and taking during the day worked for myself.

Your T3 result at 5 looks pretty good so looks like you’re converting well. I’m a very poor converter and only can convert 8% of t4 to t3 so that’s why I take t3. I’m so so much better splitting t4 and taking and splitting t3 now.

[FrostyKnickers in reply to Hidden]

Hi, sorry to butt in but even my endocrinologist said T3 should be at least 60% of the range. I stopped seeing him because we disagreed on some things but he tested ft3 and prescribed it for some people when their levels were low

[tattybogle in reply to FrostyKnickers]

endo's should not generalise like that , 60% may be a bit too much for some people and not quite enough for others .

Healthy people (not taking thyroid hormones) have all sorts of different T3 levels , some quite low in range, some quite high in range , some have T3 slightly higher than T4 , some have T4 slightly higher than T3 (although both are usually quite close in where they sit within the range (see the small sample of 10 people below) taken from this page thyroidpatients.ca/2022/06/...

Even though we know that taking thyroid hormone replacement changes this relationship between TSH / fT4 / fT3 levels somewhat , it is highly illogical to think that once taking thyroid hormone replacement everyone will magically be optimal at 'x' % , they are still individuals. and where they feel best, and how much thyroid hormone their body needs daily ,, will still be very individual .

,,

[FrostyKnickers in reply to tattybogle]

He's one of the few that is enlightened enough to prescribe T3, that's all I'm saying and personally at 60% I can barely function like the many thousands that contributed to the research I've read. I will be leaving this forum now because I see bad advice given on a regular basis.

I wish you all wellness though thyroid disease is tough when symptoms persist

[Heloise]

Hi CAB, just a thought since your thyroid numbers do not appear too high. Those symptoms could be applied to your adrenal glands. In fact if your thyroid hormone is inadequate your adrenal glands have to compensate which they do by using cortisol and adrenaline. It may account for the palpitations and no sleep as that's what they are paid to do. I don't know if this is correct in your case but I used to recommend John Bergman's video on you tube on the close connection between the thyroid and adrenal glands. Or you could look for newer information about that elsewhere.

[Hidden in reply to Heloise]

Hi Heloise,

Thank you for your reply! That would make sense, basically I ran a marathon last year, underfueling and overtraining for 6 months (unintentionally!) I also have 2 young children so perhaps the over exercise and under fueling has caused adrenal issues? Do you have any advice how to help those? X

[Heloise in reply to Hidden]

My daughter ran a few marathons and had the same issue. In her case I thought she was using up the T3 in her system. I'm a big believer and and take T3 only myself. I didn't convert well so it wasn't that I was overusing T3, I just could raise my levels of FT3. You seem to be doing pretty well with that. Are you still training?

We used to have discussions about adrenal support here and I've been here since 2013 but not so much lately. Back then I took Thorne's adrenal cortex and felt it helped me. Maybe you can find information in the archives. Best wishes.

[Hidden in reply to Heloise]

Oh that’s interesting - how is your daughter now? I’m not running no but I still keep very active x

[Heloise in reply to Hidden]

She's doing great and still runs, usually just 4 or 5 miles, and loves hot yoga. She has been on Thyroxine for years.

[Hidden in reply to Heloise]

Brilliant! How did she overcome her adrenal fatigue x

[Heloise in reply to Hidden]

I had adrenal problems but I think she just needed to raise either T3 or T4.

[jgelliss in reply to Heloise]

Great insight Heloise.👏👏👏👏

[Heloise in reply to jgelliss]

Hi H, hope you are doing well, don't come as often. You find me though, haha. Thank you!

[jgelliss in reply to Heloise]

Yes.I miss your very thoughtful and Informative wonderful posts. Glad when you do show up .Wishing A Very Healthy New Year.

Please come by more often.

[Heloise in reply to jgelliss]

It's definitely going to be a little tougher this year, H.

I just happened to see this post so stopped in. We've lost some good people, but I'm glad so many people find it. I hope you stay healthy and happy as possible, too!

[jgelliss in reply to Heloise]

Yes it's very very sad and tragic we lost Diogenes and Seaside Susie. Tremendous and Valuable members of our Thyroid Community. I still have a hard time to wrap my head around it. Very very giving of themselves to help us all. Lets hope they are Praying for us all.

[Franjy]

Are you sure you're not menopausal? It sure reads like that despite seeing your age. Anyway, I'd check that first before you do anything re: thyroid meds.