FT4 over range, ok to skip Levo for a day or tw... - Thyroid UK

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FT4 over range, ok to skip Levo for a day or two then reduce dose?

11Ananke11 profile image
14 Replies

I got my results back today and FT4 is over range. I plan on reducing Levo from 100 to 75mcg and testing again in 8/10 weeks. I guessed I needed a reduction as I've been feeling over medicated.

I'm wondering if I should skip Levo a day or two then take the reduced dose.

TSH 0.794 mIU/L (Range: 0.27 - 4.2)

Free T3 4.6 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine X 26.7 pmol/L (Range: 12 - 22)

Thanks!

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14 Replies
tattybogle profile image
tattybogle

personally , i'd say yes , if you feel overmedicated, then skip a day , or just take half dose for a couple of days , then resume at lower dose ~that's what i do if i feel definite symptoms of overmedication , doesn't seem any point topping up a pot that's already overflowing ~others may disagree and say it's better to do things more gradually.

tattybogle profile image
tattybogle in reply totattybogle

p.s having said that , just noticed you intend to reduce from 100 to 75, you might find that is too much of a reduction and you'd end up feeling undermedicated once new dose settles . it might be better to reduce by 12.5mcg rather than 25mcg for now and see how that feels first. I find 12,5mcg adjustments are enough to achieve a change i how i feel and in blood results . (usually done by taking eg. 100mcg/ 75mcg alternate days to get 87.5mcg )

Regenallotment profile image
RegenallotmentAmbassador in reply totattybogle

I agree, I did this exact move having FT4 at 28 (12-22) and 3 months on I was getting quite hypo. Small adjustments really work better 🙏

11Ananke11 profile image
11Ananke11 in reply toRegenallotment

Good to know, thanks. I'll do the 87.5 instead.

11Ananke11 profile image
11Ananke11 in reply totattybogle

Thanks for your help Tatty, very much appreciated. Alternating days is a great idea.

Cats416 profile image
Cats416 in reply totattybogle

I have lost a lot of weight and in November I was very overmedicated with horrible symptoms. I had my levothyroxine dropped twice by 25mcg each time and I still have symptoms of being overmedicated. I want off levothyroxine! These hyperthyroid symptoms are too much for me. I'm going off it and my GP will check my blood work in a few weeks.

11Ananke11 profile image
11Ananke11 in reply toCats416

That sounds horrible Cats, hope you feel better soon. I'm hoping to lose more weight over the next few months so I'll really need to pay attention to this. I didn't take levo this morning and feel a wee bit better already, my heart isn't as fluttery. Please keep us posted on how you get on.

Regenallotment profile image
RegenallotmentAmbassador in reply totattybogle

Was going to say the same thing 👆

Jaydee1507 profile image
Jaydee1507Administrator

Just checking that you allowed 24hrs from last dose of Levo and this test?

Your FT3 is on the low side at only 40% of range and can be a reason for feeling over medicated too.

What are your latest vitamin results and what are you supplementing with?

11Ananke11 profile image
11Ananke11 in reply toJaydee1507

Hi, yes at least 24hrs.

My FT3 seems to sit around 4.2 - 4.6 so yeah, not great. I'll try introducing T3 at some point.

I've lost weight and think that might be why I am now over medicated.

Last Vitamin test was a year ago so I really should get that done again. I'm taking B complex (stopped 2 weeks before test) and Better You D3 (3000IU)/K2 spray (I take 5 sprays instead of 3), Magnesium Citrate 400mg.

Iron Status

Ferritin X 252.00 ug/L (Range: 30 - 150)

Vitamins

Folate - Serum ! Sample error

Vitamin B12 - Active >150 pmol/L (Range: 37.5 - 188)

Vitamin D 64.9 nmol/L (Range: 50 - 250)

jimh111 profile image
jimh111

You can use a half-life calculator but as a rough guide skipping one day will lower your total T4 by about 10%.

11Ananke11 profile image
11Ananke11 in reply tojimh111

Thanks, that's really good to know.

SlowDragon profile image
SlowDragonAdministrator

was test 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)

Essential to test vitamin D, folate, ferritin and B12

What vitamin supplements are you taking

11Ananke11 profile image
11Ananke11 in reply toSlowDragon

Hi, test was done at 6:20am on an empty stomach, glass of water before taking the test as per test instructions. Last Levo was just over 24hrs before test.

Vitamin test needs updating but I've posted the last one on my reply to JayDee .

Thanks.

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