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  • Am I on too high a dose?

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    Old 04-27-2013, 10:19 AM   #1
    Rae28
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    Am I on too high a dose?

    I just got lab work done. Did NOT take meds the morning of labs.

    FT4 1.28 (.82-1.77)
    FT3 4.5 (2.0-4.4)
    TSH <.006

    I am on 3.75 grains NP thyroid daily plus 137 mcg Levo once weekly.

    I feel like I can't tell if I'm hypo or hyper. I have a bit of anxiety and jitteriness. My heart at rest is faster than normal. I have insomnia. BUT I often get those symptoms being hypo, too.

    I am also newly pregnant, so pretty sure I will need more meds as time goes on.

    What should I do? Stay on this dose or drop it back to 3.5 and retest in a month?

     
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    Old 04-27-2013, 04:13 PM   #2
    lakeshow24
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    Re: Am I on too high a dose?

    Hey Rae! When did you increase your dose from 3.5 grains to 3.75 grains? Im pretty sure your FT4 is supposed to be in the middle to upper range and your FT3 should be in the upper range. TSH will be suppressed. How did you feel on 3.5 grains and why did you increase the dose?

    If you just increased your dose and you are feeling jittery give it a few more days, but if you have been feeling jittery for a while then it is probably hyper symptoms. You should keep increasing by half a grain about every 2 weeks until you reach your optimal dose where the symptoms disappear.

     
    Old 04-27-2013, 04:14 PM   #3
    lakeshow24
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    Re: Am I on too high a dose?

    Hey Rae! When did you increase your dose from 3.5 grains to 3.75 grains? Im pretty sure your FT4 is supposed to be in the middle to upper range and your FT3 should be in the upper range. TSH will be suppressed. How did you feel on 3.5 grains and why did you increase the dose?

    If you just increased your dose and you are feeling jittery give it a few more days, but if you have been feeling jittery for a while then it is probably hyper symptoms. You should keep increasing by half a grain about every 2 weeks until you reach your optimal dose where the symptoms disappear. If it is hyper then you should decrease your dose.

    Last edited by lakeshow24; 04-27-2013 at 04:16 PM.

     
    Old 04-27-2013, 06:27 PM   #4
    Rae28
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    Re: Am I on too high a dose?

    lakeshow,
    I've been on the 3.75 for 6 weeks. I increased bc I was raising 1/4 grain every 6 weeks til I found my "sweet spot". I just can't tell if I've overdone it or if I need more, or if the new pregnancy is contributing to the symptoms I'm having, etc.
    I hate trying to figure all this out!!!!!

     
    Old 04-27-2013, 07:03 PM   #5
    lakeshow24
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    Re: Am I on too high a dose?

    Wow for 6 weeks. I usually cant stay on a dose of naturethroid for more than 2 weeks without increasing cos symptoms come back. I just started taking it 2 months ago and am at 3 grains (just increased from 2.75 to 3 this morning). Did you feel the anxiety and shakiness at all during your 6 weeks of 3.75 or is it recent symptoms?

    I'm a guy so I have no idea how pregnancy messes with your hormones but I'm sure that is probably contributing to your recent symptoms. Why dont you try lowering the dose down to 3.5 grains in a few days if your symptoms dont improve. Then take it from there. Hopefully someone else can chime in.

    Last edited by moderator2; 04-27-2013 at 07:07 PM. Reason: please do not post a commercial website for any reason

     
    Old 04-27-2013, 07:43 PM   #6
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    Re: Am I on too high a dose?

    This seems like a high dose, your symptoms are consistent with hyperthyroid state, your FT3 is a little high, and your TSH is way too suppressed. You need to be on a lower dose, and with a newly pregnant state as well, your Dr needs to be consulted. Pregnancy will not increase your need for thyroid when stable on meds. I've never heard of taking levothyroxine once a week. Your levels need to be monitored carefully, as with hyperthyroidism the baby may gain insufficient weight. I would consult both your OB and endo Drs.

     
    Old 04-28-2013, 05:05 AM   #7
    Rae28
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    Re: Am I on too high a dose?

    Ladybud, my TSH is always suppressed, even when my Frees are
    Low I'm their ranges. It's been <006 for years now.

    Pregnancy for me (this is my 7th) has always caused an increase for more meds, and a study I read awhile back even suggested that hypothyroid women increase their dose upon confirming pregnancy because the majority needed a 45% increase within the first few weeks.

    That's why I'm hesitant to lower my dose.

    My OB knows nothing abt thyroid and my doctor lets me treat by symptoms. That's why I'm turning to y'all.

     
    Old 04-28-2013, 07:58 PM   #8
    Rae28
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    Re: Am I on too high a dose?

    Can anyone else offer any other thoughts?

     
    Old 04-29-2013, 08:48 AM   #9
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    Re: Am I on too high a dose?

    Having no medical guidance about dosage is worse than having too much interference, I think. And now... With a baby to consider in the mix!

    I would say you are probably overmedicated. My own doctor considers heart rate an important sign. If yours is high all the time in a resting state, your dose should probably be reduced. Above range FT3 is a good sign you're taking too much. Your symptoms say "hyper", your labs say "hyper". It only makes sense to adjust the dose down to see if it helps.
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    Old 04-29-2013, 09:38 AM   #10
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    Re: Am I on too high a dose?

    Another complication of prolonged hyperthyroidism is osteoporosis. If your TSH has been undetectable (where it is now) for years, you are clearly on too much medication and have been for a long time. I would get a bone density test after delivery, as a baseline, and if these doses are being condoned by your Dr, I would get a new Dr! Being in a constant hyperthyroid state is harmful to you, and now to your baby, and may certainly adversely your fetus's development. Your resting heart rate should be in the 60-85 range. If resting heart rate is usually 90 or above, or pounding, that is a good sign of hyperthyroidism.

     
    Old 04-29-2013, 10:08 AM   #11
    Rae28
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    Re: Am I on too high a dose?

    ladybud, thank you for your concern, but I have not been over medicated for years. It is well known in thyroid circles that one does not dose by TSH. If I did, I'd be non functioning. To get my TSH anywhere near an "acceptable" range, my actual thyroid hormones (Frees) fall completely into the garbage.

     
    Old 04-29-2013, 10:14 AM   #12
    Rae28
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    Re: Am I on too high a dose?

    Midwest, I have had medical guidance this entire time (20+ years). And fired over a dozen doctors, lol!, who have only ever wanted to treat my TSH which kept me sick, sick, sick. I finally have a doctor who does things as he was taught - old school - and leaves things up to the patient and his/her symptoms.

    I am only .1 over the FT3 range, and like I said my heart races when hyPO, too. So I wasn't certain of what to do. I am thinking however that I'm indeed a touch over medicated but will keep an eye on things because with every other pregnancy I've needed a pretty hefty increase in meds in a short time.

    Last edited by Rae28; 04-29-2013 at 10:15 AM.

     
    Old 04-29-2013, 10:15 AM   #13
    midwest1
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    Re: Am I on too high a dose?

    Quote:
    Originally Posted by Rae28 View Post
    ladybud, thank you for your concern, but I have not been over medicated for years. It is well known in thyroid circles that one does not dose by TSH. If I did, I'd be non functioning. To get my TSH anywhere near an "acceptable" range, my actual thyroid hormones (Frees) fall completely into the garbage.
    Absolutely correct. Multiple studies have concluded that suppressed TSH is only tied to long-term, untreated, naturally-occurring hyperthyroidism as seen in Graves' disease.

    My own TSH hasn't been higher than .02 in more than 10 years. The four DEXA scans I've had during that time prove that it isn't hurting my bones. TSH with natural thyroid treatment is completely moot, except to say it should be suppressed for treatment to be optimized.
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    Old 04-29-2013, 10:20 AM   #14
    midwest1
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    Re: Am I on too high a dose?

    You know your history, of course. But unless you've had these kinds of labs before and felt fine that way, what they show now is that a tiny dose decrease might be in order. If it isn't, you can always bump it back up again!

    Good luck to you and your wee one.
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    Old 04-29-2013, 10:33 AM   #15
    Rae28
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    Re: Am I on too high a dose?

    Midwest, that's the excitement of the whole thing for me. I haven't had labs this great in yeeeears! And I know hyper isn't great, but to me I'm finally seeing numbers working together well. Usually my FT4 is bottomed out and my FT3 has never, EVER made it even to midrange!

    And even then my TSH teetered between .006-.01.

    I have cut back to 3.5 grains after skipping meds entirely for two days. I will just make sure to get labs again soon, and already I've noticed my heart has slowed back down and the anxiety is leaving.

    Glad y'all are here. Thank you!

     
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