You folks have aleady answered two questions for me which led to this latest inquiry. I was incorrectly treated and overdosed with L-Thyroxine making me extremely HYPER. I am diabetic as well and lost control becuase the hormone causes insulin resistance. I have been reducing the homone from 150mcg down to 37mcg for a month now and today I took nothing for the first time.
However, My blood pressure has been going up for several weeks and continues to do so. I was 210/90 yesterday and BP meds for 10 days now have no affect. Members of this forum found the answer to that question at the Mayo Clinic yesterday which basically states that the high systolic number is mostly likely the result of being very HYPER. Since I've been reducing the meds for a month now I can't see how this could still be possible.
Then it occured to me that perhaps my own Thyroid Gland has somehow been pushed back into functioning due to the reduction in outside additions in L_Thyroxine which would increase my TSH. I'm thinking that my body may be trying to compensate becuase yesterday I still had a high BP /AND/ hand tremors which are another symptom of being HYPER. I don't think my blood levels could still be high enough to cause this unless my own body is making hormone again. ???
Levothyroxine doesn't increase your TSH. Levothyroxine increases FT4, which is converted to FT3 and used by the body. Theoretically, when hormones are higher, TSH should be lower; however TSH often becomes a mute point once a person is on replacement medication.
Whether or not your own thyroid gland started producing hormones or not, depends on the cause of your hypo to begin with. If you have Hashimoto's, it's very unlikely that your thyroid would start working again, unless you're swinging hypo to hyper, which can happen in the early stages.
What are your latest thyroid lab results. Please be sure to include reference ranges, too, since those vary lab to lab and must come from your own report.
Hyperthyroidism caused by taking too much thyroid hormone medication for hypothyroidism is called thyrotoxicosis factitia (also called factitious hyperthyroidism, factitious thyrotoxicosis, thyrotoxicosis medicamentosa).
When thyrotoxicosis factitia occurs because the prescribed dose of hormone medication is too high, this is called iatrogenic or "doctor induced" hyperthyroidism.
Hyperthyroidism is one of the causes of a wide pulse pressure. Your pulse pressure is wide at 120 mmHg. Pulse pressure is normally around 40 mmHg. Eg: 120/80 = 40. The forceful cardiac contraction increases the systolic blood pressure.
Thyroxine takes time to build up in the blood (around 6 weeks) when staring thyroid replacement so this is a rough idea of how long it could take for hormones to lower back to normal after you have stopped medication. This may be longer depending on how much excess thyroid hormone is in the blood.
Serum thyroglobulin is a lab test you could request if hyperthyroid symptoms continue. Serum thyroglobulin is usually low or low normal with thyrotoxicosis factitia unlike all other causes of hyperthyroidism.
Since I know from another of your threads that your testing has been pretty inadequate (TSH only), I'm guessing you haven't had antibody tests, either, and don't know if you have Hashi's or not. File away TPOab (thyroid peroxidase antobodies) and TGab (thyroglobulin antibodies) as two more tests to request...they will confirm or rule out Hashi's.
As Barb said, initial stages of Hashi's can include swings from hypo to hyper, but if the antibodies are destroying your thyroid function, it very, very seldom spontaneously resolves. That being reiterated, however, there are a couple of types of "temporary" thyroiditis (researach DeQuervain's and silent) that can and do frequently spontaneously resolve. Both are characterized by an initial hyper phase, followed by a return to normal, a hypo phase and a (sometimes slow) recovery.
Without blood work (don't mean to beat a dead horse), it's impossible to know if you are hypo or hyper at this point. In my opinion, TSH is such an unreliable diagnostic that without supporting FT3 and FT4 numbers, it's possible that you were quite overmedicated for a fair amount of time. You weaned off levo, and only just today discontinued it, so your FT3 and FT4 could still be quite high. Depending on your actual T4 requirements, you might have still been overmedicating until yesterday!
I had high BP when overmedicated the last time. My doctor advised me to d/c thyroid meds for 3 days, then resume at my former dosage. The three days off did a lot toward relieving hyper symptoms, but it took 10-14 days for them to go completely, and I had caught the overmedication immediately and hadn't been hyper for more than a day or two.
Today I completed my written workup detailing how badly my medical treatment has been handled for the past 6 months. Tomorrow I'm going to submit my report at the clinic and I'm sure this will bring about many changes. My report does not speak as a doctor /or/ talk about all I've learned from you and others here on this forum group. It's a simple, factual document which speaks for the mistakes in a gentle yet frim way. I don't think what happened to me was pre-meditated, just unfortunate .
My BP today was 205/90 so the pulse width is still 5+ times normal. Based on other information from this group, taken from the Mayo Clinic, Isolated Systolic Hypertension is serious and difficult to treat without lowering Diastolic to much. I DCd the Levo totally today and perhaps I waited too long but wanted to wean just to be safe. My body is already badly weakened from the months of 500+ blood sugar levels I endured and the consequential neuropathy and retinopathy suffered as a result.
I am writing down all I'm learning here from you great people so I can begin diagnostics once again in a few weeks. This time I'll know what I need and be certain to get it. My thyroid was damaged many years ago after 3 years on Lithium for another misdiagnosed malady. Still, with only 2 known TSH results, I can't say anything intelligent to help you all. My plan is to get well and I'm suffering badly now and more to come before it gets better.
My greatest comfort has been this forum and even my ER Doc buddy has learned a great deal about Thyroid Disorders and Treatment. He's a great guy with NO EGO problems and simply was never trained sufficiently about diagnosis and chronic care of this desease. He deals with acute and very short term care so he could not do much to help me this time. I will certainly stay with this forum and report further results. Perhaps I can help others from my experience as you and others are doing and have done for me.
I'll keep posting to share what caused the high BP for sure.
No, what happened to you I'm sure was not pre-meditated. Unfortunately, lack of knowledge in thyroid care is rampant. The more I see of doctors, the more I wish it were limited only to thyroid care. Best of luck with your report to the clinic. Are you a doctor? Best not to mention online forums...makes many doctors very nervous that we might be educating ourselves.
I'm afraid you're probably right about more suffering before it gets better.
ER doctos are in an entirely different realm. Care of chronic disease is pretty far afiled from what they're trained to do. A doctor with no ego? Is he married??? LOL However, with him as a friend, you can at least rest assured that he COULD order any diagnostics you require should you have trouble getting someone else to do so.
Please do keep us informed on how it goes. Textbook cases really don't learn a lot about their disease, do they? I'll be interested to see how your BP reacts in the next few days after d/cing and in the next 7-10 after that.
I think I am an oddball. I had hashimotos hypothyroidism for several years before swinging hyper. I was taken off meds and flip-flopped back and forth between hypo and hyper for a bit. I was off meds for about a year and eventually kept going hyper so I had to have my thyroid removed. Of course now I don't have a thyroid at all and I still swing back and forth a lot, sigh. I guess I am not the norm, but it can happen.
Keeping you posted on my progress. I previous said that I completely discontinued Levo at 37mcg but did that for only 2 days. By the third day my BP was still high and I was getting very weak and doing nothing again. I feel like I'm going HYPO after 2 weeks at 37mcg but can't know for sure.
Blood pressure is coming down a little and now at 180/80 which is heading in the right direction. Thing is, I don't know if the BP meds are responsible for the drop /or/ that my blood levels of Levo are coming down enough to help. It's hell to work without lab results and I'm afraid to go back up on Levo and raise BP again. No word from the clinic yet on my formal written complaint but it's only been 3 business days.
So... started back on 37mcg couple days ago and felt much better for 2 days. Then I had a day feeling weak and useless so I increased to 50mcg for the past 2 days. I did not respond feeling better with the second increase to 50mcg so I will most likely go back to 37mcg and hold while I wait for a clinical response. I need it to keep working and not feel so sick.
I know my first TSH was 11.2 and a single month on 150mcg brought me to .3 TSH. I guess I'm saying that I know I need some by how I feel but anything above 37mcg will only help for 1 day. Then I just feel sick and don't want to do anything. So I write this just to keep you all informed for whatever learning can be gleaned from my unfortunate experience.
I would advise others not to play with dosages as I am right now. It's purely to learn all I can about the relationships to how I feel /and/ my BP at this point. My mind tells me I should be taking 100mcg daily in a perfect world. These meds are not intended to be played with as I'm doing. I'm trying to keep working while recovering from a serious overdose. Without it I can barely think or do anything physically.
Gee, no one even has to argue with you...you're really good at presenting both sides of the argument!
I wish I had as much faith as you do in a speedy reply from your clinic to your letter. Given the litigious climate of our society, I would suspect that kind of a letter wouldn't be responded to until reviewed by their legal department...and once they get ahold of it, I wouldn't expect anything to move quickly. It's not hell to work with no lab results, it's impossible.
Of course, you're right about not playing with the dose. They're not intended to be played with that way, and really you learn absolutely mothing by playing with them that way. How you feel today is the result of all the meds you have taken in the last 4-6 weeks (with diminishing importance the further back you go), so upping your dose for a day or two is more likely to be detrimental than helpful and how you feel will not be reflective of that dose.
My best advice to you would be to order up FT3, FT4 and TSH online ($85 for all three last I looked). You'll have results the next day or day after and can make some truly intelligent decisions about where to go. I just fear your clinic will drag their feet and you will be miserable way longer than necessary.
I suppose you're right in saying I argue both sides. I'm a computer systems engineer with 40+ years experience. Diagnosis and experimentation are my nature as is the practice of debating a problem from both sides to see who wins. What I'm doing with the meds was a desperate action on my part.
I'm basically alone and sometimes lonely folks will do weird things. I do know that the clinic is not rushing to welcome me back but I'm trying to stay optimistic. I know they just want me to go away but my hope was that they would at least try to correct the damage somehow. If they don't answer in a few days I'll move to the lawyers who will only take the case if I'm really injured. Not hopeful but my ER Doc buddy insisted I go on record at the very least in case the complications cause a stroke or worse.
I'm going to call a local lab today and ask the price for the Thyroid Panel. I can just walk in and get that done having you folks to post results to /and/ a Doc to call in meds for me. Money is tight right now so I'll have to work that part out but then we'll have something to go by. I suppose I would need to add the TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies) tests as well.
Thanks for the continued support and I've stopped the meds again and will leave it that way until blood work is done. It's just making me sick at this point and BP is not coming down.
I was a systems analyst for years. So, I know what you mean...diagnosticians with a "different" kind of patient.
TPOab and TGab would be a good addition. However, I wouldn't delay the FT3 and FT4 over them. What's important right now is getting your thyroid hormones under control. You can find out later what's causing your hypo if necessary.
I understand your frustration over the BP. Have you tried any different meds to control it?
There are many out there who have had TT & still swing back & forth due to being under/over medicated. Many just don't post. I have 2 co-workers who have had thyroid issues & like us they go up & down..
I had a TT almost 19yrs ago & still have my hypo flares. I just got dosage upped to 200mcg in June.
I did get a reccomendation from Dr. Lupo to ask for T3 in combination to the T4 to see if that helps.
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