Missed two days of Synthroid, okay to double dose?

[derekkka]

I'm on 200mcg. I missed my Synthroid dose two days in a row. Anyway I took the Synthroid today finally, but right now and all day yesterday I've been feeling iffy. Libido is low, feel slightly down/depressed over absolutely nothing, energy isn't great. Way more tired in the mornings and at night than usual. Can I really get acute low thyroid levels this quickly? Or is it something that won't take effect for weeks?

[goolarra]

Of course, this is not the time to have labs drawn and base any medication changes on them.  You skipped a couple of doses, then you doubled up.  So, labs are not going to tell you much.

How were you feeling before you missed your doses?  If you were feeling good, the plan of action seems simple:  Get back on your routine and wait for your levels to stabilize again.  

Can you have some symptoms after that length of time?  Sure.  Are your levels critically low, i.e. below range?  Very doubtful.  Your levels are simply a bit lower than your body likes them.  If you go back to doing what you've been doing, you should start to feel the way you felt before missing your doses relatively quickly.

[derekkka]

Also to note I've woken up with cold feet and arms the past couple mornings. I'm not in a cold room, its warmer actually. I'm usually super vascular in my arms each morning too, but not these recent ones. Definitely pretty sure my levels are low.

[derekkka]

I took two today within two hours of each other. Don't have any acute bad side effects. Still feel the same as the past couple of days. Going to get a thyroid panel done now. Not sure if the double dose today will have a big affect on it but I'll ask.

[Red_Star]

Last time I stopped my medication cold turkey (I was hyperthyroid) I was hypothyroid in about a day. And then it took 2 weeks to be able to breath better. If my breathing worsens I'll take another tablet regardless if I have taken on that day and it starts to work within maybe 1 to 1 1/2 hours or so. So yes you can feel that bad that quickly.

[goolarra]

If you read the literature on Synthroid, they will tell you not to double up to compensate for a missed dose.  Practically speaking, however, because T4 is so slow acting and is the "storage" form of the thyroid hormones, when we take it is not crucial.  If you have any sensitivity to the meds, I certainly wouldn't double up.  You are also on a fairly high dose, which once again would make me wary of doubling.  

Your levels are not acutely low; they're simply lower than you are used to.  You've probably just fallen out of your sweet spot a little and will come back up quickly.

A missed dose will continue to "haunt" you for 4-6 weeks.  FT4 level today, because of the long half life of T4, is a compilation of everything we've taken for the past 4-6 weeks.  Of course, the longer ago the missed dose was, the less effect it has on levels.