What causes the problems with meds?

[diazmommy]

I stopped meds a few weeks ago because I am very sensitive to them. I was only on a low dose 13 mcg of tirosint and tried to move to 18 mcg and my body rebelled it. It has happened several times.....I get really energized and alert off a small dose and it causes insomnia. In the past I usually stopped cold turkey since  it was a low dose  and things would normalize back and then I could restart my dose. It would not cause any major probems for me.

Well this time.....I felt fine for about 2 weeks and then I started feeling horrible......I mean HYPO.  I know that was about the time the meds left my system and now I realize that I should not have completing stopped. However, I was basing this off every other time I did it......this time lesson learned!

I had to restart the meds and I immediately started at 25 (I know this is more than last time) but I felt so hypo and much worse than ever when I started 13 or 18.  It has been a little over a week and I have started to feel a little bit better but still tired.

My question is:  why is it when you start the meds things like anxiety and problems sleeping occur?  (It is starting now and has every other time with me) Is it that I am just sensitive or is there a better explanation. It feels like my body decideds to go into flight or fight at random times and even though I am exhausted...I cannot sleep.  This is not from being hypo. I have been hypo many times and mainly I am just plain tired. It is the meds.....I just cannot figure out why? Any explanations?  

Also my labs below do not seem that bad. I  have been at those levels before and have not felt like this.....why does the way I feel vary even those labs are similar?

P.S. Here are my labs from about a week ago before starting meds.....I need to get my FT3 but the original fax was cut off.....will have that tomorrow when they refax.  

TSH  5.05  (0.27-4.2)
Free Thyroxine  1.14 (.80-1.70)

[Barb135]

I've always just alternated 2 doses - in your case, I would have alternated 13 and 25....... one day 13, next day 25, for an average of 19/day, but it works either way. Of course, you have to have your doctor's blessing in order to get the different dosages, which makes self medicating pretty much impossible.

I went through a long period just like you are -- falling to sleep, but not staying asleep (still do sometimes).  The tylenol pm helped some, but I mostly just had to bump on through it. I also discovered that a lot of my issue was anxiety over things that were happening in my life that were out of my control.  You might want to take a look at what's happening around you and see if there could be something else contributing to your sleep issues, other than thyroid. Because we know the thyroid can wreak havoc with the entire body, it's often easy to blame things on it, that might not be related. This may not be the case with you, but it's worth looking into.

[diazmommy]

I did 13 one day and then 2 of the 13 the next (every other day).  Tiny bit over 18 per week I believe.  Is that the right way?

[diazmommy]

Thanks Barb!   I will keep on trucking...I usually go to bed every night same time.  It is the going to sleep not staying asleep that gets me.  I will try the Tylenol pm or I may add my melatonin back in to help.  Will keep you posted and thanks again!

[Barb135]

Meant to ask you -- how did you move from 13 mcg Tirosint to 18 mcg?  These are gel caps and not "splitable" (new word?).  Did you alternate 2 different dosages?

[Barb135]

Oh - I'd love to have your FT3 level....... my latest one was only 3.1 and I have hypo symptoms.

No, I don't think you should increase until you give the med a chance to stabilize.  Increasing/decreasing too quickly is what got you into trouble.  Even though you usually feel better after a week, the medication is not stabilized in your body and with your FT3 as high as it is, you could go hyper again, quickly....... this could become a vicious cycle.

What is your schedule like?  Do you get up and go to bed about the same times every day/night?  When I had sleep problems, my endo recommended that I take Tylenol PM to help me get/stay asleep.  I ended up having to split them into quarters, because a whole one left me too groggy in the morning, when I had to go to work.  You should talk to your doctor about that.

[diazmommy]

Another question...I do not feel that much better after a week of 25... Can I go up some more on my dose or should I wait?  I know it takes 4 to 6 weeks but usually I feel better after a week?

[diazmommy]

Hi Barb

Here is ft3:

3.54 (1.80-4.20)

I know you are right about stopping meds..... This is the first time I have had a bad reaction to doing that.  I have learned my lesson!  Have never had adrenals checked....I find that I am most tired during the day and hen "wake" up more at night.  Still tired but cannot sleep.

[Barb135]

Forgot to mention -- the "fight or flight" could also depend on what's going on in your life.  If you've been under a lot of stress for a long time, it may be harder to regulate thyroid hormones, because the adrenals do try to compensate when the thyroid doesn't produce adequately......if conditions warrant, sometimes we stay in a constant state of "ready for crisis"......  I've been there for at least the past 2 yrs and even beyond.

Adrenals need to be treated before thyroid.

[Barb135]

Your TSH is too high, and your FT4 is too low...... this indicates hypo and I'm guessing your issues are not caused by the med - Tirosint is as hypoallergenic as you can get, because there are no fillers/binders to worry about, and the active ingredient (levo/T4) is identical to what your body would produce if it could.

You can't keep stopping and starting the meds - you can cut back or you can increase, but you're playing with your dosage too much... You have to give each dosage change at least 4-6 weeks to take full effect.

It's not unusual for patients to report exaggerated hypo symptoms when starting a med or increasing a dosage.  It takes time for the body to get used to having hormones you've been doing without........

Sleep issues can be just as prevalent with hypo as hyper....... I've been hypo for well over 5 yrs (never hyper in that time) and I've had tons of sleep issues.... the hormone levels have to get right for your body before you will feel well.

Please post the FT3 level as soon as you can...... that will help us further assess your situation.

Have you  been tested for adrenal issues? That's where the "fight or flight" comes from, but thyroid issues can make us feel the same way....