Overmedicated Thyroid

[Vicschick]

A year and a half ago, a doctor put me on Armour thyroid because I had a lot of symptoms of hypo but my bloodwork all showed my thyroid to be functioning perfectly.  He said sometimes, people have the symptoms but their blood work doesn't show it.  Well, I started low and gradually worked my way up.  Several months ago, he upped my dose again because of symptoms.  Five weeks almost to the day (Tuesday a week ago) I woke up with horrible anxiety, racing mind, pounding and very rapid heartbeat, hot flashes like crazy, couldn't eat, and very high blood pressure (I don't normally have high blood pressure).  I took my thyroid that day but called the dr. and he said its the thyroid, stop taking it for three days then get back on.  On Thursday, I went to my internist (not the guy who put me on the thyroid) and he said it was classic overmedication.  Put me on a very low dose beta blocker.  Drew my blood and tested TSH, free T3, free T4 and for Hashi's.  Called me on Monday and said my bloodwork was in the normal range (I don't know the numbers) but he still felt like it was too much medication.  He said just because your labs may say "normal" does not mean your body is not extremely sensitive and you feel the effects of too much medication long before your labs say you are overmedicated.  My BP was still extremely high this Tuesday and he put me on a drug called Diovan...still no thyroid medicine.  He told me this could take several weeks to even out.

My question is has anyone else experienced overmedication and if so, how long did it take to feel not crazy with anxiety?  This is brutal and I just want it to go away.  After 10 days of no thyroid medication, I am not exhibiting any symptoms of hypo that I did almost two years ago.

Thanks for your replies.

[Barb135]

This is an old thread, so not likely that Vicschick will respond.  

Can you post your actual thyroid hormone levels, so we can see exactly where you're at?  Please be sure to include the reference ranges, since these vary lab to lab and must come from your own lab report.

[mfletelier]

Hi,
I have been in the same boat for some time. I had a low free t3 and was put on armour, I was ignorant and did what the doctor told me. I was fine for 9months and then became hyper. Lowered the dosed and it seemed to improve for a week. Then became very hyper, especially insomnia. I went off meds for 6 months. In time, hair fell out, sleep continued to be a problem as my body has been programmed with insomnia, and the low t3 I believe does not let me rest at night, I wake up all night, fatigued became bad, and my colon stopped contracting altogether. Colon surgeon suggested I remove it. I was skeptical, because all this happened with thyroid, I was constipated before, but nothing like colon ceasing to work altogether. I contacted an open minded endocrinologist, who started me on low doses of t4 and t3, like very small dose. At first, energy for a couple of weeks, then jittery started, and then insomnia went way up, out of control. Labs just show low levels of t3 and t4 now (before only low t3) and TSH is going down very very fast. I am confused and not sure what to do to get my life back.

[Vicschick]

Okay, I just got my numbers and here they are:

TSH:  .53 - reference range of .40-4.50
T4 total:  7.9 - reference range is 4.5 to 12.0
T3 total:  127 - reference range is 76-181
T3 uptake:  27 - reference range is 22-35
Free T4:  2.1 - reference range is 1.4 - 3.8

Now, what does this all mean?  It looks pretty normal to me but I certainly did not feel normal at all and I'm still having moments where I feel very energetic then it calms down.  Maybe its just all in my head and I'm going nuts.

[allmymarbles]

I was using myself as an example. If I have a headache I take only half an aspirin. When I developed high cortisol and resulting panic attacks, I was put on Xanax as a stop-gap while being treated. The doctor, knowing me, put me on the smallest dose (.25mg). I broke the pill in half and that usually worked for me. (I was careful not to use it on a maintenance basis because that stuff is nasty.)

[Vicschick]

Thank you all so much for your comments and insight.  It sure makes me feel better.  The farther I get away from the thyroid pill, the better I'm feeling.  You know not ONCE in almost two years of being put on the T4/T3 did the doctor ever check my blood levels.  Grrrrr.  Haven't heard from my internist's office yet with the numbers but I'm hoping she will call today and I can post them here.

And Barb, my internist told me that when he treats a thyroid disorder, he gives the medicine at the lowest dose possible and waits 6-8 weeks, retests the blood, and will start adjusting from there.  He always goes slow until he gets a patient to symptom relief without overmedication.  He's a good guy.  Unfortunately, he's not the one who put me on the thyroid med in the first place.

This has certainly been a learning experience for me.  Metabolic hormones are not to be messed with if you do not know what you're doing.  I cannot imagine taking this medicine and feeling like this to lose weight......which a lot of weight loss "doctors" use.  I don't EVER want to feel like I felt in the last two weeks again.

[Barb135]

Hope you don't mind me using you as an example in my previous post.  I'm appalled that your doctor went straight to 100 mcg/day, when there might have been (obviously was) something in the middle that was sufficient to alleviate your symptoms.  

You said you have Hashi's, so I'm sure you are aware that as time goes on, your thyroid will produce less and less, so your med dosage will increase - probably numerous times, until your thyroid is completely destroyed and you are totally dependent on the med.  

Your "roller coaster" did not have to go nearly so high or fast, which is the point I was trying to make in the first place.

I always get a copy of my labs (my endo allows the lab to send me a copy directly), and I mark on each report, what dosage I was on, how I felt, symptoms, or other pertinent data.  Then when things aren't so well, I can look back and say "gee, this is what my FT levels were and I felt pretty good; I need to try to get back to those levels"....  

Good luck

[Barb135]

You're free to disagree with me, although I'm not real sure just what it is, you disagree with. You are absolutely correct that people react differently, given the same conditions, dosages, etc..only conditions will never be the same for two different people.  And no, there is no "one size fits all", because we are all individuals.......  there ARE those who could go straight to 150 and think nothing of it; then the next person comes along and BAM...... we never know, but why take the chance?

That's why it's almost always best to start at a lower dose than you might think you will ultimately need, and go up by baby steps, giving the body a chance to adjust to each tiny increase.  That's not trial and error; that's deliberately edging toward the dosage that's going to alleviate symptoms, but not send you over the top.  

Take FOXMULDER, for example:  If his doctor had not been in such a hurry to "get him well", he would not have started FOX on the high dosage of 100 mcg, right off the bat......a really good thyroid doctor would probably have started him at 25 mcg for a week or two, to let his body adjust to having some hormones again, then up to 50 for several more weeks, then retest.  From there, on up to 75, when needed.  It takes longer, starting out at lower dosages, but quite often you get there with a lot less trouble, along the way.  AND why would the doctor go all the way to 100, when 50 or 75 might have been sufficient?

Some people even alternate dosages each day, to get a smaller increase than the med(s) allow for.  I did that for some time, alternating 50 one day, 75 the next to get 62.5; then I finally needed another increase and went up to 75 daily, but after a while, I needed a bit more, so I alternated 75 and 88 to get 81.5 until I needed to move on up to 88 daily.  I have finally landed at 100 mcg, and might stay here a while...... again, this was calculated to get me where I needed to go, without pushing me over the edge.

It's also not unusual for people to report really bad symptoms for a few weeks after a dosage increase; this is the body getting used to more hormones, and it usually goes away.  

I think this holds true, whether or not one is on a dessicated med, such as Armour or the synthetics such as synthroid, levo, tirosint, cytomel, etc.... Anything containing a  T3 med has the potential it hit hard and fast.

The point is that each increase can be too much; that's why it's best to go in tiny increments until you hit the right numbers that will alleviate symptoms.

[FOXMULDER]

When I first was diagnosed a 18 months ago, my GP put me on 100mcg Synthroid.  I'm a 36 you otherwise very healthy and athletic male and it takes a lot for me to go to a Doc and say "I'm always cold, I'm constipated and sleepy".  So when I went in to finally get examined, I was quite far down the Hashi road. Anyway, 1 month to the day (weird huh?) of starting on Synthroid I almost collapsed at work.  I had to have someone drive me home.  I started having palps, panic attacks, strange tunnel vision, very "fast" digestion...a whole list of stuff.  I go back to GP and he says go see Cardio doc so we can rule out heart issues.  I know now it was because he new how much of a shock to my system 100mcg was going to be and that the only serious damage Synthroid can do until leveled off is if I had a heart defect.  Cardio said I'm fine and told me he would suggest to my GP to drop me back to 50mcg and titrate up.  Well, GP asked me to tough it out for a couple months so we can get about 3months behind me on 100mcg.  Those were the worst 2 months of my life...until he DID drop me to 50mcg.  After 1 month at 50mcg I dropped back into a serious funk.  I was much more Hypo-sick than I was prior to going on Synthroid.  Brain fog was so bad I was really worried about my job (I'm a manager at a Fortune 5 corp.).  I could barely get out of bed in the morning after sleeping 10 hours. The depression and anxiety was so bad I demanded my GP put me on a SSRI and I went to therapy.    Finally after 3 months on 50mcg I was put on 75mcg and I have been much better ever since.
   Conclusion: it's a roller coaster ride and it is so important to pay attention to your tests and your symptoms.  Good diet and simple exercise(walking, biking) is important too. Tell your Doc how you feel and the good ones will work with you.  I tell my Doc each time I see him that I'm glad I stuck with his logic and didn't react like many people who self-titrate.  Your body needs a LOT of time to adjust to this new metabolic hormone.  

[allmymarbles]

I disagree. People react differently given the same conditions and the same dosages. One size does not fit all.

[Barb135]

Dosage of thyroid med should be based on symptoms and labs; it should not be "trial and error". There should be a certain amount of calculation involved.  It's always best to start at a lower dose of a med, then test after a few weeks, and compare labs with symptoms, then go from there, very slowly, testing every 5-6 weeks until levels are right for you and stable.  

Post the results when you get them; that will give us a lot more to go on
.

[allmymarbles]

My daughter was put on low-dose Armour thyroid and was told to raise it after a few days. Immediately she felt the untoward effects of the higher dosage and dropped back to the low dose. After that she felt better. She told her doctor what she had done and he said she was right. Dosage is a trial and error business. You may have been on the too-high dosage for some time. If so, it may take you longer to return to normal.

[Vicschick]

Thanks so much!!!  Your answer helped calm me down a lot.  I called the doctor and asked the nurse to give me the numbers so I could post here.  He offered me a copy of the lab report on Wednesday when he put me on the other BP med, and I was so out of mind with energy that I told him I didn't need it.  He did tell me to be patient and this wasn't going to go away overnight but dang, this is miserable.  What's funny is I'll feel pretty good for an hour or two and then BAM...my hands are sweating, my mind is racing and my body feels like I drank 800 pots of coffee!  Yuk!  When I get the numbers, I'll post them.

[Barb135]

Unfortunately, both doctors are right - you can have symptoms of being hypo, even though your blood work is "normal". AND just because your labs are "normal", doesn't mean you aren't overly sensitive to medication, and feel it before the labs indicate it.  

The problem is that "normal" on the lab report, doesn't necessarily mean "normal" for your body.  We all react differently to medication, and it's very important to watch WHERE, in the range your levels are; if your levels are high in the range, an increase in med would not be called for.  

It would really be helpful if we could see the lab results for FT3, FT4 and TSH, along with reference ranges, since these vary from lab to lab.

Fortunately, for me, I've never been that over medicated, so I can't tell you exactly how long it would take for the effects of the medication to go away.  I do know that T3 is very fast acting, so goes into your system quickly and is out in a few hours; the T4, on the other hand will take much longer to get out of your system.  10 days is probably not long enough.