Too much Synthroid?

[mar85]

I think I am getting too much Synthroid. I have recently made some lifestyle chages (mainly cutting out fluoride sources--from drinking water and dental products). In the past 7 months, my doctor has reduced my Synthroid dose down from 150 to 137 to 125 to 100(just this week). My most recent TSH test came back at .288 this week--the previous TSH test was .18.  I don't know my t3 and t4 numbers--I have an endo appointment next week. I am having debilitating exhaustion, flu-like symptoms, breath-catching, anxiety, jitters, trouble focusing, and just generally feeling awful. My question is, since I plan to continue these lifestyle changes (by getting a shower filter to reduce more fluoride exposure, etc.), I don't feel like I can wait another 8 weeks feeling like this before my next blood panel. What if I asked my Endo to put me on the lowest dosage (or none) and work up from there with the blood work. I don't even know if I can continue to take this dose for the next week.

[mar85]

So I have been on this reduced dose of 100 Levothyroxine for 10 days now, down from 125. Sorry, I thought it was Syntroid, but it's Levo. I have still been having the anxiety, fatigue, tightness in throat, nervousness, shaky hands, etc. I also have a splitting headache and achy joints.

Yesterday and today my heart rate has been fluctuating up and down within a matter of seconds. I usually have a resting heartrate of around 60, so the levels are not super high (fluctuating between 60 and 88 last night and 60-112 today). I called my primary physician's office last night, told them all symptoms, and they said come in today. They had the nurse practitioner see me, not the doctor. They hooked me up to the EKG machine and said everything looked ok, except they want me to get an eco-cardiogram because they did notice a variation, but said it was not an emergency and probably not related. I gave them all my bloodwork results, etc. and my list of symptoms, etc., and they prescribed Xanax for anxiety to take while my "dose adjusts". Nurse practitioner left the room to ask the doctor a few questions, but he never came in to see me.

I called my endo last night too (before I called my primary) and she was no help, said it would take more time for the dose to level out, but she didn't have my chart, etc, said to call Monday. I asked her about the T3 again and she said she wanted to wait until she does all of the bloowork in 6 weeks (well, 4 for me).

Any thoughts on whether I should still be feeling these symptoms after being on 100 for ten days?

[mar85]

Thanks so much. I think I will definitely do the tests after 4 weeks. In the meantime I am in search of a new endocrinologist because I really feel I need more clarity on the Hashi's diagnosis, etc, and overall someone who is more pro-active and a listens to my concerns.

[goolarra]

Well, she got it half right...she lowered your T4 meds a little.  Too bad she didn't just add some T3.  The vast majority of the T4 decrease will have stabilized in your blood in four weeks.  You might get your labs drawn four weeks after the decrease.  At least she has said she would add T3.

[mar85]

Thanks gimel and Ericamegan!

I definitely think I need to get a different endo! I really don't understand why she didn't just prescribe me the T3 now to take with a l lowered dose of Synthroid. When I asked her about T3, she said, "Yes, adding T3 seems to help a lot of women. I am going to add that". But then she said wait six weeks for the blood work. ugh.

Also, when the nurse called back in May with those blood work results, she only told me the doctor wanted to reduce synthroid and add vitamin D supplement. She said the ultrasound, etc. were normal, so I had no idea until yesterday that I tested positive for Hashi's! And then the doctor didn't even explain to me what this meant--she was just surprised I didn't know.

Sorry to vent, it's just so frustrating. But I guess it all starts with a good doctor -- who knew a good doctor would be so hard to find! That's what I'll be focusing on now.

I read the endo my list of symptoms yesterday. Here they are: Debilitating exhaustion, trouble catching breath, tightness in throat, achy/flu-like sypmptoms, frequent urination, irritability, anxiety, shaky hands, nervousness, trouble concentrating, memory issues, neck and shoulder pain, stiff joints, hard time functioning, decreased appetitite, leg cramps. This plus my high blood pressure count at the appointment. I feel like these should have inspired a little more proactive treatment plan from the doctor!

Thanks for listening and for all of your great advice.

[Ericamegan]

I had similar labs to yours with a very low FT3.   I saw much improvement when I reduced my synthroid and added 5mcg cytomel (split twice a day). Over time I've made the switch to armour and am feeling even better.   I would start searching for a new dr.   You also could talk again to your current dr about the fact that you may benefit from adding a very low lose of cytomel, since your FreeT3 is at the very bottom of the range.

[gimel]

You've gotten lots of good info from goolarra already.  Just wanted to mention that it looks like your doctor is reducing your meds based on the suppressed TSH level.  That doesn't work.  When hypo patients take thyroid meds, often they cannot achieve the necessary levels of Free T3 and Free T4 until after their TSH becomes suppressed and the patient is dependent on only the meds.  Until that time as the meds are increased, the TSH is diminished and production of natural thyroid hormone is reduced, resulting in little change in the overall level of thyroid hormone in your blood.  

Unfortunately doctors with the "Immaculate TSH Belief" think that a suppressed TSH means you are hyper.  In actuality you are hyper only if having hyper symptoms due to mainly having excessive levels of Free T3 and Free T4.  From the above it looks like you still have hypo symptoms, not hyper.

A good thyroid doctor will treat a thyroid patient clinically by testing and adjusting Free T3 and free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not just TSH.