Aa
Aa
A
A
A
Close
1598028 tn?1297398117

Too much medication?

Is it possible I am taking too much medication with results of?

FT3 3.58pg/ml (2.50-3.90)
FT4 0.79ng/dl (0.65-12.26)
TSH 0.065uu/ml (0.340-5.600)

Currently taking: ERFA 60mg + 30mg Nature Thyroid in the morning and, EFRA 60mg in the afternoon.  

I have two Endocrinologists (different countries – long story)

The one in the country I live, in suggested I put my medication up by half a grain in the morning to try help with me flagging before I take my second dose in the afternoon.  By 2pm I’m like a nodding dog!   Two weeks ago I visited my other doctor for routing tests.  She suggests I stop taking the 30mg in the morning and add some T4 re the above readings, because my heart rate is too high and my not sleeping well.

Before I was asked to add the extra 30mg in the morning my readings were (which I thought were good)

FT3 4.15 pmol/L (2.60-5.70)
FT4 11.31 pmol/L (9.00-19.04)
TSH 0.50 uIU/ml (0.35-4.94)

Any suggestions?
7 Responses
Sort by: Helpful Oldest Newest
1598028 tn?1297398117
I tend to take my morning meds about 7am'ish and my afternoon at 3.  I will move it to 2 and see what happens.

Vit D was;

25-OH Vitamin D3 53.9 ug/l

optimal = 20-70 ug/l
insufficiency = 10-20 ug/l
severe deficiency {10 ug/l

I'm due to see the doc here in the next few weeks (if they have scheduled me an appointment).  I will see what he has to say, but I will add the extra T4 after I've had the blood work done.

Thanks

Helpful - 0
Avatar universal
A couple of thoughts for you to consider.  I also think it would be a good idea to add maybe 25 mcg of T4 to your meds to move your Free T4 nearer the middle of its range.  I don't think I would reduce the 1/2 grain of Nature-Throid, at least for 4 weeks, in order to give the T4 med time to reach full effect on your serum Free T4.  

Next I think you might reconsider how you are taking the other meds.  T3 med reaches full effect in about 3 hours, and I think it tails off over the next 3-4 hours,  probably coinciding with the time you mentioned you get tired.  Not clear when you take your morning and afternoon doses, but you can try moving your afternoon dose a bit closer in time to your morning dose and see if that helps both with avoiding the afternoon sag, and also allow you to be ready for a good sleep later.   Some people even take their NDT type meds in three doses during the day, trying to even out the effect.  

One last thing.  What was your actual Vitamin D level and reference range?
Helpful - 0
1598028 tn?1297398117
Gimel, I stand corrected, the upper level is 1.26ng/dl....too many papers (I must wear my glasses more...)

No, I don't take my medication before tests in the morning, I wait until all the blood is drawn then take my normal medication.

I am vitamin D insufficient, though having just been tested, I am at present doing well (I get more sun and take the odd supplement, whereas in the past, I had injections)

I also take a B12 supplement, latest test 870pg/ml (180-914) and was taking folic acid, but the doc said my levels were good now.

I am also diagnosed as pre-diabetic and have been put on temporary medication for this.  My diet is good, has been for many years, and since being put on the medication, I make sure I exercise 5-6 times a week.

Also the usual with Thyroid issues, sporadically high cholesterol.

Ferritin - after looking through ALL my paperwork, I was tested in 2011! 62.6ng/ml (11.0-306.8)

Cortisol reading is also within range.

I was feeling fine when I had the other tests, I thought (doc also thought).  The only reason he said to add the half Nature (.5grain) to my morning dose, was to try stop me flagging in the afternoons.

I suffer from Insomnia bouts terribly, always have, but seem to be a lot worse.  

Flyingfool - As I live in the Middle East, getting medication is hard as they do not have, or, prescribe any form of T3 medication.  I started to order the ERFA from Canada to friend in America, then have it shipped to the country I lived in via another friend.  The pharmacy then stopped this, and would only ship to the person on the script direct.  Shipping to where I lived was a no no. I went home for a short stay (UK) and I found the Nature on-line without a script and could easily get it into the UK.  To tide me over until I found a solution, I took ERFA and Nature.  It didn't work as well, as my TSH rose.
I moved countries (still within the ME) and now use a private script from my Edio here and ship my medication in (ERFA).  It arrives and has only been opened once, though they still let it in :)
The doc suggested adding the .5 Nature to to try give me a tiny pick-up as it doesn't work as well for me.
Long story I know (sorry) it's been a testing few years lol

I feel well, though tired at times (like most) it seems to come in waves.  Nothing like I was a year or so ago!  Other than the lack of sleep, supposedly high heart rate and at times, terrible memory (age? lol)
Helpful - 0
Avatar universal
I agree with gimel.

blood levels are not as important as how you feel. When you feel well it is then important to get the blood levels so you then have a target for you as an individual to shoot for if the labs ever very or you start to feel not so well again.

One question I had was why two different Natural Dissected Thyroid (NDT) medications instead of one common brand?

Because Natural dissected thyroid has a "set" amount of T4 to T3 ratio that is in the pig thyroid.  It is not uncommon for some people to have to take a straight synthetic T4 or even T3 medication in addition to the NDT to balance out the individual blood lab levels. But certainly not everyone.
Helpful - 0
Avatar universal
Well, there has to be some mistake in the upper limit of the range.  I've never seen a range for Free T4 that was higher than .8 - 1.8 ng/dl.  Regardless, I have some other questions.  Did you take your meds in the morning before the blood draw for tests?  If so, that can cause the results to be falsely higher than expected.  It is best to wait until after blood draw to take the morning dose.

You mentioned that you thought the test results looked pretty good prior to the increase in dosage.  How were you feeling at the time?  Why did the doctor increase dosage?

From your most current test results, your Free T3 is in the upper quarter of the range, which is usually adequate to relieve symptoms for many hypo patients.  Your Free T4 is on the low side, and it would be good to add some T4 med to bring it up to around the middle of its range.  

Since the only symptom you mention is fatigue in the early afternoon It makes me wonder about other areas besides thyroid.  Have you been tested for adrenal function, with a 24 hour saliva (or urine) cortisol test?  Also, since hypo patients are frequently too low in the ranges for Vitamin D, B12, and ferritin, I would also suggest that you should be tested for those.  In addition, hypo patients with low ferritin sometimes find that increasing their meds can cause hyper like symptoms.

So, lots more questions than answers right now.
Helpful - 0
1598028 tn?1297398117
Correct range and result according to the paperwork I have.  I have checked my previous test too and the range is the same 9.00-19.04pmol/L
Helpful - 0
Avatar universal
Before going further, please confirm the reference range you listed for FT4 in the latest test results.  I have never seen one that high.
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.