hypo and hyper?

[jenny511w46]

is it possible to have symptoms of hypo and hyperthyroidism? i have days when my symptoms are very hypo  (sluggish, exhaustion, cold etc) and a few times lately i have been feeling nervous, jittery and with much energy. just wondering. i am dx as hypo, take 150mcg of levothroxine and 1000mcg of  b12/day. my TSH 5weeks ago was 120. i go back to dr. jan2. thanks~

[goolarra]

Early stages of Hashi's can be characterized by swings from hypo to hyper.  Have you had antibody testing to see if you have Hashi's?  TPOab (thyroid peroxidase antibody) and TGab (thyroglobulin antibody) are the two markers for Hashi's.  As the antibodies kill off the thyroid, the dying cells dump hormone, causing fluctuations.  However, after 13 years of being hypo, one wouldn't think you're in the "early" stages...  Hashi's is the most prevalent cause of hypo in the developed world.

It's quite possible that you actually do need an increase, but going from 125 to 200 was too much and gave you the hyper symptoms. Once you're overmedicated (like you were on the 200 mcg), it takes a while to settle back down.  Of course, it's never smooth...there are bumps in the road as it settles.  Also, even though you backed off to 150, there was no hiatus in meds, which helps to level things out faster.  (Last time I was overmedicated, my endo advised me to stop all meds for three days, then resume at my former dose...really helped.)  

[jenny511w46]

lol! it was quite a boost from 125 to 200mcg which is why i told my new dr. to drop it to 150 which is what ive been taking for about 5weeks. at first i felt very nervous,jittery headaches heart palps even a few panic attacks. after about 3wks i started feeling better, still have a few days of those nervous feelings and a few of depressed been a roller coaster this last week, thats why i wonder if one can be hypo and hyper? but i havent had all the extensive tests many mentioned here, im actually looking forward to getting these other tests. 13yrs of only TSH and not being tested for vitamin deficiencies etc. it seems like this past year my symptoms have been crazy, brain fog increased depression oh and body aches and weakness something ive never had.

[goolarra]

What a relief!  I couldn't even imagine starting on 200 mcg...gave me tachycardia just thinking about it!

You definitely need your FT3 and FT4 tested.  TSH can be elevated for any number of reasons.  Any disturbance in the hypothalamus/pituitary/thyroid axis can cause TSH to be off.  

How do you feel now?  Are your still feeling overmedicated (hyper)?  Hypo since dropping back to 150?

[jenny511w46]

actually ive been dx as hypo 13yrs ago and was on .75 for about 10yrs. drs. only checked TSH. after changing drs. 3yrs ago my levo has been slowly increased from .75 to 100 to 125 then 200 just this year. my newest dr also only checked TSH based on my symptoms which have been getting worse lately. they just want to give me antidepressants, tell me its stress, i need a vacation, blah blah blah. this forum has been so helpful because i am now armed with the right things to ask and hopefully on the right path to getting better. thanks~

[goolarra]

Many of us find that we are sensitive to thyroid meds and have to start out low and increase slowly as tolerated.  If you are young, haven't been hypo for very long and have no other medical issues, the starting dose should be in the area of 50 mcg.  It's important to retest after 4-5 weeks on a dose (it takes the dose 4-6 weeks to reach its full potential in your blood), re-evaluate symptoms and increase if necessary.

Wow!  200 mcg?  Did you start on that?  What were your symptoms like on that dose?

I suspect you know that your doctor should be testing FT3 and FT4 every time you have blood work.  You should request FT3 and FT4 at your next blood work on Jan 2nd.  TSH just doesn't tell the story with enough accuracy to base meds adjustments on it.

You are probably experiencing the nervous, etc. symptoms as an adjustment to the meds.  You started on a high dose, and your body just has to have time to rebalance now that thyroid hormones are present again.  However, you could also be overmedicated.  Only FT3 and FT4 can really show what's going on.    

[jenny511w46]

i was on 200mcg for about 3mths, did not like the effects, i split the pills in half so i could at least be on something because i was changing drs. my new dr. did  a TSH only (5wks ago, it was 120) and she wanted to keep me at 175-200mcg but i told her how i felt on that high a dose (nervous,anxious,jittery,headaches) so she dropeed it to 150mcg. i was still exhausted at first but now i have days where i feel nervous,jittery etc. and im wondering what i can do to stop that feeling. its producing panic attacks. hate it. went to er once and they gave me xanax. ugh...

[goolarra]

Did you start right out on 150 mcg or did you build up to that?  It takes levo 4-6 weeks to reach its potential in your blood.  During that time, FT4 levels are building.  

Since you're five weeks into levo, your meds are just about stabilized.  It could be that you are slightly overmedicated, or it could be that your body is just getting used to having thyroid hormones present again.