# Over-medicated? When does it get better?



## doublev (Apr 8, 2013)

Hi everyone, I'm new to these boards and looking for some experiences/advice with over-medication.

I have been treated for hypothyroidism since last August. After many trips before that to my GP, the urgent care, and even a cardiologist for basically just feeling crummy with anxiety, palpitations and fatigue, they tested my thyroid levels and discovered that I was hypothyroid. I don't remember my exact lab results back then, but i think my TSH was 7.something.

I started on 25 mcg of levothryoxine and began seeing an endocrinologist who tested me every three months and increased my dosage at each visit from 25 mcg to 50 mcg, and then most recently to 75 mcg in February. After about two months on the 25 mcg, I felt a difference. I didn't even realize how crummy I had felt. I felt like a 25 year old should! Anxiety, fatigue and palpitations were greatly reduced. I felt myself again. After the increase to 50 mcg, I was feeling not as great...a little more rundown. My endo said my labs were still abnormal and we were basically "chasing my thyroid" (his words, not mine) so I was increased to 75 mcg at the beginning of February.

Well, about six weeks after that increase, on March 18, I was in the urgent care for some serious vertigo. They discovered that I had some fluid behind my ears and gave me an antibiotic. The doctor at the urgent care tested my thyroid and said my levels looked "great" and I had probably found my right dose. I didn't think to ask for the labs then, I just believed her.

After the antibiotic, the vertigo cleared but I still wasn't feeling great. My anxiety was coming back full force (I had it under control after getting my thyroid treated and seeing a psychologist who I love). Even lorazepam wasn't helping the anxiety. I was getting lots of palpitations again and just back to feeling crummy. I wound up back in the urgent care on April 2 after leaving work early. They did an ekg and lots of bloodwork which came out normal except for my thyroid. The doctor there said it looked like I probably was taking too much medication and my thyroid was saying "no more!" He showed me my lab results from my visit two weeks before to compare and my TSH was down quite a bit.

These were my most recent lab results:

03/18 (my vertigo visit) 
TSH 0.27 (range 0.34-4.82)
FT4 1.08 (range 0.59-1.17)

04/02 
TSH 0.02 (range 0.34-4.82)
FT4 1.45 (range 0.59-1.17)

My endo had me do bloodwork again on 04/04 and my TSH was 0.04 and my FT4 was 2.4 (I believe...the number was 2.something). I was instructed to half my dose and follow up with bloodwork in three weeks. I started taking half of my dose on Friday (04/05) and was still feeling no better on Sunday. Some of my symptoms are anxiety (through the roof! Haven't had it this bad in a long time), jitteriness/jumpiness, palpitations, elevated heart rate (above 90) slight tremor of hand, crying spells (not usually emotional), clammy hands and feeling warm, and a few other things that I can probably attribute to the extreme anxiety.

Yesterday (04/08) my endo instructed me to stop taking the levothyroxine for three days and resume on the half dosage on Thursday. At the end of the day yesterday, I felt a little better...not as shaky...but still pretty bad. Today will be the second day that I skipped my dosage and I'm hoping it will be better. I've missed too much work and have pretty much been housebound...I need to feel better!

After my long essay, I'm basically just wondering what other people's experiences with over-medication have been like? How long until I feel "normal"? Will stopping the medication for three days have any ill effects? Does this even sound like over-medication? I would like to get out of the house and back to work this week.

Thanks!! :winking0014:


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## bigfoot (May 13, 2011)

Sounds very much like being over-medicated. Long-term, depending on your future labs, you might consider asking about an in-between dose like 62.5 mcg. That is, if 50 mcg was too little, and 75 mcg was too much. No, they don't make that dosage specifically, but you could cut a 125 mcg tablet in two, or else take a 50 mcg combined with half of a 25 mcg (12.5 mcg) to get the 62.5 mcg.

When I was over medicated the anxiety was rough, and the feeling of being spaced out and fatigued was persistent. Since the half life of T4 is measured in weeks, not days, it may take a little longer to notice the drop down in dosage.

Since hypo and hyper symptoms can be the same at times, it's hard to know exactly where you are. If you check your temperature and pulse daily, it can give you a rough idea of things. For me, when I was hyper, my pulse was up over 100 and my temps. kept going up.


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## CA-Lynn (Apr 29, 2010)

I've had Hashimoto's for over 20 years and never had to take a day off from work for it. We are all different.


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## sjmjuly (Mar 23, 2012)

I have Hashi's so getting the dose right is a crap shoot. BUT, I was recently overmedicated too. I was taking 1 1/4 grain of Naturethroid which is about 81 mcgs. Took this for months and then started having all the symptoms you described. My worst one was skipped heart beats. They were awful. Doc said to lay off the meds for three days and then start at a lower dose. After three days I did just this and took the smallest dose I could. Two days later I was hyper again and feeling like crap. I stopped taking it again and I am four days out and NO symptoms of either hyper or hypo. I am side-lining the medication until I see my doctor again on Friday. Hyper is way worse than hypo in my opinion. I did notice improvement right away after stopping. Had a few skipped beats but only a couple yesterday and none so far today. 
Have you been tested for hashi's? It's alot different than straight hypo.


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## doublev (Apr 8, 2013)

_bigfoot_ - Thanks for the reply! I was considering asking for an in between dose at my follow-up, but I wasn't sure if it existed. Now I know how to go about it, thanks! The anxiety is the worst part, but I'm not expecting it to go away overnight, just need it to be more manageable. My pulse has calmed down the last couple of days, but it's still in high 80s/low 90s. I don't have a way to take my temp right now...

_CA-Lynn_ - Believe me, I hate missing work, but I work retail and it's really hard to do my job when I'm always running around/going up and down ladders and my heart starts pounding really bad. Even at the registers I was getting way too shaky to do my job the way I normally do. I had to make the decision to cut some shifts over the last week instead of showing up and being sent home early for being sick (they can see I look and feel like you-know-what) or having to take a dozen short breaks just to get through my shift. I've had some bad anxiety/panic spells before and never had to miss work, so I feel really bad about it.

_sjmjuly_ - Sorry you are going through this as well. I agree, these hyper feelings are much worse for me than my hypo feelings. I'm hoping I see some improvement after this little med break. I'm going to sound really naive right now, but I'm not sure if they ever tested me for Hashi's. I assumed they did because they did so much bloodwork and my endo came recommended and I've had good experiences with him so far. How is Hashi's tested? I guess this experience has taught me I need to be much more proactive about my condition....I will bring these things up at my next appt. Hope we both get to a good place soon.

Thanks, everyone!!


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## Andros (Aug 26, 2009)

doublev said:


> Hi everyone, I'm new to these boards and looking for some experiences/advice with over-medication.
> 
> I have been treated for hypothyroidism since last August. After many trips before that to my GP, the urgent care, and even a cardiologist for basically just feeling crummy with anxiety, palpitations and fatigue, they tested my thyroid levels and discovered that I was hypothyroid. I don't remember my exact lab results back then, but i think my TSH was 7.something.
> 
> ...


I have never been over-medicated and am happy for it. Just wanted to give you a warm welcome!


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## doublev (Apr 8, 2013)

Andros said:


> I have never been over-medicated and am happy for it. Just wanted to give you a warm welcome!


THANK YOU! :hugs:


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## hashimotocoaster (Mar 22, 2013)

Oh wow, we're twins! I did the exact same 25-50-75-OOPS YOU'RE HYPER! routine over about the same time period. They knocked me back down to 50, still hyper, and now I'm back down to 25. Lowering my dose has really helped with palpitations, chest pain (I ended up in the ER one night because I thought I was having a heart attack), shaking, anxiety (!!!!!), etc., though I'm still not feeling great. I'm waiting on an endo referral and I hope I'll find out more then, but I can tell you that lowering your meds WILL more than likely make you feel much better, and it shouldn't take long. I think I noticed a big difference in under a week.

And don't feel like you have to justify missing work--only you know what you feel like and what you're capable of doing. Good luck!


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## sjmjuly (Mar 23, 2012)

_sjmjuly_ - Sorry you are going through this as well. I agree, these hyper feelings are much worse for me than my hypo feelings. I'm hoping I see some improvement after this little med break. I'm going to sound really naive right now, but I'm not sure if they ever tested me for Hashi's. I assumed they did because they did so much bloodwork and my endo came recommended and I've had good experiences with him so far. How is Hashi's tested? I guess this experience has taught me I need to be much more proactive about my condition....I will bring these things up at my next appt. Hope we both get to a good place soon.

Thanks, everyone!![/QUOTE]

doublev,
The reason I ask about hashi's is because you can go between hyper and hypo with no warning. Hashimoto's is actually an autoimmune disease and not a thyroid disease, but it ends up beating your poor thyroid to death. Literally. If you have the antibodies (TPO) they see your thyroid as an invader and attack it. When this happens, your thyroid goes into panic mode and spews out extra hormones into your system making you hyper. Eventually, the thyroid dies from the war going on (though it could take years) and you then become hypo. Hashi's is the leading cause of hypothyroidism. You need to ask your doctor to run the antibodies test to see if you have them. It's just a simple blood test and then it can be confirmed with a FNA (fine needle aspiration) but usually the blood test is good enough to indicate hashi's. At least it will rule it out. Have you ever had an ultrasound?


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## doublev (Apr 8, 2013)

hashimotocoaster said:


> Oh wow, we're twins! I did the exact same 25-50-75-OOPS YOU'RE HYPER! routine over about the same time period. They knocked me back down to 50, still hyper, and now I'm back down to 25. Lowering my dose has really helped with palpitations, chest pain (I ended up in the ER one night because I thought I was having a heart attack), shaking, anxiety (!!!!!), etc., though I'm still not feeling great. I'm waiting on an endo referral and I hope I'll find out more then, but I can tell you that lowering your meds WILL more than likely make you feel much better, and it shouldn't take long. I think I noticed a big difference in under a week.
> 
> And don't feel like you have to justify missing work--only you know what you feel like and what you're capable of doing. Good luck!


Hi, twin!! Wow, that does sound exactly like what I'm going through! I have noticed some improvement of some of my symptoms, though the anxiety is the most persistent. Good luck with your endo appointment and thanks for the support! 



> doublev,
> The reason I ask about hashi's is because you can go between hyper and hypo with no warning. Hashimoto's is actually an autoimmune disease and not a thyroid disease, but it ends up beating your poor thyroid to death. Literally. If you have the antibodies (TPO) they see your thyroid as an invader and attack it. When this happens, your thyroid goes into panic mode and spews out extra hormones into your system making you hyper. Eventually, the thyroid dies from the war going on (though it could take years) and you then become hypo. Hashi's is the leading cause of hypothyroidism. You need to ask your doctor to run the antibodies test to see if you have them. It's just a simple blood test and then it can be confirmed with a FNA (fine needle aspiration) but usually the blood test is good enough to indicate hashi's. At least it will rule it out. Have you ever had an ultrasound?


Thanks for all of the information. I've read a little bit about Hashi's, but just figured it never concerned me. I'm not sure if they ever tested TPO. I only have copies of my bloodwork from my most recent urgent care visits. I have never had an ultrasound. It's never even been discussed. Well, I definitely have a lot to bring up to my endo. He did seem quite concerned at my low TSH and elevated FT4, but said he wanted to see what a reduction of my meds would do first.


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## hashimotocoaster (Mar 22, 2013)

To echo sjmjuly, definitely get your TPO antibodies checked! At first my doctor thought I was hypo because of viral thyroiditis, but my bloodwork showed elevated TPO antibodies that indicate Hashimoto's. It was a huge relief for me to get a diagnosis and start understanding what was happening. I've had both "hypo" and "hyper" symptoms (in quotation marks because it's often hard to tell them apart) when my TSH has been low and high. I'm still figuring out what's going on and how to deal with it, but the more information you have, the better!


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## bigfoot (May 13, 2011)

Quoted for truth. Sometimes the lines really blur between hypo and hyper. And the anxiety should, once everything is leveled out, be much, much better. Along with many of the other symptoms, too. The trick is finding the 'sweet spot' and being consistent both with the meds and with frequent testing. Beware the doc who tells you to come back in six months or a year.


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## doublev (Apr 8, 2013)

Thanks, everyone! I will definitely be following up with my endo about the TPO antibodies.

Today is my third day off of the levothyroxine. I feel somewhat better...not as anxious...I was able to run a few errands by myself this afternoon without having a panic attack lol. I still feel somewhat jittery though and my heart still races sometimes with very little effort. I woke up from a nap this afternoon with my heart beating pretty fast. Tomorrow is my first day back to work this week, so hopefully I will be okay.


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## WhoosierMama (Apr 9, 2013)

I just posted a similar question regarding when I could expect to feel less hyper symptoms due to over-medication. I guess I should have looked around the board a bit before doing so. I'm curious whether you, or anyone else who's reading this, ever took any medication to help with the anxiety. I can deal with the headaches and fatigue, but my anxiety is through the roof right now. It's to the point where I'm having frequent anxiety attacks a day. Is it unreasonable to try to deal with this with some anxiety medication? I mentioned this to my doctor, but he wants to wait to see how the lowered dosage makes me feel before medicating the anxiety. Problem is, I am having trouble working because I feel so terrible.


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## doublev (Apr 8, 2013)

WhoosierMama said:


> I just posted a similar question regarding when I could expect to feel less hyper symptoms due to over-medication. I guess I should have looked around the board a bit before doing so. I'm curious whether you, or anyone else who's reading this, ever took any medication to help with the anxiety. I can deal with the headaches and fatigue, but my anxiety is through the roof right now. It's to the point where I'm having frequent anxiety attacks a day. Is it unreasonable to try to deal with this with some anxiety medication? I mentioned this to my doctor, but he wants to wait to see how the lowered dosage makes me feel before medicating the anxiety. Problem is, I am having trouble working because I feel so terrible.


I don't think it's unreasonable at all. I took lorazepam (ativan) to help with anxiety before I got diagnosed with my thyroid problems and still take it now. When my thyroid levels are good, I don't have to use it as much. Over the last few weeks with these hyper symptoms I've had to use it more. I don't even want to think what my anxiety would be like right now if I didn't use it at all. If it's interfering with your ability to work, I think it's worth bringing up again.


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## WhoosierMama (Apr 9, 2013)

doublev said:


> I don't think it's unreasonable at all. I took lorazepam (ativan) to help with anxiety before I got diagnosed with my thyroid problems and still take it now. When my thyroid levels are good, I don't have to use it as much. Over the last few weeks with these hyper symptoms I've had to use it more. I don't even want to think what my anxiety would be like right now if I didn't use it at all. If it's interfering with your ability to work, I think it's worth bringing up again.


Thank you for your thoughts. My doctor has ordered an MRI because I've had terrible headaches non-stop for the past several weeks. He said he wants to wait for the MRI results to come back before making any medication changes. I have a follow-up appointment this coming Tuesday, so I'm hoping I can keep myself in check until then. It's tough though! Hoping my lowered dosage starts kicking in soon. I have felt like a complete nutjob this past week.


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