# Missing Doses Causing setback?



## bbdailey (Sep 29, 2011)

Hey everyone...Sorry for posting so much lately! So Ive been on levothyroxine for a little over six weeks now and im feeling crappy(depressed/tired) After about 4 weeks I was feeling very hyper so I didnt take the levothyroxine for 2 days then took it the next 2 days after that then skipped 2 days after that(4 days missed total). I thought I would be feeling better by now since it took about 4 weeks last time to feel better on the medication. So my question is....Could missing the dose those couple of days set me back? I would have thought that I had been taking the medication long enough that it would have built up enough to not be affected by a couple missed days. Anyways its been a week since my last missed dose and Im feeling worse now....Any thoughts?


----------



## Octavia (Aug 1, 2011)

I guess it depends on how "fragile" or sensitive your system is. I think missing a few doses like that wouldn't bother some people too much, but could bother others quite a bit.

Since you've been on it 6 weeks, have you gotten any labwork done? (I would question its accuracy just a bit since you haven't been consistent, but it's still good to get it done.)


----------



## bigfoot (May 13, 2011)

Short answer: Yes, I would imagine it could.

Long answer: The trick is being consistent. The half-life of levothyroxine is about 7 days (3-4 days in hyperthyroidism, 9-10 days in hypothyroidism), according to Wikipedia.

Ideally you should not be skipping any doses. I've got to believe that part of why you aren't feeling good is because you're causing your body to yo-yo. Some days it is having to work less because you are adding external thyroid hormone; other days it has to pick up all the slack because you are giving it nothing. The end result is you feel like crap and your body doesn't know which way is right-side up.

It could also be that you are either: a) over-medicated, b) under-medicated, c) just going through the usual adjustment process, or d) some other issue. Do you take any other medications that could be interfering with the thyroid medication? Do you consume a lot of soy or iodine-containing food? Have all pertinent labs and tests been run on your thyroid and related aspects?

The docs will say that it's not possible to feel the effects of levothyroxine very quickly. That doesn't seem to be my newbie experience, although yours may vary. For me, when I increase a dose it takes a couple of days and then I begin to notice some changes. But I also am pretty sensitive to any medication.

hugs6


----------



## bbdailey (Sep 29, 2011)

Thanks for the responses! Bigfoot I dont take any other medications just vitamin B12 and Vit D but I wait 4 hours after levo to take them. I also dont eat anything with soy, dairy, and gluten. I have had TSH, FT3, FT4, and TPO done over the last year or so with the results coming back "normal" other than one TSH that was over 5 and the TPO being 250 last time it was checked. I am frustrated because I felt well on the levo last time but I ended up stopping bc it went way down hill at the end. I am hoping that I just need to get my TSH and FT3/4 in a very specific area to fell well....otherwise ive pretty much run out of what it could be


----------



## bigfoot (May 13, 2011)

It could be that after a month or two your body is getting everything it can from your dose of levothyroxine and is requiring a dose increase.

You mentioned being tested for TPO antibodies -- did they test Thyroglobulin antibodies as well? Both of these, combined with your elevated TSH of over 5 might be suggestive of something autoimmune like Hashimoto's. If that's the case, it may not just be the thyroid hormones wreaking havoc, but antibodies, too. Hard to know unless the proper tests are run.

There really is a narrow therapeutic window for all of this stuff. What lab values, dosage levels, and types of medications work for one person may be completely different for someone else. I have been struggling for months and months myself. I think I sailed right on through my "window" LOL. Some days are definitely better than others!


----------



## bbdailey (Sep 29, 2011)

I believe ive had the Thyroglubin as well and it came up negative I believe. But I was diagnosed with Hashimotos with the TPO antibodies being present. My TSH was only 5 once...mostly it has been inbetween 1.9-3.0. Im wondering if the colonoscopy I had in late august possibly messed with my system and created a bigger attack on my thyroid bc I was feeling pretty well on the medication til that point but soon after it got very bad and I ended up stopping the levo.


----------



## bigfoot (May 13, 2011)

I think you should do some further research into Hashi's and your situation. From what I have been told here, Hashi's would be a very possible diagnosis if you have both TPO antibodies *and* Thyroglobulin antibodies present. If you truly are positive for one, and negative for the other, I'm not sure what you might have going on re: autoimmune diseases and/or thyroid issues. With your TSH values it appears you are perhaps leaning to the hypo side of things.

Folks here have also advocated for getting an ultrasound as well as a FNA biospy to help assist with diagnosing Hashi's. I know I was diagnosed without either of these two procedures; my endo is certain I have Hashi's. Other thyroid tests they have mentioned here on the site would be the TSI test and also the TBII test to assist with getting the whole picture. Again, no experience with those personally, as I haven't had a doctor yet who (right or wrong) sees any value in them for my situation.

Your theory on the colonoscopy is something I don't really know much about. Supposedly if there is some sort of trauma to the body that can set things off. I know in my case it was a year of chemo that fooled my body into attacking itself, and from there on it apparently didn't stop. Have you had any other large doses of medication or significant events? They even think large amounts of stress can trigger things, too.

Another thing: the body doesn't like big swings in the TSH level in either direction. And by "big" swings I mean something even as small as a point or two. This can wreak havoc with how you feel, both physically & mentally. It could be that by skipping your medication for a few days you are subjecting your body to this sort of thing in the short-term. Dr. Hall has an excellent article you should read on this: http://www.drrichardhall.com/anxiety.htm

Again, this is just my opinion as a fellow newbie. Let us know what you discover!


----------

