Levothyroxine Only Works at the Right Dose
Levothyroxine is the #1 most prescribed thyroid medication on the market.
As you probably are already well aware, levothyroxine is prescribed to treat cases of LOW thyroid otherwise known as hypothyroidism.
Levothyroxine works by providing your body with the thyroid hormone that it isn’t able to create on its own.
Sounds good, right?
Well, it can be, provided you are using the exact right amount.
I like to refer to thyroid hormone as a “Goldilocks” hormone.
In order for you to feel good, you need to take the exact right amount.
Take too much and you may start to feel hyperthyroid.
Take too little and your symptoms won’t disappear and you will remain fatigued.
But when you find the exact right amount, your symptoms should subside and everything should feel right again.
Unfortunately, getting to the right dose is easier said than done and can take both time and a little bit of knowledge.
Today we are going to focus on what happens when your dose is too high and the type of symptoms you will start to experience if this happens.
You will learn:
- What your symptoms tell you about your dose of levothyroxine
- Warning signs that your thyroid medication dose is too high
- What to do if you experience any of these symptoms
- And how excess thyroid hormone negatively impacts your body
Let’s jump in…
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Signs of Levothyroxine Overdose
The first thing I want you to know is that being overdosed on levothyroxine is not nearly as common as not taking enough thyroid hormone.
Because doctors know that taking too much thyroid hormone can be dangerous, they would much rather err on the side of giving you too little.
So MOST people taking levothyroxine end up with persistent symptoms of hypothyroidism despite taking the “right” medication for their body.
Having said that, there are certainly some people who DO take too much levothyroxine and this article is for those people.
Whether you are taking too much levothyroxine or if you are just really sensitive to thyroid hormone, these are the symptoms you may start to experience as your dose of thyroid medication creeps higher and higher.
One of the first symptoms people experience when their thyroid is off is a general sense of irritability.
Irritability can be felt on if your medication is too high or too low but it tends to be more associated with higher doses and hyperthyroidism.
Unfortunately, irritability is a non-specific symptom and can also be associated with plenty of other conditions and issues so just experiencing irritability by itself doesn’t guarantee that you have a problem with your thyroid dose!
It is an extra piece of information, though, so it can be helpful, especially if you are experiencing some of the other symptoms below.
#2. Hair Loss
Hair loss is another big symptom that can be associated with both high and low thyroid medication.
The good news is that the type of hair loss that occurs with both conditions is different.
When your dose of levothyroxine is too high your hair will become dry, brittle, and start to crack.
You may also notice that the quality of your hair starts to change.
The quality, the texture, and even how it lays on your head can all be impacted by your thyroid medication dose.
This is different from when your dose of levothyroxine is too low.
When your dose is too low you will notice that your hair just sort of falls out by the handful.
You will notice that your hair falls out when you shower, when you comb your hair, and so on.
Even though both conditions result in hair loss, the type of hair loss is actually different.
This is really helpful because the type of hair loss that you are experiencing can help you figure out the CAUSE.
To complicate things further, you should also be aware that levothyroxine itself can cause hair loss.
This hair loss is variable and can mimic the type of hair loss when your dose of thyroid medication is too low or too high.
I have articles that outline how to reverse hair loss in thyroid disease that you should take a look at if it’s one of your primary issues.
Another common symptom that people with excess thyroid hormone in their body experience is anxiety.
It may sound counterintuitive but thyroid hormone can amp up the body.
Thyroid hormone is really a source of pure energy but too much of that energy can result in nervous energy or a jittery sensation.
This jittery sensation is often enough to result in anxiety and even panic attacks in some individuals.
The higher your dose of levothyroxine the more amped up you will feel and the more prone to anxiety you will become.
The exact opposite is true when your levothyroxine dose is not high enough.
If your dose is too low then you will tend to feel depressed or suffer from depression.
As your level of thyroid hormone decreases you may start to experience slow thoughts which is sometimes referred to as brain fog.
As your dose of levothyroxine increases, it will become more and more difficult for you to fall asleep and have a restful night’s sleep.
When you are really amped up and you have the sort of nervous energy that I talked about previously, it will be hard for you to calm your body down to fall asleep at night.
If you are having trouble calming down your mind at night, if you are having racing thoughts, and if you find that your heart rate is elevated when you try to go to sleep, then that’s a good sign you should take a look at your thyroid medication dose.
Insomnia can also be tricky because it is another one of those non-specific symptoms.
There are plenty of other conditions, including other hormone imbalances such as menopause, which can make it difficult for you to get enough sleep.
So don’t just look at how well you are sleeping as a gauge of your dose.
You need to put it together with the other symptoms we are discussing here today.
#5. Muscle Weakness
Muscle weakness is hard to miss but it’s also associated with insufficient dosing of your levothyroxine.
This is another non specific symptom but it is one that you should be aware of.
#6. Fertility issues
Infertility is another big one (1) and this problem is associated with both taking too much levothyroxine and not taking enough levothyroxine.
How can you tell them apart?
The easiest way is to look at the length of your menstrual cycle.
Women who are taking too much levothyroxine tend to have more RAPID cycles (2) compared to whatever is normal for them.
Imagine that you are running on a 28-day cycle.
If your dose of levothyroxine was too high then your cycle would become more rapid your cycle would fall to 20 days.
Unfortunately, this rapid cycle does NOT allow for normal ovulation. It doesn’t allow for the normal peaks of various hormones such as progesterone and estrogen and it is these problems that lead to infertility.
It’s simply not possible to become pregnant if you are NOT ovulating.
The exact opposite is true when your dose of levothyroxine is too low.
In this case, your cycle would become prolonged and would not happen as frequently.
Using the 28-day cycle as a guide, if your dose is too low then your cycle would occur every 40 days.
But, again, this scenario also causes issues because it doesn’t allow for ovulation.
How can you tell if your thyroid medication dose is interfering with your menstrual cycle?
All you need to do is keep track of it!
If you started levothyroxine and your menstrual cycle has been around 27-28 days for the last 2 years and suddenly it is now occurring every 20 days then you know you have an issue.
#7. Rapid Heartrate
This symptom is probably one of the most common symptoms associated with high doses of levothyroxine and is most likely the first symptom that you are likely to notice.
As your thyroid hormone medication dose increases, your heart rate will start to increase as well.
You may or may not notice this change, however!
One of the best and easiest ways to measure how well your thyroid medication is working is by checking your resting heart rate on a daily basis.
When I put thyroid patients on T3 thyroid medication I always have them keep track of their resting heart rate.
Because it helps me to know how well that medication is getting into their body and how well it is working.
Over time, I better see that heart rate increasing as a patient takes more and more thyroid medication.
If the heart rate doesn’t increase then I know that there is some sort of issue either with absorption or thyroid conversion.
Keeping track of your heart rate can also help you determine if your dose is TOO high.
A normal resting heart rate in the 70’s indicates that your thyroid is probably doing just fine.
A resting heart rate in the 50’s usually indicates your thyroid medication is too low (assuming you are not extremely fit).
And a resting heart rate higher than 85 is usually an indication that your thyroid medication/levothyroxine dose is too high
The best time to check your heart rate is FIRST thing in the morning right after you wake up.
This information does not apply if you jump out of bed and start doing jumping jacks and then check your heart rate.
You should be aware that often times an elevated heart rate can go completely unnoticed which is why keeping track of your heart rate is so important.
Nowadays, you can use tracking devices such as an Apple Watch or Fitbit, or various other wearable technology to keep track of this information for you.
If you have any sort of thyroid problem make sure you are keeping track of your heart rate!
#8. Heart palpitations
While an elevation in your resting heart rate may go unnoticed, it’s highly unlikely that you will miss heart palpitations!
The good news is that even though they may freak you out, heart palpitations are typically harmless.
Heart palpitations simply mean that you are feeling the sensation of your heart beating in your chest.
Yes, it may feel like your heart is beating OUT of your chest but they are almost always harmless.
No, just because you are feeling your heart beating in your chest doesn’t mean that you are having a heart attack or that anything is wrong with your heart.
It is just the sensation that your heart is beating.
It can get confusing because if you aren’t used to feeling your heart beating you may believe that your heart rate is elevated but this isn’t usually the case.
Whenever anyone tells me that they are having heart palpitations, I always ask them to check their resting heart rate.
In MOST cases, their resting heart rate is completely normal which means that they are simply feeling their heart beating.
Why does levothyroxine result in heart palpitations?
Remember, thyroid hormone amps up the body and it does the same thing to the heart.
There are special cardiac receptors that are sensitive to thyroid hormone.
When thyroid hormone latches onto these receptors it can actually increase the force of contraction of the heart (3).
It’s not that the heart is beating too fast it’s just that each beat is stronger than before.
This tends to fade fairly rapidly, though, as blood levels of thyroid hormone fall.
But what I want you to know here is that MOST cases of heart palpitations are harmless even though they may feel scary.
Next up is diarrhea or loose stools in general.
Thyroid hormone, and, therefore, levothyroxine, help to control the kinetics of your bowels.
The kinetics of your bowel simply refers to how quickly your intestinal tract is moving.
The more thyroid hormone you take the faster your bowels will move and the less time your “food” will stay in there.
More thyroid hormone and levothyroxine = looser stool
Less thyroid hormone (or hypothyroidism) = more solid stool
In this way, hypothyroidism tends to lead to constipation and hyperthyroidism tends to lead to diarrhea.
But, of course, this all exists on a spectrum and it is proportional to your dose.
What do I mean?
If your dose of levothyroxine is only mildly elevated then you may only experience slightly loose stools.
If, on the other hand, you are taking way too much levothyroxine, then you might experience full-blown diarrhea.
#10. Heat Intolerance
Another important side effect is that of heat intolerance.
As your levothyroxine dose increases and becomes too high you will notice that you are simply not able to tolerate the heat.
If you are taking levothyroxine and you feel like you are flushing, or sweating, or feeling like you are having hot flashes, then it may be that your dose is too high.
These symptoms are all associated with heat intolerance.
Another good way to tell if you are having issues with heat intolerance is to do the “heater test”.
If you find that you simply cannot stand having heat blown in your face then you need to evaluate your dose!
Most people taking levothyroxine struggle with cold intolerance and are often too cold all of the time.
Cold intolerance is a sign that your dose of levothyroxine is not high enough.
What to Do If you Have These Symptoms?
So what should you do if you find that you have many of these symptoms?
The good news is that the treatment is actually incredibly easy.
All you have to do is lower your dose!
As you lower your dose your symptoms of levothyroxine overdose will subside fairly rapidly.
You should be aware, though, that each dose of levothyroxine will stay in your system for about 4 weeks total (4).
You won’t experience symptoms of overdose for that long, however, but it may take you some time to find the correct dose because of this.
Whenever I would treat patients who were taking too much thyroid medication (of any type), I would simply have them avoid taking their medication for a few days to allow the thyroid hormone levels to fall.
Once you stop taking your medication for a few days you can then re-start back up on a lower dose than what you were taking previously.
From there you can re-check your thyroid lab tests including your TSH, free t3, free t4, and reverse T3, to see where you are at.
Don’t be surprised if a dose of thyroid medication that was previously working for you is now too much for your body!
This happens from time to time and you shouldn’t expect your dose of levothyroxine to stay static throughout your life.
Is your Dose Too High or Too Low?
As I mentioned previously, it’s far more common that thyroid patients are not taking enough levothyroxine as opposed to too much but it definitely does happen.
The good news is that it is fairly easy to tell if your dose is too high and the solution is also quite simple.
Reducing your dose should fix your symptoms within a few days.
And now I want to hear from you:
Do you think your dose of levothyroxine is too high or too low?
Are you experiencing any of the symptoms listed above? If so, which ones?
Are you taking levothyroxine or Synthroid? Do you find that you are more sensitive to one over the other?
Or are you using an entirely different type of thyroid medication and still having some of these issues?
Leave your questions or comments below!
93 thoughts on “Levothyroxine Overdose: Signs You Are Taking Too Much”
Is there an adjustment period when you first start taking NDT that you will get some of these hyperthyroid/overdose symptoms until your body gets adjusted to the medicine or does it always mean your over medicated?
Also, I tested negative for antibodies(TPO/ anti-thyroglobulin antibodies) but my Thyroglobulin is high (80 ng/ml). Selenium is borderline HIGH , iodine is borderline Low, TSH ( 2), Free T3 (3.1), Free T4 (1.23 ), Reverse T3 (16). My labs are WNL (without medication) but doc says my thyroid is slightly swollen and I have hypothyroid symptoms . Is high Thyroglobulin due to inflammation or just low iodine? Every time i try a supplement with iodine- my hair loss gets much worse (tried all of yours). Any help would be appreciated!
It’s possible that you could need to acclimate to the new dose but it’s generally not a good sign to experience hyperthyroid symptoms early on in the course of treatment.
My son who is 18 has almost all the same blood results, iodine is low, and co-factors are high although he does supplement.
TPO – O
Thyroglobulin is 255
TSH swings between 2-4.5
FT3 always 4.1
He CANNOT take iodine but in serum, his iodine is on the low end. We have been to 3 endocrinologists and they say he is going through puberty. OMG! His ultrasounds show mildly enlarged thyroid but no nodules. So frustrating. He has not tried medication yet. Have you considered LDN? I believe this problem may be methylation or heavy metal problem.
im hypersensitive to it. some people do have a hyper period before settling down. raise in micro increment of 5/6mcg at a time and stick for at least 4-6wks at that level. hope that helps you.
hi sir im vijay 28y.i was dioagnised with hypothyroid nov2018.i started medication thyroxin 100mcg.after 6 months started neglecting my main problem is losing hair.still losing hair i used so many medications for stop the hair loss PRP treatment also but i did not find any improvement.15 days back again went to thyroid doctor.this time he gave me 50mcg levo thyroxine this is my story. sir please help me to come out of this hell.give me hope sir please
i know you are bussy but your one reply is a ray of hope to me thank you sir
Have you tested your Free T3? He has a lot of articles why you need to test T4, T3 and RT3. Perhaps you need a combination of Synthroid and Liothyronine. That’s what I take. It’s hard to figure out the right dosage so make sure you notate all your symptoms.
I have Hashimoto’s Thyroiditis and I have always struggled with finding the right dose. Presently I’m on both Levo (50 mcg) and NP Thyroid (1 grain or 60mg). Lately I’ve had ringing in my head and headaches and generally not feeling well. Though my levels are within range except my TSH was 0.1. I’m wondering if I’m on too much NO thyroid and if I can’t tolerate the T3 though I am splitting the dose 1/2 in the morning and 1/2 in the afternoon.
you are on too much!!! been there. 🙂
I was taking 162.5 mg of NatureThroid when I found it was recalled for sub-potency. I switched to WP Thyroid but I could only take 150 mg because the pills are not formulated the same. I started having a very elevated heart rate and losing weight but just dealt with it for a while thinking it would go away. When it did not go away and became worse at night when trying to sleep or it would wake me up, my primary care Dr said it was time to see a Cardiologist. I see one every year anyway but this was new. The cardiologist suspected right away it was my thyroid medicine even tho I had changed recently to a lower dose. I had blood work done and sure enough my Thyroid was over treated and my testosterone too high. I went down again to 120 mg of WP Thyroid. I am also starting to have some acid reflux issue which I have never had before and a sensation of a lump in my throat diagnosed as Globus Sensation. I am going on 3 years now since being diagnosed with hypothyroidism and starting thyroid medication and it is so hard to get the dosage just right.
It can be difficult but using a compounded thyroid medication may work best for you.
I was on a very high does of Levo 300mg for nearly 20 years. After feeling unwell and exhausted I got in touch with a thyroid specialist .. they said I had thyroid burnout . I had hashimotos but now no antibodies. After 9 weeks on NDT I don’t think I want to continue. It’s too expensive as a life time commitment and I found the highs and lows difficult to manage.
I am wondering whether to go back to Levo with T 3 or just T3 ?
Do you have any advice on that ? I am 52 years old.
Unfortunately, there’s no way to tell for sure how you will react to any given thyroid medication which is often why trial and error is the best approach.
Diagnosed w PTC and Had a TT on 11/30 , para thyroids looked good and no Lymph nodes removed. Put on Synthroid. So far doing ok except having heart palpitations and already affecting my hair /skin in form of dryness. Should I be taking supplements (vitamins) along w the Synthroid . Any advice is much appreciated .
In my opinion, yes. You can learn more about why I make that assertion here: https://www.restartmed.com/thyroidectomy-supplements/
I also have a bundle designed for those without a thyroid here: https://www.restartmed.com/product/thyroidectomy-rai-bundle/
changing supplier means strength may change too. shouldn’t but it does x
Hi, my doctor has reduced my levothyroxine from 125 down to 100 and now after two months he has reduced it again to 50. Is this safe ?
It’s probably not harmful but it may cause you to feel worse.
I have taken Levothyroxine for 15 years. The last few years I have had problems with sleeping, frequent night time urination and gastric reflux. I was prescribed Lansaprozole but find that it gives me diahrrea. Reducing the Levothyroxine by half means that I sleep better and have less gastric problems. I have never been able to lose weight and I am obese at 16 stone. I still have gastric reflux and take lansaprozole despite the effects. I am managing but am concerned about the long term effects of reducing the levothyroxine. I take 100gm every other day. No alternatives seem to be offered in the NHS UK to Levothyroxine. I am 70.
I have had problems for years, with levothyroxine, and I have cold intolerance, hair loss, weight issues, fast heartbeat, anxiety, depression , etc and am switching to Armour thyroid, what do you think?
Please do not hesitate to cut down your tonhyroid medicine. I was put on it 28 years ago after having been treated with radio active iodine for hyper thyroidism. Somebody messed up. Even though I had no symptoms flow thyroid. I quit the hormone for 11 years and did not die! The was put on it again for the same circus. Last doctor put me on 100mcg! I decided to be my own doctor and am now on 75 mcg a day and I feel like I did 188!
Hi Dr. Childs,
Thank you for sharing your video and this information. I recently found out that I was being overmedicated on Levothyroxine 175mcg. Over the last year I have made a decision to live a healthier lifestyle through diet and exercise (I lost 30 lbs!) and I believe that is the reason for the over medication. I had many of the symptoms you described, but one additional one is pins and needles in my hands and feet. Is that a normal side effect? Will this go away once my thyroid numbers are optimal? My dosage had been lowered a few times during this 4 week period.
Not usually, that could be related to many different things including nerve impingement or even over-supplementation with something like vitamin B6.
my levels do cause pins and needles for me yes. I think maybe because your levels affect oxygen levels/nerves and everything. I also get extra hyper sensitive when too high.
We keep my level at about .03. I do have the heat intolerance but if we drop lower, I gain even more weight. I have gained so much even on the 150mcg to put me at my current level. 1 tab everyday except Sundays a half tab. Can you please give some insight into helping with the weightgain, heat intolerance, and insomnia?
Yes, it sounds like you are probably dealing with more than just a thyroid problem. If you are having trouble nailing down your dose it’s probably because another hormone system, such as your adrenals or cortisol, needs to be addressed.
I am a 59 year old female that underwent a thyroidectomy last year due to thyroid nodules and a thyroid goiter. The surgeon left two of my parathyroid hoping that I would not need thyroid replacement. Three weeks after surgery I ended up in the ER with severe muscle weakness, elevated BP and bradycardia. At that point I was placed on levothyroxine, it has been monitored and adjusted a few times over the last year. My dose of levothyroxine is now at 150mcg but recently have begun to experience heart palpatations and irritability but this was after my dose of medicine had been too high on 175mcg. Soon after the reduction in dosage , I experienced a resting heartrate in the 50’s, now I have a resting heartrate in the upper 60’s which had previously been my normal. These symptoms have all been over the past two months. The palpatations began about two weeks ago with worsening symptoms when I physically exert myself.
My doctor says we will wait a few more weeks before checking my levels. I did skip my dose today to see if that will help reduce the symptoms.
Thank you for your help.
It sounds like you are experiencing hyperthyroid symptoms but it’s hard to know for sure without lab tests. If you are feeling poorly then I would push for more immediate lab tests from your doctor.
I am taking 25 mg from last 4 years. I have many of the symptoms indicated above. How many days should i stop taking the dose.
I can’t really provide that type of medical advice here but I would strongly recommend touching base with your prescribing doctor for more information on that. Usually, avoiding a dose or two is reasonable and may help you get back on track but some people may need to avoid doses for one or more weeks.
I’m having problems finding the right dose. A few years ago I was increased to 112mcg and it worked like magic for the first time in a decade! I naturally lost weight with exercise, slept well, and felt healthier overall because I was able to lose weight and got better sleep which helped me to eat healthier, but without any hyperthyroid symptoms. I loved feeling normal. This lasted for an entire year. Then something happened and I started getting hyperthyroid symptoms and had to decrease to 100mcg. I gained 9lbs in two weeks! I lost all progress I made, felt fatigued, depressed, my face looked puffy, my heels cracked. But since 112mcg ended up giving me heart racing/insomnia etc my dr was reluctant to do anything about it since my TSH was now “controlled”. A year later my TSH was over 4 and so a new dr was willing to try 112 again with the same results. I don’t know what to do. I feel like my thyroid is always under-functioning at 100 and that can’t be good for my health either. I have a multinodular goiter and feel like my throat is fuller. I feel unhealthy with the inability to lose weight and weight gain of almost 10lbs in such a short amount of time. I’m stuck in between.
You might find success in trying to find a dose between 100mcg and 112mcg that could work. You can either compound it or simply take a higher dose every 2-3 days to compensate.
I can tell if i have too much or too little medication by my blood pressure.
It can help guide you but keep in mind that other factors also influence your blood pressure as well!
I was reading your great article, with which I related to greatly, when I got to Myth #10. It says if you are experiencing heat intolerance, that you should “increase” your dose. I think you mean “decrease” if I’m not mistaken? Or maybe you do mean “increase”? Thank you so much for all the valuable information.
Can you please quote the section you are confused about? I just glanced over it and it looks like it is correct but if there is a specific sentence in questions please quote it in response here.
Dr. Childs, thanks for the informative video about Levothyroxin.
I was diagnosed with hyperthyroidism and Graves disease a few years ago and taking 125mg daily for about a year with normal TSH, T3/T4 levels.
However, I have a sudden onset of Thyroid, Eyes (Protosis in one eye); and I understand the association with inflammation and eye pressure. However, I don’t know why I have this condition. In addition, regarding the eye issue, I am a candidate for Trepezza for it and will probably start the infusions soon.
Is the eye swelling correlated with the drug dosage, or is this something of a thyroid malfunction causing?
I appreciate your time and advice.
TED is mediated by the immune system (not the thyroid).
Hi Dr. Childs, Great information — thank you. I had a full thyroidectomy several years ago and did extremely well on 120mcg Tirosint (112/125, alternating) for about five years. A few years ago, things took a turn and it’s been downhill from there — steady weight gain of ~40lbs, exhaustion, brain fog, and digestive issues. More recently, I developed the hyperthyroid symptoms you described and ultrasounds showed that I’ve had some tissue regrowth, so I reduced my dosage to as little as 100mcg, which stops the hyper symptoms but still doesn’t get me back to my sweet spot where I’m feeling good and able to maintain a healthy weight. My last panel showed normal free T3 and T4 but a TSH of 18, so my doctor and I are at a loss. Any idea what could be going on? Thank you for your time!
Unfortunately, there’s not enough information here for me to say one way or the other. I would recommend checking out this blog post which may explain some of your issues: https://www.restartmed.com/you-cant-stay-on-the-same-thyroid-medication-dose-forever/
I had my thyroid removed five years ago. Started in levothyroxine 125 but it was too high and then lowered it to 100mcg. I felt okay for a while. I dealt with a lot of heat flashes, over grown hair, hair loss, puffy face, kept telling my dr but she kept telling me everything looked normal. Finally one day I had severe stomach aches, diarrhea, joint pain, blurry vision. Later was diagnosed with sibo. Changed my medication to synthroid and get better but I still at times get resting heart rate in the 50’s and I am now more sensitive to cold and I got my puffy face again. Hair just falls out like butter. And yet mornings I have high palpitations like brushing my teeth makes my heart rate go in the 90s at times and at night my heart rate drops to 50’s. I always feel tired and I constantly wake up at night to go pee. I have been experiencing issues with my bladder and menstrual cycles. I’m not sure what to do. My dr keeps telling me it’s fine. I finally went to see a functional dr and he said I wasn’t converting my t4 to T3. Gave me supplements but I haven’t seen much of a difference.
Please see this article on how to improve your free T3 and how to improve thyroid conversion naturally! https://www.restartmed.com/increase-free-t3-naturally/
I love reading your articles. They’re so helpful.
Had a thyroidectomy end of 2018 for papillary. Just had a central left neck dissection this past July 2031. No matter how my endo adjusts my dose, my FT4 is always up by the high border.
I currently take .100 MCG of synthroid 7 days a week.
Starting January, I will be taking 5 days .100 and two days of .88. Then I’m to take 5 MCG of T3 (generic form). I’m a bit nervous and I’ve asked my endo this important question, will it make my FT4 higher? Will it cause me to be hyperthyroid?
I can’t tell how I’m feeling right now. Sometimes I feel I go from hyper to hypo. I’m never cold. I’m very intolerant to heat and I’m so hungry throughout the morning and early afternoon. I take my synthroid at 6:30 am and run my lab around 21-11:30 am.
Endo says I’m not converting the synthroid. My FT3 is low normal range.
I’ve been hyper through this thyroid cancer journey and I’m now 63 and they want my TSH below 1.
Any suggestions or feelings about me adding T3?
It would definitely be worth considering T3 in your situation.
I was taking 88mcg and started to feel fairly normal again. Then I wanted to switch to Levoxyl because it has fewer fillers. It’s been about three weeks and I’ve been splitting the dose between night and morning but I’ve started to have diarrhea and some heart papalpitations. I feel like the dose is too high even though my lowest heart rate is around 48 (have had bradycardia for years) but I feel better because it’s not dipping down to 40. Should I just start taking half for a while?
Unfortunately, I can’t give you medical advice regarding what you should do with your dose of medication. Having said that, it’s never a good idea to blindly make changes to your thyroid medication without first testing your labs and waiting at least 4-6 weeks (unless it’s obviously too high).
A month ago my doctor reduced my 60 mg of NP Thyroid to 30 mg daily because my T3 measured much higher than ever. I do not feel any different at this point but will take this dose another month and test again. It seems to me that reducing the dosage by one-half was too much, but 30 mg is the next lower dosage of this product. My main symptom is cold intolerance but I had that before reducing the dosage too. I’m having some hair loss, not drastic, and again I was already having this at 60 mg. Your thoughts?
NP thyroid does come in 15mg increments so there’s no reason to go down that drastically. Please see this article: https://www.restartmed.com/free-t3/
Living in South Africa I use Euthyroid, my GP adjusted my medication only three months before. Then my blood pressure shot up, to such an extent that I had to use medication for that. Had heart palpitations, was anxious and had panic attacks and diarree at times. Also constantly gittery and nervous even when I had no reason to be. Went for a scan chronic thyroiditis were diagnosed but my blood tests were negative for graves ♀️ It’s been two months with no medication, and things are stabilizing. My blood pressure is within the normal range again and the other hyper symptoms has gone. It were an awful at best. Will go for blood tests in the coming week. Have liver and gall bladder problems as well, took 13 years to diagnose that! My liver is battling and is probably the reason that I’m hypothyroid. Removed most toxins from my home and personal care. Started with drinking water and toothpaste. I still have lots to do especially with food, living in a small mining town it’s not possible to eat organically.
Please see this article on the connection between thyroid medication and blood pressure! https://www.restartmed.com/thyroid-medication-high-blood-pressure/
My doctor started me on 100mcg of Levo, within a week or so, I started to feel lethargic and it was difficult to work. I thought my thyroid was getting worse and took an extra dose, made me feel much worse and had to go home and rest during the day. After I stopped the medication,It took over a week to start feeling better. My doctor and pharmacist do not understand why over-dosing would cause this, any ideas?
Thank you for your videos and products.
Yes, this can happen if you have a conversion issue: https://www.restartmed.com/testing-for-thyroid-conversion-issues/
This is so helpful and at the same time confusing. I tried to up my levothyroxine from 75 to 100 and that did go not well. I felt it was too high. So i switched back to 75. Then i was very cold for a month, like this inner cold. That is weird for me, because for 4 years, i had hot flashes all the time. I hated summer. Now i hate winter and love summer. After that i was just ok. On 75 i feel meh. Some weeks i lose more hair than other weeks. Some weeks i feel more tired. But i’m always tired basically. Maybe i will try to add 12.5 mcg instead of 25. I’m not looking forward to the changes. My heart rate is mostly 64-67. Maybe that’s too low. I’m not at all in shape.
You may want to play around with every other day dosing or with a completely new type of thyroid medication. Something like Tirosint may give you more consistent results: https://www.restartmed.com/tirosint-beats-levothyroxine/
Thank you for replying. In my country there is only levo. I would have to pay out of pocket for a T3 medication. And convince a doctor to give it to me. No one supports this. It’s just: here is your medication. Goodbye. I have seen a lot of doctors. They have never heard of a natural medication too. And they never believe the patient. Anyway, not your problem. 😉 I am glad someone cares!
Sorry to hear that! I do know that some patients get T3 from pharmacies in other countries. I generally recommend against this but it is something you could consider if all other options were exhausted.
Good Morning DR
My name is Ernesto, I am on Tirosynt 100 mcg and Liothyronine 10 mcg in the morning + Liothyronine 5 mcg at 3 in the afternoon and everything is quite well except irritability and cold intolerance
my labs from a month ago are as follows
But my doctor says it’s fine like this
that will be correct
I am 55 years old
I really appreciate your help
Please compare your lab tests to those ranges found here 🙂 https://www.restartmed.com/normal-thyroid-levels/
I have MIXED symptoms–lots of jittery sensations where heart rate increases from high 40’s, low 50’s to 70’s, heart feels pounding, stool consistency is soft formed but sometimes have to strain to get it to move, heat AND cold intolerance (cold during day, get hot and sweaty middle of night while husband is shivering cold), no trouble falling asleep but trouble staying asleep (maybe due to hot flashes but I’m 77 and way past menopause), skin dry and itchy, nails dry and brittle and split lengthwise, hair falling out. I had half thyroid removed with large benign nodule 5 months ago, remaining half has small benign nodules. Also had 2 parathyroid glands removed (1 defective, 1 inside nodule). Have gradually worked up to Levothyroxine 75 mcg daily now. TSH still high at 11.9, total T3 86, free T4 1.1, Thyroid peroxidase antibodies 15. I have a history of intermittent atrial fibrillation with 3 brief episodes over past 6 years (first one lasted 5 hrs, second one lasted 3 hrs, last one was only 35 minutes) but I can tell when it starts and stops because I get that same jittery feeling I get now. No atrial fibrillation since March 2020. That was before any thyroid medication and TSH was just beginning to be elevated. 1) Could that AFib have been related to thyroid problems? 2) Why are my symptoms so mixed?
It’s because each tissue can get a different amount of thyroid hormone. It’s explained in more detail here: https://www.restartmed.com/hyperthyroid-and-hypothyroid-at-the-same-time/
I wish my son’s doctor had told me this when he was born! Had to learn the hard way–can you speak on twitching? My son tends to twitch or have facial twitches and throat humming when his levels are too high OR too low–and its super hard to figure out which is which! He is on a t3/t4 combo…..and can you add anger and extreme mood swings to the mix? Please do a blog on this one! (generally when too overmedicated) So what do you notice about twitches and involuntary muscle spasms? How do you interpret these?
Thanks for the suggestion! I will add that to the list of future blog post/video topics 🙂
Dr. Brand, I don’t know why I haven’t read this before! I am 3 years post thyroidectomy (1/2) and have struggled with getting the right dosage. At the same time dealing with (decades long) gut dysbiosis, heart palpitations and PVCs, estrogen dominance. The gut issues have made getting the right meds a challenge. I’m not sure if my thyroid meds need to be balanced first or my gut. Seems they’re fighting each other. Recently I started on T3 as well as Levo. It seems to help with the heart and my resting heart rate is now over 60. Thank you for your knowledge !
I don’t know who Dr. Brand is but I’m glad you found it helpful 🙂
Dear Dr Childs
Thank you for your articles.
I am under treatment for Hashimoto’s hypothyroidism.
(T4) Euthyrox 50mcg once a day
(T3) Cynomel 25mcg – half a tab once a day Monday to Friday
And other supplements as well
My most recent lab results (12 Nov 2021) shows
FT3 : 3.43 pmoI/L
FT4 : 11.7 pmoI/L
TSH : 3.33 uIU/mL
Too far for medical help for me,but try to manage.
TSH is only thing I can test its 8.4….3.5 to 4.9 recommended,taking 2 mcg daily, should I reduce to 1 Thank You
Unfortunately, I am not able to make recommendations regarding what you should or shouldn’t do with your medication.
Drawing from personal experience being overdosed looks a little something like this.
You go on a road trip with your best friend and along the way they mention that you have to pull an 8 hour drive and just the thought makes you extremely irritable. You find yourself feeling unrested, looking tired and struggling to keep up, not to mention you’re hot. Normally an 8 hour drive would be no big deal so you book an apt with the Dr and find that your total T4 is over range yet everything else looks normal, in fact your TSH is still 1.5, FT4 is 1.6 and FT3 is 3.8. This is on T4 only.
Next scenario. You’re on T4 only and you decide to try NDT so the Dr tells you after a week to bump your dose up to 2 grains, after coming off of 88mcg of T4 daily. Within a few weeks trying to complete a task like walking is difficult and tiresome. You feel a bit off and very hot. Tests show your FT4 is 2.0, FT3 is 5, and TSH is 0.05.
Last scenario. You’ve been on a lower dose NDT and you start getting severe hypo symptoms so you move back up to 2 grains of NDT but before the week is up you start feeling extremely hot and completing any task is impossible and your sleep is terrible. You want to dig a hole in your garden for a plant but you can’t muster the energy and you’re sweating not to mention every time you bend over and up you feel dizzy. Even trying to walk your dog is too much. Tests now show TSH is 0.05, FT4 is 1.2 and FT3 is 3.5. After dropping back down to a lower dose the symptoms go away and you feel great for about 4 days only to feel severely hypo again by the end of the week.
Few times I’ve felt what it’s like to be overdosed but the one thing in common was that I felt very hot, weak, and everything was difficult.
I had my thyroid removed, do to cancer. Surgeon put me on levothyroxine 175 then after treatment for cancer my general Dr. Said to high ,now 150 daily.I haven’t been well from beginning of pills. Never had a weight problem, or panic attacks,sad, nervous,no get up and go. Don’t know if I could suggest something to do. By the way I’m up 46 pounds ,and that’s not me.
I have hypothyroidism & am a T1 diabetic. Im at my wits end with my thyroid. I take 100 mcg/day and am tired by 3pm. I sleep 12 hrs/night, BUT only 3-4 nights/ wk. The other nights I can’t fall asleep for 4-5 hrs. It drives me crazy. Physician increased Levothyroxine & added 150 mcg/ 1 day a week. Now I can’t fall asleep 4-5 days a week. Nothing works! The not falling asleep is killing me. Of course, they want to give me sleeping pills which I’m against. Any suggestions?
Of course! This article is designed to help you optimize your thyroid medication so I would check it out: https://www.restartmed.com/how-to-optimize-thyroid-medication/
Next, I would take a look at this article to get an idea of what you can do to help improve your sleep: https://www.restartmed.com/how-to-sleep-for-better-thyroid-health-immune-function-weight-loss/
Lastly, you can also try some of these natural therapies for your thyroid: https://www.restartmed.com/natural-thyroid-remedies/
Since covid Vax I felt so bad I stopped taking my thyroxin. I feel dreadful. If vaccine is as bad as they say. I font trust medication either
I felt dreadful
I have a lot of this symptoms. My Dr. Changed my dose from 100 to 75. I am so fatigued all the time. He change my dose after I asked him if we could maximize my results. I was told the smaller the dose the more medication I am getting. Is this right or am I going the wrong Direction with my dose of medicine. And I’ve also went from having high pro thyroidism to having Hashimoto’s
No, that is not correct. The smaller your dose the LESS thyroid hormone you are getting which means you will minimize your results. Perhaps you are confusing your thyroid medication dose with the TSH? As thyroid medication goes up the TSH will fall and vice versa.
I’ve been treated for Hashimoto’s for 20 years, I believe the lowest dosage of Levothyroxine was 100mcg, have been on 137mcg for many years but a few months ago I was moved back to my highest of 150mcg. I have always somewhat struggled with my weight but have been able to somewhat regulate through outdoor activities/exercise. Just before my last dosage change, I was in the hospital for unrelated issues and the alarms were constantly sounding for excessively low heart rate 30-40s. They assumed it was because I used to run long-distances but haven’t for 8 years now. I am 59, I have my hair cut every 3 weeks and it grows so fast the barber is always shocked. Have always sweated excessively if I’m working or doing anything physical, I really thrive in cold temperatures (prefer to sleep below 70degress). Recently retired, I had a lot of great plans for my retirement but frankly I don’t have the energy, I spend a lot of my day as a couch potato thinking about everything I should be doing, napping and sleeping much more than I ever have. I’m gaining weight much faster than I have experienced in the fast and never during summer months. It feels like I’m still low even after the adjustment. Does size factor in? Im 6’3″ and 275, usually stay around 250ish. When I’m below 250 I tend to run/hike/bike and do much more physical type activities. Thanks for the information.
Yes, size certainly can play a role. Some poeple recommend thyroid dosing based on those metrics but I tend to not be a fan of that type of dosing. The first place to start would be with a complete thyroid lab panel: https://www.restartmed.com/normal-thyroid-levels/
You will also want to check your testosterone levels: https://www.restartmed.com/thyroid-lab-tests-men/
I took Levothyroxine 88mcg for about 20 years and was diagnosed with Major Depressive Disorder about 15 years ago, then Bipolar about 5 years ago. I am being treated for these. I also suffer from anxiety. My PCP retired and now I’m seeing a new doctor. After having tests, my results were TSH 4.28, T4 Free 1.17 and T3 Free 2.5. The doctor raised my level to 100 mcg. Since then my anxiety has worsened and I am EXTREMELY heat intolerant, reminiscent of Menopause. I am 62. Could the increase be causing this and, if so, what do I need to do? My recent test results (4 months later) were TSH 0.527, T4 Free 1.04 and T3 Free 3.2. Being this hot all of the time is unbearable and is ruining my life!
It could be, yes. The only way to know if it’s related to your thyroid medication or not is to adjust the dose. If the symptoms persist after dropping your dose then you’ll know it’s unrelated.
I have all of these symptoms and all my doctor told me to do is to stop taking one dose on the 7th day. It’s not helping and now he says I need to see my primary doctor which does not make sense because he is my endo doctor. I feel like he fired me as a patient. I’m at a loss.
I’m not sure what he is thinking exactly but he/she might also be thinking that your symptoms may be unrelated to your thyroid. Whether or not that’s true is another story, though.
My mother is 86, has dementia and recently went off 2 of her blood pressure meds (after Covid) per her doctors. Her blood pressure suddenly was low. We tracked it for a month and it has stayed low. At the same time, she started shaking and stuttering. We initially thought it was a change in her brain from being hospitalized (and with dementia)
She ran out of her thyroid med (Levothyroxine 50 mg) and wasn’t able to take it yesterday or today (holiday-pharmacy closed) and SHE DID NOT SHAKE OR STUTTER YESTERDAY and so far today. So my questions is, can certain blood pressure meds actually cause a change in your thyroid?? (it has been 3 months since her hospitalization)
Yes, some blood pressure medications are known to block thyroid function. You can see a list of prescription medications that do this here: https://www.restartmed.com/prescription-medications-that-block-thyroid-function/
My TSH 3.9, FT4 11.0, FT3 4.5, however, lately I have been constipated which I have never been before. I am 83 years old. Please let me know if you think my figures are too high? Lately I have been perspiring quite a bit, my body very clammy and moist, and problems falling asleep.
My dose of levothyroxine is too high. I had a thyroidectomy Jan. 2021 and they have raised my dose many times in an effort to find my perfect dose. About 6 months ago I was in range about .4. Now about 3 weeks ago I am at .23 and I am irritable, hot sweaty, gaining weight, have insomnia, muscle and joints ache, and I am exhausted. Last week I went to ER due to afib and heart palpitations. My heart was out of rhythm for about 2 hours. They rechecked my TSH it is .2 my T3 and T4 were ok. My problem is that my doctor says my dose is fine. 200 mg. I have gained 60 pounds since my thyroidectomy and I am still gaining, so she feels that my dose isn’t high. I get crazy hot, then I am cold for 30 minutes or so, then hot again. I can’t sleep, tired all the time. How can I convince my doctor GP. that the dose is too high? I also see an ENT and cardiologist, but they say my GP must adjust my dose. No longer going to endocrinologist because I see about 20 doctors and I just can’t go to so many appointments. Besides without a thyroid I don’t think I need to see an endocrinologist, but I may be wrong. I kept my ENT because I have a paralyzed vocal cord and one dysfunctional cord. What do you suggest?
While it is possible that your dose is too high and that you are just sensitive to thyroid medication, it’s also possible that you are experiencing vasomotor symptoms from perimenopause or menopause depending on your age. You will want to test to make sure it’s not menopause before proceeding to change your thyroid dose: https://www.restartmed.com/menopause-symptoms/
Even though your TSH is low, there are plenty of post thyroidectomy patients who have much lower TSH levels and do not experience hyperthyroid symptoms. It can still happen, though, especially in those who are sensitive to thyroid hormone.
I am a 33 yr old female and have been on Levothyroxine for over 10 years. It seemed to work fine for me until a couple of years ago, when I developed many Hypo symptoms. For years, I was on 75mcg, until I became pregnant, and my doctor changed it to 150mcg. I’ve been on that dose now for a few years and while my Free T4 levels have been normal, my TSH levels have been Low. I have been gradually gaining weight over the past few years but recently have been gaining a pound every 1-2 days. My Hypo symptoms are very severe. I had my doctor test my blood last week and found my TSH level to be 0.03 and my Free T4 to be 2.02.
Is it possible I could be on too high of a dose of Levothyroxine and my body is creating too much Reverse T3 in defense? After getting my results back last week and being told everything looked fine, and of course knowing it isn’t, I searched the web and came across your site. I have reduced my dose to 75mcg and have ordered a new set of labs that includes T3 and Reverse T3, so I should have those next week. I am desperate for help so please let me know if you have any advice for me!
P. S. I have also ordered your RAI bundle and will be starting those supements as soon as they arrive.
Thanks so much for your help!
Yes, it’s absolutely possible that taking too much levothyroxine can increase reverse T3 levels. It’s a defense mechanism by the body to prevent hyperthyroidism from excess T3 production. It usually indicates (but not always) that you need to alter your thyroid medication to a blend of T4 + T3.
Thanks for your help! I got my labs back and that is exactly what has happened. I am now deciding if I want to try T3. The only thing that makes me hesitate is the possibility
of hair loss… I’m trying to get over that hurdle. I have dreadlocks so I fear I will go completely bald.
One more question I have is if I choose not to try the T3, is there any other way to reduce my reverse T3 levels? Would lowering my Levothyroxine dose and taking supplements be enough, over time? Thank you so much!
I have been on 125mg of Levothyroxine for about 18years. A new doctor has reduced this to 100 because of danger to my liver. After 6 weeks l feel wretched. Tired, cold , low. Do you know of liver damage caused by Levothyroxine? I never drink alcohol .
Thyroid medication will really only cause liver problems if you are taking a very high dose. You can learn more here: https://www.restartmed.com/thyroid-storm/
Everyday doses like 125mcg or 100mcg shouldn’t put you anywhere near that threshold. The number 1 cause of elevated liver enzymes right now is insulin resistance which should always be the first place you look if you are experiencing elevated liver enzymes.
My sister has Hashemitos thyroid and pots syndrome. She is taking 90 mg of dedicated thyroid medicine. Over the past month or two she has lost 30 lbs while eating strictly outside and more unhealthy fatty foods than usual and has started having weird symptoms like insomnia, head tremors, and weakness in her arms. She does have intolerance to heat as well. Her instinct is that her thyroid medication dose is too high. Her doctors checked her levels and told her it’s fine and would not reduce the dosage. Is it possible for your blood work to be normal but still be overdosed?
Absolutely. Some people are just very sensitive to thyroid hormones, regardless of what their labs show.
I was on 110 mcg of natural (pig) hormone for years and I felt fine with a TSH a bit higher than 1. At some point I became hypothyroid and my TSH went up to 7. It appears that the natural compound was yielding sub clinical dosages. Then I switched to Levothyroxine at 110 mcg and was fine until last year. I stopped eating all animal products and several months later my TSH was below 1. I felt irritable and developed a tremor in my left lower limb. I stopped taking Levothyroxine and felt better even with a TSH of 34. Now I am on 75 mcg after several months on 50. This last week the irritability and tremor are back. Could it be that I am just better off with a higher TSH? My free T4 was in the normal range even when the TSH was 34.
Everyone is different and some people do feel better with higher TSH levels so that could be a possibility.