Sounds like hyper symptoms. Did you change anything about how you take your meds? For instance, if you were taking them with food before, then switched to taking them on an empty stomach (the preferred way) then you might be absorbing more and getting an effectively higher dose. Have you changed brands of thyroid medication? Or, like I said, autoimmune diseases can calm down during pregnancy, maybe your thyroid antibodies have decreased?
Still - going from 125 to 100 is a pretty good drop - I would hate to see you overshoot and become hypo. (I wish we knew your free T3). You might ask your doctor to try a smaller decrease first, to 112 mcg (they can have you alternate 125 one day with 100 the next). What is your resting pulse?
See, different manufacturers can vary by as much as 10% potency. This is enough to throw some people off as the therapeutic range for thyroid hormone is rather narrow. There is a real problem with people being switched from one maker to another by their prescription plans and their thyroid levels rising or falling as a result.
I would discuss this important fact with your endo. You should either 1)have your dose re-adjusted on this current generic and stick to this one maker or 2) better option would be to switch back to Levoxyl (doctor can specify no generic substitutions) at your current dose and see how things go. (T4 has a long half-life, takes a week or two for a new dose to level out, takes 6 weeks for the TSH to respond. You could speed things up slightly by simply skipping one day's dose, then starting the Levoxyl). Note that I am assuming you were stable for a while on that Levoxyl dose before and felt well on that dose - is that correct?
BTW - I haven't said congratulations yet!!!!! I'm so happy for you (Even though I'm still not completely sure who this is, but I read through some of your other posts and I THINK I have it figured out - I had it narrowed down to a few suspects, but your "voice" pretty much narrows it down to one. Geez, a lot has gone on in your life since we met!)
Just thought I'd say Hi....and chime in on the stop smoking thing.
Quote: Most people don't use the gum properly, though - you just chew it a couple of times to release the nicotine, then park it in your cheek like chewing tobacco. When the cravings return, give it a couple more chews and park it again.
That's definitely me. Heck since I've started the gum, I don't even think about tobacco. Of course, I've kind of disregarded the whole "reduce your dependence" thing I figure that's just a guide.
Anyway, I thought of more hyper symptoms -- *both* eyes twitching a couple of days ago. Every once in awhile, I get one eye twitch related to stress (like every few YEARS). But, I've never had both eyes going. Also, last night I was very hot and uncomfortable in bed without covers and it was 65 degrees and H was cold. VERY unusual.
So, I called the nurse today. She pretty much blew off my concern about the switch to generic, but she did call in Levoxyl with no substitutions.
Note that I am assuming you were stable for a while on that Levoxyl dose before and felt well on that dose - is that correct?
Well, not exactly. I started on 75 in July, went up to 125 at the end of August. In October I got pregnant and I was on the hyper end of normal, I think, or maybe even slightly hyper, but the endo kept me at 125 as I was pregnant.
So, I guess I'll go with the 100mg for awhile. I've just switched OBs to one in an entirely different system and I may switch Endos. The HMO I'm with practices medicine in a very paternalistic way a la 30+ years ago when it was assumed patients knew nothing and communication with patients was a waste of time. They say things like "Nurse will take you to see Doctor now." My endo actually isn't too bad, but getting past the red tape to him is impossible. This system actually strongly discouraged me from changing to a different OB within it when I told them I was not satisfied with my care and there were clear cases in which my OB had demonstrated incompetence -- for instance, not knowing about nuchal translucency testing.
I'm sure glad the Republicans saved us from the evils of a decent system of national health care. (sarcasm)
Well, now you're doing what I WOULDN'T recommend - lowering your dose AND switching back to Levoxyl at the same time - this is probably going to drop you too low IMHO. It's usually best to only change one thing at a time.
But given the difficulties involved in dealing with your doctor (REALLY common, btw) and the fact that you really don't want to risk going low and not having it picked up for a while since you are pregnant and we really want to keep those hormones in a good range for this baby, here's what you might do for now (I'm estimating, btw, that on Levoxyl your proper dose would probably be around 112 mcgs a day if your labs were slightly hyper on 125 of levoxyl but you didn't have symptoms, and the switch to generic pushed you into symptoms):
Start the 100 per day of levoxyl. Give it two weeks - that should be enough time for your T4 and T3 to come down (TSH lags and won't show reponse for 4-6 weeks). Try to get your doctor to test your free T4 AND free T3 after two weeks (maybe you could talk your OB into ordering it if you explained?). If they just won't test it then, and all your hyper symptoms are gone, email me and we'll talk about other options (elliestough@hotmail.com). Given what we know about the effects of maternal hypothyroidism on kids, I just want to make sure you don't slip too low.
And go ahead and skip one day's dose before you start the 100 mcg Levoxyl - it will give you a little head start on lowering your levels (T4 has a long half-life so you don't have to worry about fluctuations from a single missed dose). You should feel better in a week or two.
Give it two weeks - that should be enough time for your T4 and T3 to come down (TSH lags and won't show reponse for 4-6 weeks). Try to get your doctor to test your free T4 AND free T3 after two weeks (maybe you could talk your OB into ordering it if you explained?)
Perfect -- I have my first appointment with a high risk OB practice with an excellent reputation in two weeks.
BTW, this is another weird thing. I'm diabetic, Type II, diet exercise, always normal HBA1C, only I would fail GTTs. As soon as I got pregnant (like at 5 weeks, only 3 weeks after conception), I started on insulin. I'm now on Humulin 2x/day (36pm, 20am), Humulog 3x/day (16-18 before meals). I'm going to have to increase the pm Humulin as my fasting BGs are into the 90s. But, my daytime BGs seem to be doing *better*???????? Could the hyperthyroidism be lowering my BGs?????
Alternatively, could the pregnancy somehow be improving my metabolic systems generally?
I've gained weight, about 10-12 pounds, but I'm thinner generally in the face and elsewhere except for the baby and breasts. So, maybe my body fat has decreased a bit. Would that explain the changes?
Well, treating your thyroid will improve your glucose tolerance, and it's possible that being slightly hyperthyroid was lowering your blood sugars even more because of the increased metabolism (I used to get positively hypoglycemic if I skipped a meal when I was hyperthyroid).
Now of course you will be coming down a little on your thyroid so watch those BS measurements carefully - you may not need to decrease your insulin.
BTW - I can relate to your story of being too hot at night - I used to throw the covers off and freeze my H when I was hyper (usually I'm cold in bed).
I'm so happy for you