Guest Author - Jim Lowrance
Recently on the Thyroid Health Forum, a member asked about over-treatment on thyroid medication (thyroid medication induced thyro-toxicity) and asked how a patient can know if this happens.
That's a good question because some patients have a degree of hyperthyroid type adjustment symptoms to new doses or dose-changes of thyroid hormone medication but doesn't mean they are going toxic because these only last a week or two.
I would say, as a well studied fellow-patient opinion that toxicity would be significant hyperthyroid type reactions that last more than a couple of weeks. For example if heart rate reaches above 100 BPM and is sustained that high, that might be a sign that the dose is too high. This varies as well however because some patients have a higher heart rate to begin with, so it might be better to say a sustained increase of about 15 to 20 BPM. Other patients can tell by their increased, sustained anxiety feelings.
When I was started on Synthroid when first diagnosed with hypothyroidism (later switched to Armour Thyroid), I had hyper reactions but was mainly due to being started on too a high a dose rather than a more gradual titration upward (gradual dose increase to proper level) over time. My heart rate went from 80 to 120 BPM and the anxiety was severe, making me feel like climbing the walls. This went away after about a week and my blood labs showed I was not over-treated but actually needed a dose increase afterward.
Blood retests are the best indicator of over-treatment and if a doctor doesn't let more than a 6 or 8 week interval pass before retesting, there's not much danger of toxicity occurring long enough to cause any real damage and can be settled down with a slight dose decrease.
Over-treatment over long periods, causes hypertension that can affect the body's organs if severe and goes on for long periods, plus can cause bone loss (osteoporosis). These are the same effects caused by hyperthyroidism of other causes.
Doctors do however need to also consider the adverseness of under-treatment that can also affect the heart over time and reduce a patient's quality-of-life. Unfortunately getting patients at the best treatment level is not always easy for the patient or doctor and sometimes takes effort and time. This is why some doctors are reluctant to optimize patients and instead place their levels anywhere within the normal ranges and call it good. Patients have to be proactive in insisting on reaching their set-point (best optimized level) but can sometimes be a struggle and somewhat difficult process.
When you read some of the thyroid medication manufacturers and other medical source statements about being placed on a dose to treat hypothyroidism, they make it sound so simple. They state for example that "within 4 to 6 weeks, the patient's symptoms will resolve and they will return to normal" but it simply is not that easy in many cases. This is why it is so important to be treated for hypothyroidism by the most qualified doctor possible.
