Thyroxine overdose Clinical Case Tox Conundrum

If you take an excessively high dose you may be tempted to compensate by reducing your dose the next few days, but this isn’t actually a good idea. This can be teased out as you evaluate your lab tests and as you follow your symptoms. The most obvious answer is to reduce your dose back to where you felt “normal” which would be around 75mcg of Synthroid each day. I don’t recommend that you make any changes to your Synthroid dose without first consulting your doctor, but the answer to solving your issue is usually as easy as reducing your total dose. More valuable measurements may be found by evaluating your free thyroid hormone concentrations. Using a consistently high dose of Synthroid puts you at an increased risk for developing osteoporosis(3) (decreased bone density) and heart conditions such as atrial fibrillation (4).

• During the hospital stay, he developed sinus tachycardia, which was controlled with propranolol.
• Most probably LT-4 would not be entirely dissolved by the gastric juice and may not be absorbed in the duodenum (normally about 10-15%) but would be absorbed in the jejuno-ileum (normally about 53% of absorption of LT4).
• 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.
• She ultimately developed symptoms of thyrotoxicosis, such as arrhythmia, dyspnea, dizziness, and coma.

Should You Take A Statin If You Have Hypothyroidism?

There are plenty of other conditions, including other hormone imbalances such as menopause, which can make it difficult for you to get enough sleep. And, unfortunately, many people are either taking too much or simply not enough resulting in all sorts of symptoms. This section collects any data citations, data availability statements, or supplementary materials included in this article.

• In some localities thyroxine may be obtained at drugstores without prescription (mostly in the generic form).
• Because symptoms generally revolve around cardiovascular manifestations of thyrotoxicosis, admit to a cardiac monitored bed while appropriate beta blockade, IV hydration, and control of agitation and hyperthermia are achieved.
• To avoid overmedication with levothyroxine, your healthcare provider will use your thyroid blood test results to see if you are getting too much.
• Therapeutic recommendations are made based only in the review of the available literature concerning a relatively large number of patients, most of them children.
• If your provider determines that you are taking too much levothyroxine, they will reassess your treatment plan.

Day Thyroid Reset: How To Super Charge Your Thyroid

Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Certain other medicines may also increase or decrease the effects of Synthroid. The counter effects of those concomitant drugs like propranolol and sertraline are always to be considered as a cause in a patient with thyronorm overdose for being asymptomatic. The symptoms of too much thyroid medication can mimic hyperthyroidism or hypothyroidism, so it’s important to have your TSH, T4, and/or T3 levels checked regularly and any time your medication changes. Contact your healthcare provider if you’re experiencing symptoms of too much levothyroxine.

Click Play to Learn More About the Dangers of Too Much Thyroid Medication

You should be aware, though, that each dose of levothyroxine will stay in your system for about 4 weeks total (4). If your dose of levothyroxine is only mildly elevated then you may only experience slightly loose stools. This tends to fade fairly rapidly, though, as blood levels of thyroid hormone fall. Even though both conditions result in hair loss, the type of hair loss is actually different. The quality, the texture, and even how it lays on your head can all be impacted by your thyroid medication dose.

Rare side effects

Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request. This study was conducted in accordance with ethical standard and informed written consent was taken from patient for publication of this case report.

The mean daily thyroxine dose was 1.99 mcg/kg (range, 0.3 to 6.6 mcg/kg) with a mean duration of therapy of 20.4 years (range, less than 1 to 68 years). Women taking daily doses of 1.6 mcg/kg or more had significantly lower bone mineral density levels at the ultradistal radius, midshaft radius, hip, and lumbar spine compared to controls. However, estrogen use appeared to negate the adverse effects of thyroid hormone on bone mineral density. A 34 year-old female with a past medical history of Hashimoto thyroiditis (currently taking thyroxine 200 mcg daily) who took an overdose 6 hours ago. The patient claims to have taken 60 x 200 mcg of thyroxine and 10 x 10 mg of temazepam. The patient currently has ‘normal’ vital signs (GCS of 15) and is feeling tired but is otherwise asymptomatic.

TREATMENT

The exact opposite is true when your dose of levothyroxine is too low. 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. The higher your dose of levothyroxine the more amped up you will feel and the more prone to anxiety you will become. To complicate things further, you should also be aware that levothyroxine itself can cause hair loss.

There are a few reasons you could end up taking too much levothyroxine. For example, you may become overmedicated with the dosage or type of thyroid hormone replacement therapy you are taking. Certain health conditions and lifestyle changes can also make an overdose of levothyroxine more likely to happen. Although many patients with hypothyroidism use levothyroxine as an alternative treatment, few cases of acute overdosage have been reported worldwide1, and a large proportion of them have involved pediatric patients. A 21-year-old woman initially presented with palpitation and chest tightness after an overdose of levothyroxine (10 mg). The patient transiently lost consciousness and developed atrial fibrillation during hospitalization.

As your thyroid hormone medication dose increases, your heart rate will start to increase as well. We report a case of asymptomatic levothyroxine over dosage (2.5mg) in a chronic hypothyroid patient who also was concomitantly taking propranolol and sertraline for adjustment disorder. Thyroid function tests are not routinely indicated following thyroxine overdose.

If more than a few hours of ingestion of LT-4 tablets have elapsed, most probably synthroid pancreas the tablets have travelled from the gastric cavity to duodenum. One way to confirm the presence of LT-4 tablets in the gastric cavity is endoscopy, easily conducted in many hospitals and emergency rooms. LT-4 tablets are dissolved by the gastric juice, but there are no data about the rate of dissolution of a large number of tablets of LT-4.