Thyrotoxicosis after a massive levothyroxine ingestion: A case report

A resting heart rate in the 50’s usually indicates your thyroid medication is too low (assuming you are not extremely fit). 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. 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. Levothyroxine (T4) overdose is not a common entity and it can occur accidently, mostly in children, and can happen intentionally in adults with suicidal ideation especially psychiatric patients 1. Administering activated charcoal to a patient who has co-ingested a sedative is fraught with danger. However, this patient is fully conscious and her level of consciousness is unlikely to deteriorate now that 6 hours have passed since the time of ingestion.

Thyroid hormone, and, therefore, levothyroxine, help to control the kinetics of your bowels.
Levothyroxine is the #1 most prescribed thyroid medication on the market and one of the most commonly prescribed medications period.
A potentially toxic dose includes acute ingestion of more than 5 mg of levothyroxine or 0.75 mg of triiodothyronine 3.
Because of this, people should not take over-the-counter weight loss supplements.

Synthroid (Levothyroxine): Side effects, Interactions, and Overdose

Along with its needed effects, levothyroxine (the active ingredient contained in Synthroid) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. This includes prescription and over-the-counter medicines, synthroid lipitor vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using. Your child’s dose needs may change if the child gains or loses weight.

Although most patients with levothyroxine overdose are asymptomatic or have only mild symptoms, severe cases and delayed symptoms have also been reported. Levothyroxine overdose can usually be diagnosed by the patient’s history and examination results. Treatment of a thyroxine overdose should be based on the levothyroxine dose and the patient’s clinical symptoms and signs.

This can be teased out as you evaluate your lab tests and as you follow your symptoms.
Do not store the crushed tablet/water mixture and do not administer it mixed with foods that decrease absorption of levothyroxine, such as soybean-based infant formula.
You might have too much levothyroxine in your body if you’ve recently been pregnant.

This is really helpful because the type of hair loss that you are experiencing can help you figure out the CAUSE. When your dose of levothyroxine is too high your hair will become dry, brittle, and start to crack. By the 35-day mark, you will most likely metabolize the majority of thyroid medication.

How to Increase Free T3 Without Thyroid Medication

Elevated levels of total and free T4 and T3 have been described with suppressed serum TSH levels and otherwise typically a normal biochemical profile (Table 2). In one study the half-life of LT4 was 5.7 days which is slightly shorter than the usual half-life of L-thyroxine. In one report total serum T3 levels reached the normal range five days after ingestion of 9.9 mg of LT4 (99 tablets of 100 mcg), although free T4 levels were still elevated. In many cases, there is a progressive rise in both serum total T4 and total T3 levels in the first 24 hours following the overdose, caused by continued absorption of the ingested LT4.

Propylthiouracil (PTU) might be used for blocking the conversion of T4 to T3 but may have very limited usefulness in the presence of a large load of LT4. Hemoperfusion using activated charcoal is a rather complicated procedure but has been reported to be highly effective in decreasing total serum levels. It should be reserved for adult patients with severe intoxication by very large doses of thyroxine and the same applies to plasmapheresis which has been seldom used.

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.
You can read more about my own personal health journey and why I am so passionate about what I do.
In many cases, there is a progressive rise in both serum total T4 and total T3 levels in the first 24 hours following the overdose, caused by continued absorption of the ingested LT4.

CLINICAL CASES

Rarely critical cardiac conditions, coma, seizures will follow massive doses of L-Thyroxine. A fast heart rate and fatigue are just two of the signs your thyroid medication dose is too high. This can happen when thyroid hormone replacement drugs like levothyroxine are used to treat hypothyroidism (when a thyroid gland does not produce enough thyroid hormones). About four in 100 people in the United States have hypothyroidism 1.

Tell any doctor, dentist, or surgeon who treats you that you are using Synthroid. It may take several weeks before your body starts to respond to Synthroid. It walks you through several small changes that you can make to boost the effectiveness of your medication without the need to get a new prescription or take a higher dose.

Levothyroxine interactions: What foods and medications should be avoided while taking levothyroxine?

Taking certain supplements can add to the effects of your thyroid replacement medication and lead to you taking too much levothyroxine. Natural desiccated thyroid (NDT) is also used to treat hypothyroidism. And by metabolism, I mean that your body will basically use up all of that thyroid hormone for cellular function. Never just use your thyroid lab tests or just your symptoms to determine if you are taking too much. Fifteen hours earlier, the patient had ingested 200 levothyroxine tablets (10 mg), more than 10 clonazepam tablets (20 mg), and 20 zolpidem tablets (200 mg), after mental stimulation. Cholestyramine, an ion-exchange resin (Questran ®), can be administered in the usual dose of 4 grams every 8 hours orally.

Related treatment guides

Also, you can find your optimal dose of Synthroid by evaluating both your thyroid lab tests and by keeping an eye on your symptoms. Synthroid, because it is a T4-only thyroid medication, has a half-life of around 5-7 days (6). Some people prefer a slight overdose when it comes to their thyroid medication. Do not store the crushed tablet/water mixture and do not administer it mixed with foods that decrease absorption of levothyroxine, such as soybean-based infant formula.