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8 Reasons You Have Symptoms of Too Much Thyroid Medication

Written by Dr. Michael Ruscio, DC on December 11, 2024

Written by Dr. Michael Ruscio, DC on December 11, 2024 — Reviewed by Hilary Watts

• Overmedication Symptoms|
• Overmedication Causes|
• Natural Solutions|
• Removing Medication Safely|

If you’ve been diagnosed with hypothyroidism, thyroid medication can be a game-changer for improving how you feel. But thyroid hormone needs to be monitored and adjusted routinely or you could end up with worse symptoms than when you started.

If you’re taking thyroid hormone and you’ve noticed symptoms of hyperthyroidism like digestive distress, fatigue, sweating, nervousness, and a fast heartbeat, you may need to adjust or stop your medication.

In this article, we’ll share 8 reasons you may have too-high thyroid medication symptoms, how to safely reduce your medication dose (with your healthcare provider’s support), and steps you can take to improve your thyroid function (and possibly get off the medication altogether). 

Symptoms of Too Much Thyroid Medication

Hypothyroidism itself can cause myriad negative symptoms that can be significantly improved when thyroid hormone is added. But taking thyroid medication when you don’t really need it (I’ll get into this more later) or taking too high of a dose can throw you into a tailspin.

Too-high thyroid medication symptoms mimic those of hyperthyroidism and can include 1: 

• Dry skin 
• Abnormal (fast) heart rate (arrhythmia) or heart palpitations
• Chest pain
• Anxiety
• Nervousness
• Shakiness
• Insomnia
• Higher appetite
• Weight loss or weight gain
• Tiredness
• Diarrhea
• Nausea
• Vomiting
• Sweating more than usual
• Irregular periods
• Heat intolerance (inability to regulate body temperature)
• Muscle aches or weakness
• Hair loss
• High blood pressure
• Joint pain

Needless to say, alterations in thyroid function, either up or down, can make you feel terrible. And it can be really frustrating to start a thyroid hormone medication for thyroid disease, feel better initially, and then feel worse. 

8 Reasons You Have Side Effects of Too Much Thyroid Hormone

As a clinician and researcher for many years, I’ve unearthed 8 main reasons that people with hypothyroidism experience too-high thyroid medication symptoms. As we go through these, take note of any that may apply to you and check in right away with your healthcare professional to find the solution that’s right for you. 

The Initial Thyroid Hormone Dose is Too High

It often takes some trial and error to get thyroid hormone levels right when first starting thyroid medication (Synthroid, the brand name of levothyroxine) 2. In this instance, it’s important to work closely with your doctor to find the right amount.

Taking More Medication Than What is Prescribed

After some time it may be tempting to play around with the medication dose on your own, but it’s best to get a doctor’s approval first to avoid overmedicating.

Having Symptoms Despite Taking the Right Dose of Levothyroxine, So Your Doctor Increases the Dose

Gut conditions can mimic the symptoms of hypothyroidism, leading patients and prescribers to believe there isn’t enough thyroid hormone. Before increasing levothyroxine, it’s important to check thyroid hormone levels with thyroid function tests 2. If they’re normal, it’s best to look for the root causes of symptoms—often, it’s poor gut health 3.

Improved Medication Absorption

Gut conditions like SIBO, low stomach acid, leaky gut, or food intolerances can make it harder to absorb thyroid medication 4 5 6 7. People taking thyroid hormone and simultaneously working to improve their gut health may need a lower dose of medication due to better absorption. 

Continuing Thyroid Meds Even After Hypothyroidism Has Resolved

Women with subclinical hypothyroidism who are pregnant or struggling with infertility can benefit from temporary thyroid hormone replacement 8 9. However, if overt hypothyroidism after childbirth isn’t present, continuing hormone replacement can lead to hyperthyroid symptoms.

Significant Weight Loss or Older Age

It’s common for the required dose of thyroid hormone replacement to drop as people get older and when they lose weight 2.

Thyroid Hormone Levels Are Normal With Hashimoto’s Disease but Medication is Prescribed

People with Hashimoto’s disease (elevated TPO antibodies) can have normal thyroid blood tests but still have hypothyroid-like symptoms. This may be due to antibodies attacking the brain. However, taking unnecessary thyroid hormone won’t help improve symptoms and can lead to the symptoms of too much thyroid medication 10 11.

Thyroid Medication Is Prescribed But Not Needed

This is probably the most common issue we see in the clinic, so let me spend some more time here.

Several years ago, I began to notice many clients coming into the clinic who felt terrible on thyroid hormone replacement. After some investigation, I discovered a lot of them didn’t actually have overt hypothyroidism—meaning, they didn’t need to be on medication.

So why were they given medication? Some providers prescribe thyroid hormone replacement for people with subclinical hypothyroidism (high thyroid-stimulating hormone (TSH) and normal free T4). Others (especially in the functional medicine space) provide thyroid hormone as a way to lower even normal TSH levels to fit an arbitrary ideal.

Additionally, thyroid medication may be started in people who have other health conditions that mimic a thyroid condition. For example:

Gastrointestinal conditions 3: 

●     Helicobacter pylori infection

●    IBS

●     SIBO

●     Gastritis

●     Celiac disease

Other conditions:

●     Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS) 12

●     Anemia 13

●     Stress 14

●     Sleep apnea 15

●     Perimenopause or menopause 15

Nutritional deficiencies of 3:

●     B12

●     Iron

When you dig into the research, thyroid medication doesn’t appear to be helpful in people without overt hypothyroidism.

One clinical study of 291 patients given levothyroxine without a solid diagnosis of hypothyroidism found that, when they stopped taking thyroid hormone, about 61% of them didn’t end up developing hypothyroidism 16.

Other studies have shown that 22–60% of people with subclinical hypothyroidism can stop thyroid medication with no side effects and return to normal levels of thyroid hormone 16 17 18.

As you can see, there are many reasons for too-high thyroid medication symptoms. If you’re taking thyroid medication and you just don’t feel like yourself, talk to your healthcare provider before making any changes to your medication dose. 

Chances are, they’ll do some thyroid function blood tests and ask you about your symptoms to determine how to adjust your medication. 

Natural Solutions for Better Thyroid Function

You may be wondering if there’s anything you can do to improve your thyroid function and possibly come off of medication—the answer in many cases is yes!

The number of clients in the clinic who have been inappropriately prescribed thyroid hormone is staggering. This prompted us to create an entire thyroid course devoted to helping people better understand how to support thyroid function to reduce or eliminate the need for thyroid medication. 

I’ll share a brief overview of the natural approach I use with my clients to support their thyroid gland and possibly correct low thyroid function. 

Step 1: Revamp Gut Health

In my book, Healthy Gut, Healthy You, I explain in detail how gut health is intimately tied to health and quality of life. I’ve seen time and time again in the clinic that when we focus on gut health first, better thyroid function is a natural byproduct.   

Research has shown improving gut health can target many of the symptoms of hypothyroidism, including pain 19, anxiety and depression 20 21, poor cognitive function 22, and fatigue 23. Better gut health can also improve quality of life 20.

You may be able to revamp your gut health with these dietary and lifestyle changes:

Once you’ve established this foundation for a couple of weeks, you may be able to enhance gut-thyroid connection even more with an elemental diet and triple therapy probiotics. 

Elemental Diet 

An elemental diet is a hypoallergenic, liquid meal replacement shake that’s easy to digest and absorb. It’s safe to try on your own for 2–4 days to reset your gut. It’s ok to eat some food during this time, but most of the calorie intake should come from the shakes. 

Triple Therapy Probiotics

Triple therapy probiotics can help to reduce TSH levels, improve fatigue, and reduce the need for levothyroxine 24. They can also lift depression 25 and fight infections like H. pylori and SIBO, which are associated with thyroid dysfunction 26 27.

It’s entirely possible that these simple strategies will significantly improve how you feel and your thyroid function. If so, that’s great—you can maintain your new lifestyle, reintroduce eliminated foods, and check with your doctor about reassessing your thyroid medication.

If you’re feeling somewhat better but still have some symptoms, consider moving to the next step.

Step 2: Supplements to Support the Thyroid Gland

I want to reiterate here the importance of first creating a healthy foundation with diet and lifestyle before adding a bunch of nutritional supplements. If you feel like you’re being pretty consistent with the foundations but still need more help, then nutritional supplements may be very effective for supporting thyroid function. 

Here’s a table detailing the supplements we recommend for various thyroid disorders in the clinic:

If thyroid symptoms significantly improve after adding nutritional supplements to a healthy foundation, we encourage clients to maintain their lifestyle, start weaning off of some of the supplements, and discuss their progress with their doctor.

But if things could still be better, consider moving to step three.

Step 3: Specialized Supplements for Thyroid Support

If you’re taking the above-mentioned supplements, it may seem like a daunting task to add even more pills to your daily routine. 

But in some cases, specialized supplements (taken briefly) can help you get across the finish line:

• Digestive Acid HCl—Consider adding this if you’re over the age of 65 and you have a history of anemia, autoimmunity, or upper GI symptoms like heartburn, belching, or excess fullness after meals.
• Adrenal support—If you struggle with low energy, mood, and sleep problems, even after revamping your gut health and adding supplements, consider adrenal support supplements for 2–3 weeks. If you’re feeling better, that’s great, if not, there’s no need to continue with these.
• Iron—If your ferritin (a protein that stores iron in your blood cells) level is below 30 ng/mL, consider supplementing with iron. Have your iron panel retested every 2–3 months. Ferritin should ideally be above 100 ng/mL. Remember to take iron 90 minutes before or after thyroid medication. 

If your negative symptoms persist despite implementing steps 1–3, your gut may need more attention. In this case, check out my book Healthy Gut, Healthy You where I lay out my Great-in-8 action plan for gut healing.

If you feel back on track after revamping your gut health, adding in movement and stress relief routines, and taking specialized supplements, stick with your healthy lifestyle changes. You could also consider starting to wean off some supplements. 

It may also be possible to reduce or stop your thyroid medication. If you’d like to try coming off of the thyroid hormone, seek medical advice first. While the evidence of suddenly stopping thyroid hormone isn’t conclusive, studies have found some people can experience severe reactions when suddenly discontinuing levothyroxine 28 29.

How to Come Off of Thyroid Hormone Safely

If you’ve been having the common symptoms of too much thyroid medication, or if your labs and symptoms seem to indicate you can come off of the meds, it may be possible for you to do so. 

But it’s important to wean off thyroid hormone only under the supervision of a professional. Stopping the medication suddenly may result in negative side effects 18.

Here are evidence-based options for safely getting off of levothyroxine 18:

You can see that there are a lot of available options when it comes to weaning off of thyroid hormone—there’s no need to rush the process. And no one option is better than another. The key is to stay in close contact with your provider and let your symptoms be your guide. 

Reduce or Stop Thyroid Meds with Natural Solutions 

People can end up with the symptoms of too much thyroid medication for many reasons. A couple of the most common ones we see in the clinic are improved absorption (from better gut health) and clients who’ve been prescribed thyroid medication unnecessarily. 

I can’t promise that you’ll be able to remove thyroid medication altogether. But in our experience in the clinic, natural strategies like diet, lifestyle, and nutritional supplements are extremely effective for improving thyroid function making it easier to reduce the need for meds. 

If you’d like to try reducing or eliminating your thyroid hormone, do so only with the help of your doctor. Additionally, our team at the Ruscio Institute for Functional Health is passionate about both gut and thyroid health, and we’d love to assist you on your healing journey.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.