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Thyroid UK
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Can you feel the levels of t4 drop in the body? or could it be a Hashi hyper swing?

Eight weeks ago I was on 200mcg Levo only (feeling totally hypo still) - I saw an Endo who dropped my Levo to 150 mcg and introduced 20 mcg T3 ( 10mcg initially and then 20 mcg a week or so later )

The last few days I have felt more awake and seem to be craving the T3 a little less than before. Normally I cant wait to swallow it and feel a big crash 4/5 hours later but it seems to be a lot more subtle in the crash now?

Is there a reason for this?

should I request a further drop of t4 and increase of t3? I know my tsh will be around 1 so doubt the lab will do the t4/t3 levels

I have bloods again and synacthen on Thursday afternoon

10 Replies

Stuart, the crash is more subtle because the T3 is working at a cellular level now you are no longer depleted. It may not be enough, however, and you should certainly request an increase. T3 can suppress TSH so you may get a FT3 test.

I found that 20mcg T3 made an initial improvement and although I didn't slump I had plateaued and an increase in T3 made the difference. I'm thyroidless and currently prescribed 100mcg T4 + 40mcg T3 although I dropped T4 to 75mcg when it was very hot a few weeks ago.


Thanks for your reply , do you think I should go for less t4 and more t3 100t4 30 t3?Still hypo and no I have a fight on my hands whatever I do !


Clutter, just a question: with the combo you are now taking, what is your fT3?

I'm just asking because at the dose I'm taking now mine is probably consistently around 5.5. (lab range 4.0 to 7.1) This morning I took a 'big' quarter (I'm cutting 25s and sometimes the pieces are uneven. I balance it out over time, so right now I've taken a 'small' quarter - taking this stuff every 8 hours) I could feel it to the point where I was restless, cleaned out the garbage can and washed my hammock in the bathtub....things that are not routine but I had to do something. The pool doesn't open until 10 a.m. and time was going so slowly I was getting fidgety and impatient. So not me: the usual half dead feeling like I was walking through soup. Or maybe this is the me I used to be a long time ago. It's been so long since I had energy to spare, it's taking some getting used to I guess. T4 dose is 88 mcg.

Maybe the body is having issues adjusting after spending 2 decades at fT3 4.1 or less? (range 4,0 to 7.1) I couldn't even imagine what taking 40 mcg T3 per day would be like. I'd probably pop right out of my skin.


Gabkad, FT3 was 5.2 (3.2-6.2) in April before I raised T3 to 40mcg. FT3 was 3.1 before I added T3.

I don't have much energy and absolutely no stamina as I was mostly bedridden for so long. I haven't experienced restlessness in years :-D


Clutter, I made sure my vitamin D was at 93 nmol...whatever units!!, Ferritin 120, high B12 and folate and high normal vitamin A before I even went to the endo. That way there was no excuse on her part. Even so, she dawdled around for 18 months! The first six months of this year she comboed me lower than the 125 mcg T4 she had me take all of last year.

I just hoiked all the hair out of the bathtub drain hole this morning because I've noticed recently that the bathwater was taking it's own sweet time draining. (I'm sure 'hoik' is the wrong word but it just sounds so right for the action performed. :)) For someone who only washes their hair once a week, the buildup in the plughole was (un)impressive. (Yet another thing my restless self just had to get done. In fact, this was why I found this marvellous forum. I googled hypothyroid + hair loss.) I'd watch significant quantities of hair floating down the drain for months earlier this year. I even had my hair cut short because I couldn't stand it anymore.

Was beginning to wonder if I should get my chin hairs transplanted to my head already! Those don't fall out when thyroid hormone is low that's for sure. Truly it is a miracle: the leg hair, pubic hair, eyebrow hair all migrate to the chin. Nature abhors a vacuum?


Gabkad, I had to find my own answers and present them to my endo who is probably convinced my recovery is entirely thanks to his excellent care. I tell him what meds I'm taking, he tells my GP how much to prescribe, so it works for me now.

It's not easy to age gracefully when you're losing your head hair and it sprouts elsewhere. I haven't noticed it sprouting from my ears yet :-D Hoik is definitely the right word.


Thank you for making me laugh!! What is it about facial hair? It is a constant battle to keep it all under control, now I have what I can only describe as a forest of hairs growing in my nostrils!!! They have to be kept well and truly under control!


Sesbo, I have one of those battery operated rotating blade trimmers. I think plucking out nosehairs is a bit 'iffy'. The little machine works well. They are made by the same companies as the electric shavers for men.


Thank you for the tip! However I got one of these nifty nostril gadgets a while ago..I couldn't trim the forest safely or pluck! ouch!


Stuart, T4 is usually decreased by 50mcg for every 20mcg T3 added. I'd negotiate 40mcg T3 if possible. You can always reduce it to 30mcg or skip a dose as and when if you feel hyper or over medicated. I must be swimming in the stuff now because I don't notice it when I occasionally forget to take the 2nd 20mcg dose :-D


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