T3 and hypo symptoms

Hi again

I'll jump in at the deep end, I was taking 20micro grams of Liothyonine , my TSH on the 17th July was 3.5 and my T4 was 7.2. I wake up at 3 am ish and cant get back to sleep, two or three times a week I get palpitations, chest pain most days. I had a treadmill test last Monday and was told that my heart is ok. For the past two weeks I have had chronic constipation, sleeping more and waking with a headache. I rang my GP last Tuesday and asked if I could take 10 micro grams extra mid-day to give me more energy, he agreed. I've been taking 30 micro grams, 20micro grams 4am and 10 micro grams lunch time. I'm still have the above symptoms, I rang my endo this morning, told her my symptoms, she said it may not be attributed to my hypothyroid condition and my GP should look at other causes .She told me to have a blood test asap, I have a blood test booked for tomorrow morning. I can keep taking time off work. Any advice will be very welcome

Thanks in advance


15 Replies

30mcg of Lio is unlikely to be enough on its own. That much was clear from your last blood test - Lio would normally suppress your TSH down to the 0 point somethings. I think you need more Lio and I don't agree with your endo that your symptoms are being caused by something else.

Were you on Levo prior to taking T3? How long were you on 20mcg of Lio?


Thanks for your reply, I was on Levo but had a bad reaction ,so my GP switched me to Lio, that was about 7 months ago

I think you definitely need a raise in dose. I'm always staggered when GPs don't insist on an FT3 test when someone is on T3 only. Without that result, it's nigh on impossible to judge what dose is right. Ft4 becomes completely irrelevant!

Don't be bullied into believing something else is going on - not yet, anyway. Ask your doctor if your FT3 can be tested as well as TSH - he might have to state on the form that you take T3 in order for the lab to get the message it must be done (the labs seem to be allowed to overrule requests in many areas).

If you have a blood test, don't take T3 in the 24 hrs before the test, otherwise it'll skew the result. If your FT3 comes back low in range, then there will be your answer - it needs to be towards the top of the range.

Phronsias, you are undermedicated on 20mcg T3 to have TSH 3.5. Most people need TSH around 1.0 to feel well, probably lower when taking T3. Read through Treatment Options in thyroiduk.org.uk/tuk/about_...

I think your endo is plain wrong. Palpitations, chest pain, constipation and fatigue are typical hypothyroid symptoms due to undermedication, and the stress test has ruled out heart issues.

The waking at 3am may be desperation for your next T3 dose. Try taking taking the 10mcg dose a few hours later, or even before bed, it may enable you to sleep through until 4.00am.

Don't take your 4am dose before the blood test or it will show abnormally high FT3. Take the T3 straight after the blood draw. If you can manage a fasting test (water only) TSH will be higher and your endo may agree to a dose increase.

Thanks guys!

How long should I fast?

What time is your test? Basically, don't eat or drink anything other than water tomorrow morning before the test. Your stomach should be largely empty within 4 hours, so you can still have your tea tonight if you haven't had it yet. :)


9.30 in the morning.

I do appreciate all your help!!!!!!!!!

I get the impression the endo is a bit miffed with me because I go on this forum.

All the best


Phronsias, from when you wake until the test. Do drink water though, it makes the blood draw easier.

Will do and thanks, I really don't know what I would do without the help I receive on this forum, so a BIG THANK YOU!!!!!!!!!!

I get palpitations if my T3 is low and a 3am wake up (as well as being low T3) might be your adrenals - I take 12.5mg T3 before bed and sleep like a baby now - I used to get the 2am wide awake problem before I started treatment.


If you don't mind me asking, how much T3 do you take per day? and what times do you take it?

I take 25mg as soon as I wake up, 25mg around 1pm, 12.5mg at 5pm and 12.5mg at bedtime - but I'm pretty flexible with the timings - if I do Zumba I take extra afterwards at bedtime - 😉


Do you self medicate?

Yes, my GP wouldn't even test my T4 levels, said she'd test me for diabetes as that was cheaper! I knew I wasn't diabetic so having spent the last 6 months getting my B12 sorted through self injecting I decided to try T3 and it seems to have been just what I needed - I figure I can't do any worse than her doing nothing 😆

Good for you!!!!!!

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