Beta blockers, Levo, T3, High Cortisol, Hashis

[Jefner]

Have been reading different posts re beta blockers blocking t4 - t3 and i am wondering if that is one reason my t3 levels are constantly dropping and my rt3 is high.

Looking back on my results since my doc prescribed Propanalol for the severe anxiety a few months ago (cant remember exactly when) due to going hyper from hypo, my t3 levels have dropped dramatically.

T3 results via Blue Horizon since starting them is

Dec. 4.50 (3.1-6.8)

End jan 4.44

Mid feb 2.88

Mid march 2.74

End april 2.84

Early june 2.41

NHS T3 tests

End dec 4.50 (2.8-7.1)

Early feb 3.3

End Feb 2.9

The NHS tests I was unaware had been done and my private Endo said the low levels were likely stress related because he knows how depressed and suicidal I have been; when in fact my low levels could be the cause of my symptoms. He didnt even address my high antibodies so I fired him!

But i have been jiggling my levo since october due to going hyper and losing weight. Was originally on 150mcg for 10 yrs before my crash, lost 2 stone in weight and until recently was alternating between 75/100mcg BUT my last test in early june showed my tsh had shot up to 15.70 (0.27-4.20). In april it was only 2.55!!!

Clutter said I was undermedicating so for the last 12 days I have been on 125mcg. My gp (who us not much good) suggested I might need to up again but to wait 4 weeks. Would you believe he actually offered me some T3!!!!!

Not feeling much better on the 125 yet and based on my current weight of 8st 9lbs, should I increase a little more, especially taking into account of the beta blockers I am taking which will be blocking conversion?

I did also move to taking my Levo at night for a couple of weeks as some on here have seen better results. I obviously didnt because I was unknowingly undermedicating

Am wondering whether to try nightime again as I normally only take the beta blockers morning - late afternoon, and now knowing the conversion problem I wondered whether my Levo would work better for me overnight clear of the beta blockers?

although I am still having trouble getting my stress levels down due to my high daytime cortisol levels plus the anxiety has been with me now for 9 months and feels part of me. The anxiety does subside later in the day, but getting thru each day is tough. I tried holy basil but it didnt work.

Was initially prescribed 20mg of the propanaoli three times a day but he then bumped me up to 40mg cus anxiety was so bad and i got suicidal. Also taking 2mg Diazepam when required. I rarely take a 40mg propanalol unless symptoms are really severe and usuallly break them in half as do i the diazepam.

[puncturedbicycle]

Jefner, have you got a mental health professional working with you on your situation? Not a useless writer of scripts, but a good, constructive counsellor/therapist? I only ask because of your suicidal thoughts. You need to stay alive to get well again.

For me, undermedication gave me a lot of grief in the form of intense anxiety (shaking, nauseated, knots in stomach etc). I don't have that so much now. So the good news is that that may improve once your meds are sorted.

I understand the concerns about diazepam but I'm wondering if you could get someone to work with you so you can see how you feel if you get off the propanolol and have enough thyroid meds in your system, even if you can try it for a week. This may mean taking diazepam (or something) for a week. This is my brainstorming as a fellow thyroid patient who is not a doctor, so understand it isn't a hard and fast recommendation. You may not know for sure how the BBs are affecting your conversion until you're able to do without them, but that has to be a carefully controlled situation.

I really feel for you. Anxiety is terrible. I found I could keep mine at bay if I could do some vigorous exercise (sprinting or swimming) but I also struggle w agoraphobia, so the anxiety indoors had to be worse than the anxiety about going out in order to force myself to do it. What a mess that was. But I could just about put on my trainers and sprint around the park when I needed to, and it did help.

[Jefner in reply to puncturedbicycle]

Yes i am seeing a therapist hun after months of waiting and them messing me about.

There is no way i could jog anywhere, been so inactive now for months due to being so poorly and resting a lot cus of my high cortisol, but i do try to stay active moving about. Did clean little bits of the car gently but that gave me terrible back ache as i used muscles i havent used for a while.

Think its a case of doing little things and the take regular rest breaks with ad

[puncturedbicycle in reply to Jefner]

Yes of course, sorry, I didn't mean to suggest you should do that, I was musing on those feelings and what a person will do to get relief. At this stage you need to do what you need to do to tolerate those feelings or to relieve them.

[Jefner in reply to puncturedbicycle]

Had some magnesium earlier and 1mg diazepam . now i feel really ill and weak. I so want this life over, have had enough, i cant cope

[puncturedbicycle in reply to Jefner]

Jefner I do not want you to be on your own thinking about ending your life. There are services you can access on the phone right now (Samaritans, No Panic, Depression UK etc) or you can go to A&E.

Personally - and I am not a doctor - I doubt 1mg of diazepam is sufficient to control such severe anxiety. It seems like a tiny dose and even 2 (what you were prescribed?) seems very conservative.

[Jefner in reply to puncturedbicycle]

Must be the 100mg i took then, i dont know. Am just so frightened all the time. Went to a&,e once before and after 5hrs of waiting they just sent me home with nothing.

At the end of the day no one really cares in the medical profession, we are just a number!

Talking to them on the phone never changes how i feel hun, wake up ill everyday and pretty much go to bed feeling that way. I dont think i will get better

[puncturedbicycle in reply to Jefner]

Talking may not change how you feel but it can help you tolerate it until your health improves. Low mood and low t3 go hand in hand. If your t3 levels improve your mood may follow. T3 was life-changing for me.

[Jefner in reply to puncturedbicycle]

How long ago did you try it and how long before you noticed a difference?

[puncturedbicycle in reply to Jefner]

It was, I think?, three years ago. Like you I was worried about whether or not it would make me feel more anxious, so I woke up early and took 5mcg with water (along w the levo I also take) and went back to sleep. After, hmm, maybe a week? of that and no change, I began to take 10mcg (my prescribed dose) and within a day or two my stamina had improved and my constipation and bloating had resolved. I went down what felt like almost a dress size overnight because all that fluid that I was carrying in my legs, arms and torso just seemed to go. My face looked different too, since I had been so puffy.

I've had my ups and downs but I've been on t3/t4 ever since (except for one unsuccessful go with ndt) and have felt loads better than on levo alone.

[Jefner in reply to puncturedbicycle]

Thanks for keeping me company for a while. Just managed a mouthful or two of some salmon and just taken a beta blocker so hopefully it will kick in soon. Feel so desperately helpless, just dont know how to get thru each day. I have backache now which is upsetting my stomach. Feels muscular or my adrenals i dont know. Sitting here blubbing like a baby, am so alone and in fear and flight mode

[puncturedbicycle in reply to Jefner]

Jefner you're in good company here, so many of us have been at a really low ebb and have found a way back. That can happen for you too. You're just feeling really ill but you may see some improvement soon.

Off to bed now. Sleep well. Night. xx

[Em_Lou in reply to puncturedbicycle]

Did your T3 reverse results show you needed T3?

[Jefner in reply to Em_Lou]

Have a doc appt tomos to discuss trying some t,3

[Em_Lou in reply to Jefner]

I've been going to Samaritans and just talking to someone face to face and providing a different perspective has helped. Give them a try, it's worth a shot xx

[Jefner in reply to Em_Lou]

We phone them over here, i might try them xx

[Em_Lou in reply to Jefner]

The branch near me offers telephone and face to face. Keep us updated xxx

[Clutter]

Jefner,

Betablockers can reduce uptake of thyroxine but the main reason FT4 and FT3 have dropped is because you reduced dose from 150mcg to 75/100mcg. Stick with 125mcg for 6 weeks and have a thyroid test before increasing further.

When you are adequately medicated on Levothyroxine it will be possible to see whether conversion is poor and, if so, the addition of some T3 will be helpful.

In the meantime, take as much of the anti-anxiety drugs as you require to control your anxiety levels. Your anxiety levels may improve after you are optimally medicated on thyroid replacement and you may then be able to wean off anti-anxiety drugs.

Perhaps you could post a new question asking how long members took Holy Basil before they felt improvement and what other supplements they used to reduce high cortisol.

__________________________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Jefner in reply to Clutter]

I didnt reduce from 150 straight down to 75/100 hun. I went down to 125 from 150 last oct when my t4 went high 28 (12-22). Tsh levels were nice and low in dec 0.03 (0.27-4.20). When my t4 was still showing 22.06 (12-22) in dec i decided (with you) to alternate between 125/100 which i did for a week or so but then went on 125 cus didnt want my t3 to drop too much (which it has anyway). Jan results showed very high t4 28.20 so reduced t4 again to 75/100. Feb and march t4 was still a little high at 19.63 and 19.56 and april was 20.68, so reduced to 75/100 with your guidance. Tsh has crept up from1.28 in feb, 1.81 in march, 2.55 in april and 15.70 in june. Early june tsh 15.70 so i bumped up to 125 and have been on that dose now for 12 dys

[Clutter in reply to Jefner]

Jefner,

I wasn't blaming or being accusatory. I know why you reduced dose but the fact that TSH is now 15.70 means it was reduced too much.

[Jefner in reply to Clutter]

I know you wernt blaming hun. Its this damn hashis i suppose.

As the beta blockers can reduce uptake, what if i move my levo to bedtime so it will have a good 8hrs clear of my taking any beta blockers cus i normally only take mornings and afternoons as the symptoms subside and i can cope just on the diazepam when needed?

[Clutter in reply to Jefner]

Jefner,

It won't hurt to try taking Levothyroxine at night but if the beta blockers inhibit uptake at a cellular level it may not help much.

[Jefner in reply to Clutter]

What am i to do then :(. I thought a long gap between them might help. If i take as many as needed then i wont be getting enough t4?i cant exist like this hunny, its just not going to get better for me is it. Into my 9th month now and still no light at the end of the tunnel, i have very little fight left in me and no support around me. It has to be time to give up surely?

[Clutter in reply to Jefner]

Jefner,

I didn't say it wouldn't work. It's certainly worth trying to see whether night time dosing helps but it won't make much difference until Levothyroxine dose is right.

It's going to take a while to get TSH down and you may need to increase dose or add some T3 if it remains high on 125mcg. If the anti-anxiety drugs down regulate T4 and T3 levels increasing Levothyroxine dose and/or adding some T3 should compensate.

There are no quick fixes Jennie. 9 months is a short time with respect to thyroid. It took almost 2 years for me to optimise dose and feel well and a year is not an uncommon length of time.

[Jefner in reply to Clutter]

How the hell did you cope for 2 yrs?

Would you believe my gp offered me some t3 last week. Apparently only one other at the surgery has been prescribed it.

I do have some as you know from other post but just too frightened of trying it nd upsetting things more, esp now my tsh has shot up!

I have a phone appt with him tomos morning. Am wondering if t3 is the way to go now but how would dose be calculated cus my results show high tsh and high rt3.

You have hashis as well? Did u have regular fluctuations in your levels? How did you get yours right? Were your levels similar to mine...all over the place? At what point did you say sod it and try t3?

[Clutter in reply to Jefner]

Jefner,

10mcg T3 is equivalent to 30mcg Levothyroxine. You could start with 10mcg added to 125mcg Levothyroxine. Probably best to divide T3 into 2 x 5mcg doses and take the first with Levothyroxine and the secon 8-12 hours later.

I did have Hashi's and the fluctuations made me very unwell but Hashi's cleared when I had thyroidectomy. My problems post thyroidectomy were due to intolerance to Levothyroxine and over medication by my oncologist. It was 15 months before I started self medicating T4+T3 and took almost six months to optimise doses.

[Jefner in reply to Clutter]

My ultrasound on thyroid last month revealed i have very little left, only 2cm on one side and barely detectable on the other side.

When we spoke about t3 last time u suggested one small dose of 6.25 initially.

Could it be the hashis causing all my fluctuations or that i have tweaked my levo so much this yr?

[Clutter in reply to Jefner]

Jefner,

Could be Hashi's causing fluctuations but the reductions in dose were too much too. If you've hardly any functioning thyroid gland 75/100mcg is insufficient as shown by your high TSH.

I didn't know TSH was 15.70 when I suggested 6.25mcg T3. 2 x 5mcg is still a small dose. If you are anxious about side effects start with 5mcg and increase to 10mcg a week later.

[Jefner in reply to Clutter]

Yeah i know hun cus latest test only came through beginning of month.

As regards taking my levo at night, i had todays dose around 8-9am. What is a safe time tonight to take it, even if i have to set my alarm thru the night?

[Clutter in reply to Jefner]

Jefner,

It'll be safe to take it whatever time you go to bed. There's no need to wake yourself up to take it.

[Jefner in reply to Clutter]

Wasnt sure that i would need to leave a certain amount if hrs between doses.

From your long experience on here, with someone in my situation, have you come across many members who have benefitted greatly by adding t3?

[Clutter in reply to Jefner]

Jefner,

Most people with low FT3 benefit when T3 is added. I've only come across two or three members who haven't been able to tolerate T3.

[Jefner in reply to Clutter]

I will mention t3 to doc tomos and get some whilst he is offering it!

Should i stay on 125 and add a tiny amount of t3 later in the day cus i dont want it affecting my high cortisol levels?

[Clutter in reply to Jefner]

Jefner,

Why would T3 affect cortisol levels any more than Levothyroxine does?

You can take it any time of day as long as you take it away from food and drink and supplements and meds. Try taking it with your Levothyroxine dose at night. If it disturbs sleep take it late afternoon or earlier.

[Jefner in reply to Clutter]

Cus t3 is a stimulant isnt it?

[Clutter in reply to Jefner]

Jefner,

No! T4 and T3 are thyroid hormones and Levothyroxine (T4) and Liothyronine (T3) are thyroid hormone replacement.