From hypothyroid to hyperthyroid?... Confused!

Hi everyone. I have been Hypothyroid for 10 years, currently on 100mg Levothyroxine. Whilst taking this medication, I've been confused why I still had the symptoms. Those being feeling cold, (I wear more layers than people around me), feeling tired all the time, brain fog, can't remember things, aches and pains, and a general feeling of unwellness or not how I used to be! Another thing... I am underweight at 47kg, height 5'2", high metabolism, can't seem to put weight on... Aren't I supposed to be the opposite if I'm hypothyroid?... I'm confused but doctors go silent when I point this out...

For the last few years I have found that I would spend my own time resting, recuperating, not doing anything I enjoyed just to have the energy to go to work the next day! That's so sad isn't it???

i have been signed off sick since 8 July. I couldn't carry on through sheer fatigue, stress and exhaustion. I couldn't get out of bed until noon or stand to wash my hands. Felt dizzy, headaches, aching all over, agitated, couldn't stand people talking around me or noise. Couldn't go for a walk for more than 10minutes, when I did I would collapse on the sofa when I got home.

I am still off sick now, but can manage to get up earlier like 8-9am, stand for abit longer, then feel weak and dizzy. I've only been out of the house for doctors appointments and blood tests lol! Fun life I lead!

I posted my blood test results last week but I had them done a couple of hours after taking 100mg of Levothyroxine in the morning. So a week later I had the blood tests done again, (fasting) 24hours after taking 100mg Levo as suggested by members of this forum. Results:

Last week:

TSH 4.25 (0.3 - 5.5)

FT3 4 (3.1 - 6.8)

FT4 22.7 (12 - 22)

This week:

TSH 3.54. (0.3 - 5.5)

FT3 3.7. (3.1 - 6.8)

FT4 25.3. (12 - 22)

TPO >600 <34

(I'm confused, this is all I wrote down for TPO)

B12 1,107 (197 - 771) High!

Calcium 2.39 (2.2 - 2.6)

Vitamin D 92 (50 - 144)

Ferritin. 25 (15 - 150)

(Dr said: Lower end of normal range...)

Folate. 12.5 (3.8 - 16)

HBA1C 5.4 (4.0 - 5.9)

(Glucose test, no diabetes)

Cortisol. 429 (166 - 507)

(Dr said it is higher than average but normal)

The doctor said my thyroid is now over active as my T4 is high. To reduce Levo to 75mg and repeat blood tests in a couple of weeks. He said my pulse was 94, quicker than average.

Pulse 94 (60 - 80) for my weight/height etc. 5'2", 47kg underweight.

Blood pressure 106/65

(More info: went to see an osteopath twice, he's saying my adrenals are exhausted, thyroid needs thyroxine, may have digestive problems like a leaky gut and have metal toxicity because I have grey amalgam fillings and a gold crown - he's prescribed vitamins to raise my base levels and selenium which I haven't started taking yet. Homeopath has prescribed carcinosin and said I'm doing too much! I'm pre-menopausal and since being off sick I have daily hot flushes with sweat dripping down my back and chest! All the buses have come at once lol!)

Can anyone explain any of this please?

I've gone from hypothyroid to hyperthyroid... Totally confused!

40 Replies

  • Has anyone mentioned that while your t4 is high, your t3 is just in range? Looks to me like you're not converting, or not well anyway. You might want to see if a bit of t3 helps. Your tsh is too high for someone on meds.

    Are you taking iron? You're quite low.

  • When the Ferritin is so low there will be problems converting the T4 you are taking into the Active T3. Are you supplementing B12 - as the result is good ? If not then the B12 is not getting into your cells.

    When you have Hashimotos - it is quite common to swing from Hypo to Hyper.

    Why not have the 24 hour saliva test done for the Adrenals - with Genova Diagnostics to confirm your adrenal status. I believe there is also a urine test that someone posted about here recently.

  • If you are short of selenium you can'take convert T4 to T3! You need the supplement, but take it with care, not too much! Good luck, hope you get better soon 💜

  • Sorry, "can't" 😉

  • When hyperthyroid your T4 is high and it is ,your TSH is suppressed but it is not.So the problem is most likely elsewhere .Amazing that you have a FT3 result and it is low in range . It seems as others have said you are not converting well .Selenium is worth checking as it aids conversion.

  • I have always been told there is no point retesting for at least 6 weeks. i see you are retesting after 2. I don't have an opinion but wondered if anyone else has on retesting times?

  • Silo, you're right that ideally you wait six weeks after a dose change to retest. In this case the OP's first result was contaminated because she took it straight after taking her Levothyroxine, so we can disregard that result. She did the retest in order to do it all correctly, and get a use able result.

  • Martz>> When you have Hashimotos - it is quite common to swing from Hypo to Hyper. <<

    Strictly gluten-free already? Selenium?

  • eljii,

    It is common whilst the thyroid gland is under attack. TPOAb attacks enzymeThyroid Peroxidase & TGAb attacks thyroglobulin protein.

    During the attacks you may feel hypo one day and hyper the next as stored amounts of hormone is dumped into the blood stream making you feel very unwell. This will make your TSH and thyroid antibody blood test results vary as transient hyperthyroid symptoms are felt.

    Optimal thyroid hormone will suppress thyroid activity so discouraging further attacks but doctors don't prescribe according to our auto immune status.

    Eating gluten free and supplementing selenium are both thought to help lower thyroid antibodies so decreasing the chance of an attack.

  • Naz

    Members who medicate Levothyoxine generally say they function better with a high T4 & T3 (but within range) and a TSH of around 1.0 or below. I would say you are not converting as your T4 is high but T3 is low. However, your pituitary is working too hard as a TSH of 3.54 is too high when medicating Levothyroxine.

    Have you got the tests the wrong way around as your TSH is lower 24 hours after taking Levo ? ? ..

    TPO's are way too high indicating Hashimotos and could influence thyroid function by decreasing hormone conversion and causing inflammation in the body (fatigue, puffiness, joint pain, brain fog, etc).

    Graves’ Disease is an autoimmune condition where the of formation of TSH receptor antibodies attack the TSH receptors that results in an excessive amount of thyroid hormone. The increase in thyroid hormone will accelerate the body’s metabolism, leading to symptoms such as weight loss, and increased heart rate and anxiety.

    Ask for TSIAb to be tested .. as it can either stimulate the thyroid (Graves) or block the TSH receptor (Hashi). It is possible to have both sets of antibodies. In fact ask for TGAb to tested as well.

    Also, as you are premenopausal, ask for sex hormones to be tested to ascertain if you are oestrogen dominant, as the accompanying elevated SHBG can bind too much thyroxine, leaving none free for conversion and low T3 levels.

    Ferritin so too low so requires supplementing. Cortisol is probably higher as having to compensate for low T3 levels and may compromise sex hormones already unbalanced through premenopausal status. Eating gluten free is known to help whatever type of antibodies you have.


    When doctors are uncooperative, members use private labs for testing.


    Gluten//Thyroid connection

  • Ty Radd

    All this is so confusing. I have been referred to an endocrinologist, don't know how many weeks that will take.

    For now the doctor has refused my Levo from 100mg to 75mg.

    I'm going to start taking Selenium today, I hope that helps.

    I've had symptoms for years on Levo... Could it be that I'm simply not converting the FT4 to FT3?

    I assume selenium could help that? Could try and see if it helps. Osteopath recommended I do this.

    I'm sick of having no energy and not being able to think straight, feel heavy all the time.

    Could I have a digestive problem where I'm not absorbing nutrients?... I ask this because the iron level is on the low side but I have been taking multivitamins and eating greens such as spinach, kale etc, also eat meat so I'm confused!

    Any ideas please?

  • Naz,

    Yes , many who suffer from low thyroid hormone may suffer low gastric acid and we need this for good digestion and absorption of iron and nutrients, etc.

    Members supplement Betaine HCL or Apple Cider Vinegar (with the "mother") and supplementing iron with Vit C will help aid absorption and stop constipation..

  • Spinach contains oxalic acid that blocks non-haeme iron absorption. Kale and other brassicas are goitrogens (anti-thyroid), although should be OK if cooked. Green juices are out for hypo people.

  • Oh dear didn't know that... My doctor and osteopath said having green smoothies would be good for me... I'm so confused!

  • I would avoid them as your T3 is low. Fine to have fruit or carrot or romaine lettuce in your smoothies. But cook your brassicas.

  • I lightly steam my kale and spinach, freeze it and the nutri bullet it. Otherwise it all goes straight through me anyway.

  • These results would definitely explain why you've been feeling unwell. They're a bit of a mess. Luckily there are obvious things to do to fix them.

    I'm not totally sure that you are hyperthyroid in any way. Having a freeT4 that's high doesn't mean you're hyper. The only evidence for it, I think, is the weight loss. But although the classic sign of being hypo is weight gain, some people do lose weight. It's to do with breaking down and using food in the gut, and probably other things.

    Themost important figure in these blood tests that shows you're hypo is the freeT3. You really want that to be in the top third of the range, and yours is bumping along the bottom. Supplementing to improve you vitamin and mineral levels will likely improve this. Although it would be quickly improved by taking some T3 in conjunction with your Levothyroxine. Your doctor might agree to this, but often they don't so you can buy it yourself online.

  • Hi SilverAcocado, Ty for ur reply. With regards to weight loss, I've been a steady 49kg for years, still underweight by half a stone but consistent.

    Recently I've lost 2kg so not much to say I'm hyperthyroid. The other thing was a higher than average pulse rate at resting of 92 compared to being 5'2" and 47kg.

    So don't know if these factors are enough to say I'm hyper. Still have all the hypo symptoms lol!

    Dr has reduced my Levo from 100 to 75mg... Should I continue this?

    Going to start deli in today, I pray it helps as I've had enough!

    I was thinking of taking St. John's wort for my low mood... Is it safe to have 12 hours after Levo?

    Kind regards

  • I'm afraid I don't know about St John's Wort. You could search for it on the forum, I hav era feeling its not good to take.

    Idon't think you want to be on any less medication than you were for this blood test, as your freeT3 will surely fall even lower. I think if i were you I'd start looking into self medicating with T3 to make up the difference.

  • Ty

  • be careful with St John's Wort, it can be dodgy stuff

  • Ty

  • T3 is the active thyroid hormone which controls the metabolism and therefore the symptoms. Your most recent Free T3 is at the bottom end of the normal range so you are not hyperthyroid.

    T4 is a storage hormone so cannot make you hyperthyroid. It is hard to believe that doctors do not understand this simple concept.

    With the lowish Free T3 and high Free T4 is looks like you are not converting your Levothyroxine (which is T4) well to T3. Your TSH result, high in the normal range, is also an indication that your body needs more T3.

    An increase in Levothyroxine may help but adding some T3 would be better. Definately do not decrease your Levothyroxine.

    You should ask for a referral to see an endocrinologist.

  • I wouldn't worry about being underweight - I was that weight and height throughout my teens and 20s and no one (doctor or otherwise) seemed to think there was anything wrong - it's just that we are all fatter now than we were 40 or 50 years ago. I'm hypo and not really overweight (could be because I also have adrenal problems) and others on this forum are the same. It takes people in different ways, esp if it is secondary or central hypo, not primary.

    Looks as though you aren't converting T4 to T3 properly.

    Your ferritin is very low, which might account partly for fast pulse. Needs to be at least 70. Did GP offer iron supplements?

  • No iron supplements were offered, u know how it is, the reading was in range lol!

  • I haven't read all the replies but I read the OP. Your doctor is clueless. A TSH of 3 or 4.5 or whatever is NOT hyperthyroid! Some people are naturally slim/skinny if they are hypo (my mother in law is one - bitch - jk!). Look at the numbers. You aren't converting which is why you feel shit. I'm sure some of the above replies are the same but I just wanted to say CHANGE YOUR DOCTOR!!! If you can.

  • I've had that many doctors! They're all crap... Just harp on about being in normal range etc etc... I wonder if I'll have any luck with the endocrinologist?? Mind boggles!!

  • It is all very confusing, but it's clear from your bloods that your tsh is too high, if we believe bloods r a guide, and your t4 pooling in your blood, not converting to t3. You need to make one change at a time, stick with it and only when you are sure of its effect make the next one. List all the things u could address, then prioritise. Eg take selenium see if you feel better, maybe that will change the conversion etc etc be patient.

    What I wouldn't do is count on an endo being any more clued up than your GP. And if with all your supplements and gut sorted u r still feeling crap I would look at self medicating. Maybe t4 t3 combo would suit or NDT. You can put this to your endo but don't be surprised when they make you feel little and foolish and refuse to prescribe.

    I say this having managed to get t3 only out of mine, but I have m.e and was pretty lucky and forceful.

    To check if ur stomach acid is low take a tsp of bit are soda in water and if you barely or don't burp in the ten minutes that follow u need to top up your stomach acid.

    Adrenals need thyroid optimal to work efficiently.

    You may be off work for some time. Take your time, be patient and take care.

  • Bicarbonate of soda - interfering iPad!

  • Sulamaye Ty for the help.

    How much bicarbonate of soda in how much water? I would like to do this test as I have suspicions that I'm not absorbing nutrients properly. I am underweight and can't seem to put any weight on no matter how hard I try. I've lost a couple of kilo's after years of being at 49kg.

    With regards to adrenals, I'm trying to avoid stressful situations, is there anything I can do to help them.

    I am taking Juice plus capsules, 3 x2 a day), berries, veg and fruit and now 400mcg selenium.

    Green smoothies that include spinach, Kale, avocado, half banana, flax seeds, coconut oil, coconut water, honey and blueberries. But someone said I need to boil the kale and spinach before had as raw is not good for hypo.

    I'm having oven cooked salmon, veg and potatoes, fruit and salad.

    Don't know what else to do, all the above has made a fraction of improvement.

    Waiting for endocrinologist appointment and a doctors appointment for 4 August. I'm so frustrated and confused, I know I need to be patient!

  • 1 teaspoon in a glass, so approx. 200 ml.

    You need to get a private saliva stress test to know about ur adrenals, low and high can have same symptoms but require different treatments.

    I said steam your greens and freeze. I steam mine for 8 mins in total, swapping top basket for bottom basket half way through. So prob equivalent of 6 minutes if only using one steaming basket.

  • If u want to really go hardcore with your diet cut all grains and dried beans etc. Google Terry wahls ted ed talk. But you may find you get too thin and will need to up your fat intake, coconut, etc

  • But see what happens with your stomach stuff first, def cut gluten and dairy and sugar if you have leaky gut

  • This is why you need to learn, be your own advocate. There is a lot of good information here. This document puts it very well.

  • you are not converting the t4 and it is stopping any conversion to t3, from reaching your cells. You would benefit from t3 t4 at all. You will NOT get a doctor to allow this. Do you have hashimotos? Why are you hypo? You need to find out if you have autoimmune disease or effects/changes, everything!

  • Ty

  • Hi faith

    I may have hashimotos, TPO is >600.

    I'm on 100 Levothyroxine

    Ft4 is 25.3 (12-22)

    Ft3 is 3.7 (3.1-6.8)

    TSH is 3.54 (0.3-5.5)

    I have most hypo symptoms. Feel cold, wear lots of layers, 2 pairs of socks, off work with stress and fatigue, get out of breath going upstairs, aching body, brain fog!

    If I'm hashis... What do I need to do? Vitamin B12 is top of range, ferritin is low part of range, vitamin D is in the middle...

    Any ideas?

  • i would go on t3 only or drastically reduce your t4 levo, and add lots of t3. To get rid you hashi's, google reversing hashi's.. isabella wentz, reversing autoimmune disease Dr mark what they say to do. it is usually related to eating, dairy , gluten and of course a bad/gut /immune system. i am working on this too.

  • Going gluten and diary free has been so hard and depressing!... I'm struggling with it and haven't ate as much as I should. Don't have the energy or brain power to look at recipes and varieties of foods I can eat. Do the antibodies not reduce in number if u start having T3 or do something else help?... I'm so confused and fed up... When u can't think straight and feel anxious nothing seeks to make sense and no quick fix...

    Thank you faith 63 for your help. Will google what u say and do what it says hopefully.

  • i am gluten, dairy, nut, nightshade, grain free..for months now, to get rid of hashi's and healing my immune sytem. I have not slept much for 6 years, have been diagnosed with fibromyalgia, chronic fatigue syndrome too. I have low cortisol and pituitary damage. I have vomited for 2 months daily and still did not lose weight. If i can do it, you can too. We have no hope otherwise. T3 meds, thyroid meds, do not address the autoimmune part of things. For, me, no thyroid meds make me feel well..none. I have to heal my body and of course, get to a doctor to replace my other missing hormones.

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