OMG Results

[Jefner]

Just had my results through. Got up to 15mcg t3 with 75 Levo on 2nd August

TSH 0.97 0.27 - 4.20 IU/L

Free T4 13.77 12 - 22 pmol/L

Free T3 H 9.34 3.1 - 6.8 pmol/L

Previous result

***26th July **** - after adding 10mcg t3 on 30th June with 100 Levo

CRP 0.2 <5.0

Ferritin 100.4 (20-150)

FT4 19.38 (12-22)

FT3 4.74 (3.1 - 6.8)

TSH 0.51 (0.27 - 4.20)

T4 Total 115.3 (64.5 - 142.0)

I am way over range now just in that short time. I have really messed things up now. I think my Endo was right I didn't need any t3 after all, and my readings have just been low because of the stress my body has been under since last autumn.

What the hell do I do now, desperate for help please. Worst thing about it is that because Blue Horizon have experienced a delay in receiving tests this week, I felt eager to up my t3 by 5mcg because I thought I needed to, and took 20mcg last night. I woke up after a while after taking it at bedtime and my face was all sweaty.

Please help!!!

[Clutter]

Jefner,

Did you take T3 before your blood test?

[Jefner in reply to Clutter]

Hi Clutter

Left a clear 24hrs from Levo and 12hrs from t3

[Jefner in reply to Clutter]

Clutter

Very frightened, what the hell do I do now?

[Clutter in reply to Jefner]

Jefner,

Please don't worry, it's really no big deal being over medicated for a few weeks and it won't have caused you harm. You are a little over medicated and all that's required is a dose reduction. I would skip T3 altogether for 3-4 days to let some of the T3 wash out and then reduce T3 dose to 10mcg.

[Jefner in reply to Clutter]

Clutter, I am still of the opinion that my Endo was right all along. Stress levels can affect t3 and I never had my t3 tested before my crash by my GP so I won't know whether I was actually a good converter or not. In December when I started testing my t3 is showed that maybe I wasn't but my body has been under severe stress since that time which will auto lower t3 anyway.

If I skip a few doses, what about my Levo, should I bump that back up to 100? Unfortunately I haven't left it long enough really for stable results but that overdose has frightened me plus I took an extra 5mcg last night which might have been the reason I broke out in a bad sweat?

I have messed things up so badly since last October, I should have just dropped my Levo by 25mcg and stayed on that

[Clutter in reply to Jefner]

Jefner,

I thought you had improvement in symptoms and reduction in anxiety since adding T3 to Levothyroxine? If so, you needed some T3.

Just let FT3 drop down a bit before resuming 10mcg T3, there's no need to adjust Levothyroxine dose unless you decide to stop taking T3 altogether.

[Jefner in reply to Clutter]

Clutter, I did for a few days but looking at my calendar the last week or so I am back to where I started. The anxiety hasn't reduced that much because it's my high cortisol causing the majority of that

[Clutter in reply to Jefner]

Jefner,

Apart from feeling sweaty after increasing dose to 20mcg last night you haven't said you feel over medicated so just reduce dose to 10mcg for now.

[Jefner in reply to Clutter]

Clutter

I just don't get it, I am on such a small dose compared to a lot of people. Wouldn't that be proof that I probably don't need it at all?

[puncturedbicycle in reply to Jefner]

20 t3 isn't a small dose as such. You don't really 'need it' or 'not need it' you need the correct amount. Some people need a higher dose but a lot of us find 10 to be enough.

[Jefner in reply to puncturedbicycle]

puncturedbicycle

All this t3 stuff is new to me, I only took 20mcg last night because I thought I was due for an increase. I am now pooling. Have been on 15mcg for a couple of weeks. I am glad I tested now because I would have just upped my 5mcg every two weeks without testing

[puncturedbicycle in reply to Jefner]

Yes, well this is my argument against the STTM protocol, that recovery isn't always straightforward and you can easily raise too quickly. I haven't felt brilliant for the last year or so and if I raised my t3 until I 'felt better' I'd be taking a bottle a day.

What do you mean you're 'now pooling'?

[Jefner in reply to puncturedbicycle]

puncturedbicycle

pooling means that the t3 is sitting in my blood and not getting into the cells hence my results

[puncturedbicycle in reply to Jefner]

Ok Jefner but that seems like the same thing as just taking too much t3. And the remedy is the same, just take less. Your results are high because you're on too much t3, whether it's in your cells or blood.

[puncturedbicycle in reply to puncturedbicycle]

Ok Jefner I read about 'pooling' and I can't tell the difference between pooling and just plain taking too much t3.

This is just my opinion and take it or leave it for what it's worth but I think the STTM site (or book or whatever) is best avoided for now. My opinion of it is that it is overcomplicated and rigid on causes of symptoms and not robust enough on treatment.

I was treated by a doctor with an interest in endocrine problems (at great cost I might add) and took tonnes of supplements to deal w an adrenal problem and none of it made the slightest bit of difference to my bloods. I'm not saying it won't help anyone, but don't fixate on that problem and worry about it as it may or may not be causing your problems and it may or may not be an issue once you've found the dose of thyroid meds that works for you.

[Jazzw in reply to puncturedbicycle]

Couldn't agree more about STTM. I'm sure I used to find that site helpful, but most of the content now verges on hysterical scaremongering.

[Jefner in reply to Jazzw]

Jazzw

I am inclined to agree with you I think. They do bully a lot as well. If you don't follow their protocol you won't get better. I know their site is based on patient research but not keen on the way they demand that you do things in a certain way. I see a lot of posts from people (who follow their way as regards raises and stuff) and they end up overmedicated etc or in a pickle

[puncturedbicycle in reply to Jefner]

Exactly. The whole model is too dogmatic and over time it has become more shrill re ndt. One thing you can't deny is that everyone is different, which is why it is depressing to see a one-size solution offered to everyone.

Jefner one reason you're feeling let down is because they effectively promise you wellness and then when they don't deliver (because there is no thyroid solution that can deliver all the time) it is extremely disappointing. And on top of it the obvious conclusion you come to when you're feeling vulnerable is 'I must have done it wrong' which just is neither here nor there.

I'd never say they have no contribution to make and I have no doubt their protocol works for some but even a stopped clock gives the right time twice a day. Sadly we all have to live with the fact that some of this is groping in the dark and you have to experiment to find the best way forward for you. And experiments that don't work out teach you that they're not for you and allow you to cross off those options and keep moving forward. x

[Jefner in reply to puncturedbicycle]

thanks honey, but am running out of options to be honest. I suppose I put too much hope in that t3 would be the problem solver

[puncturedbicycle in reply to Jefner]

You don't run out of options. What doesn't work the first time may work the next time, we see it here all the time. When your iron is low levo might not work but it will after you supplement. Armour might not work but Erfa will. Everything is always in flux, and everything passes.

[Jefner in reply to puncturedbicycle]

My iron levels are very good, all my results are on my profile

[puncturedbicycle in reply to Jefner]

Great! That was just an example of how small things can change big things (I didn't mean you specifically) but good to know. It isn't easy to get your iron in the right place, and it will stand you in good stead for when you find the right meds.

[Jefner in reply to Clutter]

Clutter

BP is currently 116/74, pulse 58, temp 36.4. Did you ever overmedicate when you added t3? What are the symptoms of overmedication I can't find them on the net?

[Clutter in reply to Jefner]

Jefner,

Symptoms of over medication are racing heart, palpitations, hand tremors, moist/sweaty hands, excessive sweating, diarrhoea, irritation, anger, anxiety to name a few.

thyroid.about.com/library/a...

I was over medicated with FT3 8.4. Had no symptoms other than mild tremors in hands and hair coming out in clumps which stopped a few weeks after reducing dose.

[Jefner in reply to Clutter]

Clutter

I do have the palpitations, hand tremors when I wake and the sweating last night after I took 20mcg but as you can see my bp, etc is OK although I do have a beta blocker in the mornings

[jade_s in reply to Jefner]

Jefner, are you taking that 20 mcg all at once before bed? I normally split my dose otherwise I also get sweating and shaking and other hyper-like symptoms. Sometimes when I forget my afternoon dose and take it too close to bedtime, I wake up in a sweat in the mornings too. You might be better off taking 6 or 10 mcg several times during the day, starting in the morning, and not too close to bedtime.

[Jefner in reply to jade_s]

I take it all at bedtime hon but my bloods confirm that even splitting (same dose or higher) is the wrong thing to do at the moment because I am pooling

[Jefner in reply to jade_s]

I only took one dose of the 20mcg I have been on 15 for the last 3 weeks. I take mine with my Levo at bedtime and haven't had any problems until I obviously increased

[Jefner in reply to Clutter]

Clutter

What dose were you on when overmedicated?

[Clutter in reply to Jefner]

Jefner,

100mcg Levothyroxine + 40mcg T3. I reduced T3 to 30mcg.

[Jefner in reply to Clutter]

Clutter

should I miss a couple of doses of t3 then completely or just take a low dose of 5mcg so my system still gets some as it will be expecting it. Not sure whether 75 Levo is right for me and whether I should bob that back to a 100? Just so confused right now. My t4 levels looks better but they are quite low in the range and as I am cutting back on the t3 for a while, would it be best to bob it up or even do alternate days of 75/100 because I remember the last time I was on 75 Levo, my levels went too low

[Clutter in reply to Jefner]

Jefner,

Your system has excess T3 floating around and right now you want to reduce FT3 level so skip 3-4 doses of T3 but continue taking 75mcg Levothyroxine. After 3-4 days add in 10mcg T3 with 75mcg Levothyroxine.

Your FT4 is low in range because you reduced dose from 100mcg to 75mcg. It doesn't matter that FT4 is low when your FT3 is high.

[Jefner in reply to Clutter]

I was told FT4 would go lower anyway when on t3?

[Clutter in reply to Jefner]

Jefner,

Yes, that too.

[Jefner in reply to Clutter]

Clutter

Won't my body show signs of withdrawal though from the t3 it was getting. What about if I just gave it a little 5mcg for a few days before upping to 10 again?

[Clutter in reply to Jefner]

Jefner,

You have too much T3 in your system so you want your T3 level to drop. If you don't want to stop taking T3 for a few days that is fine but you won't get withdrawal if you do. If you want to simply reduce to 10mcg T3 it will take just a little longer for FT3 level to drop.

[Jefner in reply to Clutter]

Clutter

I was thinking just 5mcg just so my body knows it's still getting something

[Clutter in reply to Jefner]

Jefner,

You really don't need my permission, if you want to take 5mcg that's fine.

[Jefner in reply to Clutter]

puncturedbicycle has just reminded me that I will be getting a little t3 from my t4 anyway durrrrrrrrrr. Doing my tax return is less complicated than this darn t3. I will go with you boss, thanks so much for your help and support. It's all new territory for me

[puncturedbicycle in reply to Jefner]

Taking both and tweaking them was exponentially harder for me than just deciding to raise or lower levo. At least now you know what you need to lower. It doesn't matter much how you tweak it - skip a few days, lower to 5, lower to 10 - but it will correct the problem.

[Jefner in reply to puncturedbicycle]

Hope so hun, thank u for your support

[puncturedbicycle in reply to Jefner]

Just fyi, the levo will also be providing some t3 if you continue to take it. So you won't be without t3 altogether.

[Jefner in reply to puncturedbicycle]

just a minor detail, I forgot that bit pmsl

[puncturedbicycle in reply to Jefner]

[Jefner in reply to Clutter]

Clutter

Just had a look at the long list of symptoms of overmedicating and I have:-

Anxiety, nervous energy, tremors, feeling jittery

Shaking hands, tremors

easily startled

Fatigue, exhaustion

overheating (always in the evening)

slightly loose bowels

Heart palpitations, feeling like heart is skipping a beat, or racing

Depression

Weight loss

Loss of appetite

hair loss

Dizziness, breathlessness

Achy or weak muscles and joints

but I have several of the symptoms daily anyway

[Clutter in reply to Jefner]

Jefner,

You ARE over medicated. The symptoms which you have been experiencing since you have been over medicated should resolve when your FT3 is back in range.

[Jefner in reply to Clutter]

Clutter

Day 2 off the t3 and feeling slightly better. Shall i leave it another couple of days?

[Clutter in reply to Jefner]

Jefner,

The longer you skip T3 the quicker the over medication will wash out so if you can try a couple of days more without it.

[Jefner in reply to Clutter]

Clutter

Will do. Shall i then add back 5 or 10?

[Clutter in reply to Jefner]

Jefner,

I think 10mcg.

[Jefner in reply to Clutter]

Clutter

Would i be better splitting it or take as i was doing at bedtime?

[Clutter in reply to Jefner]

Jefner,

Take it at bedtime as previously.

[Jefner in reply to Clutter]

Clutter

Thanks hun

[Jefner in reply to Clutter]

Is it normal to feel such awful fatigue in my situation? I feel so poorly

[puncturedbicycle]

Jefner please don't worry. You haven't messed anything up, it's all grist for the mill and you'll eventually find your levels through trial and error. It's the only way to do it. We all do it. You are holding yourself to an unrealistically high standard and then sitting in judgement on how you didn't get it right the first time. It can't be done, you just have to try stuff out and see how you go, that is the right way. That's the way the gp does it.

Please don't worry about your cortisol, there may be no way to remedy that (my results were unchanged despite being treated) and you're probably anxious because you're overmedicated.

When you say you think you should have dropped your levo to 25, why do you think that would have been better? There aren't a lot of people who would thrive on that dose.

Just fyi, 20 t3 is roughly equivalent to 60-100 levo (each mcg of levo = between 3 and 5 t3 depending on who you listen to). But the good thing is that t3 will begin to drop as soon as you stop taking it, so as Clutter says, just skip a dose or two and reduce in future.

Try to avoid the pendulum situation, where you're swinging from high doses to low doses guided only by worry and upset.

Like Clutter I was overmedicated for a while and had no problematic side effects aside from diarrhoea and feeling a bit tightly wound.

[Jefner in reply to puncturedbicycle]

puncturedbicycle

I am worried about my cortisol because getting the highs down is very very important or my adrenals will pack in completely and things will then get even more complicated. It's worse to have lower levels than high. They are so high and cause me the majority of the severe anxiety and nausea I suffer with every day and for most of the day. I am not anxious because I am overmedicated, I have had these symptoms every day now for nearly a year.

What did your levels go up to when you were overmedicated?

the problem is I was only on the 15mcg for a couple of weeks before I tested. Everyone says you have to leave longer but it's just as well I didn't otherwise I would have gone straight up to the 20mcg

[puncturedbicycle in reply to Jefner]

You have to leave 6-8wks before testing t4 (it takes time to stabilise), but t3 goes immediately into your system. This may mean that the t3 test is less reliable once you're taking t3 because no one knows when the best 'most accurate' time is to test it or how to know what level is best if your they're peaking and dropping throughout the day.

Being undermedicated can cause anxiety as well as being overmedicated. The worst anxiety I ever had was when I reduced my levo. I appreciate you've been anxious for a long time, but cortisol is just one piece in the puzzle and with respect it won't help to fixate on it.

There is such a lot of crossover, esp when everything is in flux due to antibodies and medication. I used to become overstimulated on more than two cups of tea - terrible adrenaline and shaking - but now this isn't the case and I can drink it without noticing. Why? Maybe because my metabolism has improved on a better dose of meds? Because I'm actually on a lower dose of meds and lower t3 no longer facilitates a squirt of adrenaline every five minutes? I don't actually know. I just keep trying stuff.

I don't have my high test results in front of me (this was a few years ago) but my t3 was above range. The doctor I was seeing at the time wasn't really very disturbed about it but did say I needed to slowly reduce my levo to put the t3 back in range.

I understand how disturbing this whole process can be when you're unwell and all I wish for you is that you don't panic and wobble over it, but if your problem is anxiety, that's easier for me to say than it is for you to do. I just feel deeply affected by watching you berate yourself for the very thing you're trying to do. Try to be kind and gentle to yourself. You'll get there.

[Jefner in reply to puncturedbicycle]

puncturedbicycle

It's just so frustrating as I thought I was getting somewhere and am feeling all panicky and anxious again now

[puncturedbicycle in reply to Jefner]

You ARE getting somewhere. You now know you were on a little too much t3. Now you will try a little less. Every little tweak gets you a little closer to being well. x

[Jefner in reply to puncturedbicycle]

puncturedbicycle

But I wasn't feeling any better on the doses I was on

[puncturedbicycle in reply to Jefner]

Too much too soon I think. But you must do what you think is best.

[Jefner in reply to puncturedbicycle]

I don't know what that is anymore In fact I have never known what is best. How often did you increase your t3?

[jade_s in reply to Jefner]

just as a reference, here is how quickly you might feel a change in T3 dose:

For T3, I notice that for me it takes up to 2 or 3 days to feel the full effect of a large change in my T3. Since the half-life of T3 is 1 day, after 1 day only 50% of the change would be felt, 75% after 2 days, 87% after 3 days, etc. My experience seems to concur with this.

[puncturedbicycle in reply to Jefner]

I tried 5 for a week or so and then raised to 10. I briefly tried to wean myself off levo to see if t3 only would work for me but I didn't get very far (terrible anxiety). I think I also briefly tried raising it after I had a crash (maybe six months after starting) but just got terrible palps. Ever since then my t3 bloods look good so I've left it there.

I don't feel fantastic all the time so I'm always open to tweaking it but until my bloods show me otherwise I think I'm on the right dose.

Would you like to try to pull the threads apart a little? It sounded like you thought there were some improvements but then you went back to feeling worse again ('I thought I was getting somewhere and am feeling all panicky and anxious again now'). Is that right? Or do you feel like none of it made any difference at all?

Do you keep a diary so you can chart the changes and how you felt on them? I think that would be v helpful.

I hope I don't get pilloried but re cortisol, unless you have a diagnosed medical problem (eg Cushings) just try to put it out of your mind. If we made a list of people here who don't/didn't have 'adrenal problems' it wouldn't take much time at all. Look at the folk in the world who live on fast food and coffee. They all have adrenal problems.

I don't say any of this lightly. I was so depressed I was ready for ECT. I've been on over a dozen kinds of psych meds. I know how awful it can be, but try to give yourself a rest from thinking about it. Treat yourself to a rest from it. x

[Jazzw]

Can I also throw in here that some people actually need their FT3 to be over-range to feel well? Your physical symptoms don't scream "overmedicated" at all. What actually might have happened here is that having reduced levothyroxine you're producing less reverse T3, so you're making more T3 from the levo you're taking.

No need to panic, honestly. {hug} A little less T3 should do the trick.

[Jefner in reply to Jazzw]

Jazzw

Thank you my lovely. It's very scary for me because I am on new territory. I was banking on t3 helping me and taking all my symptoms away but it hasn't, still feeling very hypo

[Hidden in reply to Jefner]

Hi Jefner

If I was you I would just stick to this community you get good advise off good people, I joined the other site (mention no names) as Jazzw said I would too be taking a bottle or even two if I followed their protocol, they are all bonkers getting up 16 times a night (slight exaggeration) to take their T3 and do observations you will find a way that's suits you, I've just dropped both my t3 and my levo even though my bloods were OK, because I wasn't happy that my pulse its double yours and palps keep me from falling asleep at night, it's all trial ad error and there is always someone on here to help you good luck Julie.