Thyroid UK
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Returning fatigue on T3/T4 combo

I've been taking the T3/T4 combo for about 7 weeks now. For the first 6 weeks I felt wonderful, improved nails, hair, mood, sleep and so on. But now I'm struggling to sleep, feeling fatigued, feeling down and anxious although still positive.p, forgetting words, lack of enthusiasm.....

I read on the Recovering with T3 blog that this can happen and it can be adrenal issues. It also suggested spreading out the T3 into 3 or 4 doses so i started doing that yesterday and am feeling a little brighter today.

I've had the short Synacthen test and Endo says that is within acceptable limits, and I'm assuming this means not Addisons/Cushing's.

Where do I go from here? I have a choice of of Thyroid 11 bloods from Blue Horizon, which I had done about 6 weeks ago and that highlighted high Ferritin, High anti-thyroglobulin and B12 'adequate' according to Endo. The other choice is the adrenal saliva test. I can't really afford both.

Please help, I was feeling so good, don't want to give up on the T3 as I'm sure it's right for me! Many thanks.

6 Replies

It might mean that you need a small increase. This is a link which may be helpful:

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I agree with shaws, you probably just need an increase in dose, which is perfectly normal. The disease doesn't just stand still so that you need the same dose for the rest of your life. It evolves.

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I would order the blood test to see what your FT3 level is. You may need more T3 or it may be that level has built up and you are over medicated.


Ok, many thanks for this. I know I don't feel right and to be honest feel like I need some extra oomph, which could explain the symptoms. I'll order a private blood test and see where it all is.


My previous reply a month ago suggested you check vitamin D - do you know your level? Are you supplementing if it's low?

B12 was low too

And what about gluten free diet?

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Haven't had the D checked yet as I decided to leave it till I got the Thyroid +11 blood screening in a couple of weeks (away on holiday on Thurday for 12 days). However I've started taking D supplement and definitely notice the difference with the SAD as it usually starts this time of year. Supplementing with B12 sublingually and also added Selenium. (Endo says B12 adequate but nowhere near the 1000 level you recommended so doing a double dose to bring it up). Have gone back onto the gluten free diet. It all definitely made a difference so many thanks for your advice - in fact gave into temptation and had a bread roll yesterday, noticed the difference immediately!

Starting to think that I feel undermedicated so will try adding some more T3, but have started to feel brighter this afternoon 5pm) with having spread the doses out. However started with palpitations again and remember reading they can occur not only when a little overmedicated but when you start to go under.

Many thanks again..


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