Thyroid UK
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Feeling Terrible – Advice Needed

Hi All,

Would be grateful for advice since posting blood test results recently.

Diagnosed with Hashis at the beginning of the year, currently on 75mg T4, 10mcg T3 and Testosterone Replacement Therapy. When diagnosed was also borderline diabetic.

B12, folate and D3 values are all mid-high range now (supplementing all).

Just received blood test results from late August (before starting on T3):

TSH Level 1.59 (0.27-4.2)

T4 Level 20.8 (12-22)

T3 Level 4.0 (3.1-6.8)

Latest blood tests (2 weeks ago, since taking T3 for approx. 2 months)

TSH Level 0.84 (0.27 – 4.2)

T4 Level 13.73 (12-22)

T3 Level 4.67 (3.-6.8)

About a month after starting T3 started to get a headache which lasted for 2 weeks and then started to get tired some of the time which progressed to feeling exhausted some of the time to all of the time. Today I spent most of my day today feeling breathless and exhausted (desk job). Considering the rapid deterioration and increase in sides I am very worried.

Had an appointment with the endo on Tuesday – thought that I was not diabetic (I have arranged for a test in a couple of weeks) and that my thyroid values were OK. Suggested that I up my T3 to 25mcg but no more as T3 is dangerous (blah, blah, blah) and is referring my case and my care to another endo as he doesn’t know why I am feeling like I am.

A few questions:-

1.From previous comments on the forum re: my latest bloods the feeling was that I was under-medicated. Considering the relatively high levels of T4/low levels of T3 in August does this suggest that I have a conversion problem?

2.Has the addition of T3 suppressed my T4 - is this a cause for concern?

3.I have increased my T3 dose to 25mcg as suggested by my endo. If I still feel like I do in a week or so should I consider upping the dose again (and if so, to what?)

4.If I do have a conversion problem then I assume that additional T4 would be pointless?

Thanks for your time


5 Replies

1) Yes, you do have a conversion problem.

2) Your FT4 isn't suppressed, but it has lowered because you are taking T3. The body only holds on to what it wants, so, no, it's not a problem.

3) No, you shouldn't increase in a week's time. It would be too soon. You need to give the T3 time to do its work.

4) As you have a conversion problem, yes, more T4 would be pointless, and could make you worse by converting to rT3. The body does that when there is too much unconverted T4 around, because it doesn't like to waste it. The rT3 then goes on to be converted to T2. But, it could also end up blocking the T3 receptors, so best not to increase the T4. :)


Thanks for the quick reply. It's only been 2 days since increasing my dose of T3. If I still feel lousy with no improvement how long should I wait before considering an increase and to what dosage should I increase to? I have 25mcg UniPharma T3 to hand


Rereading your post... You've increased your T3 from 10 to 25 mcg? That's a massive jump. But, yes, two days is too soon to feel the effects. These things take time. My personal opinion is you should stick on the new dose for about four weeks. And then get tested before you increase a gain. Not a good idea to do it blind.


Thank-you for your advice

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If you have hashimotos have you looked into diet to help reduce the reactions to gluten things. Hashis patients tend to do better when gluten is lowered in the diet. I am not hashis so don't know that much about it, but worth looking into.

With regards to dosing. More T3 can often make you worse, as can more T4, or any thyroid meds for that matter. The best way to check if more is doing you harm is to reduce down for a few days. It is simple to do and can help guide you on the correct path. So many people think they need to keep adding in more and more thyroid hormone, not realising they are creating more issues.

Dr Blanchard, a USA doc, has written some good books on thyroid treatment. Have a look on amazon. He says thyroid patients do best when the T3 dose is tiny in comparison to the T4 dose. His ratio is something like 98:2 (T4:T3). I am not saying you need this amount of T3, but it is worth trying. Realistically if you have the 25mcg tablets these can be cut into 1/8th sizes with a stanley blade and that is the smallest i can go. This means you will be taking about 3mcg T3. Certainly worth doing 75 T4 and 3 T3 for a day and see if anything changes.

Another thing he recommends is taking the T4 4h's before bed (or at bedtime) and the T3 in the morning. I find T4 at bedtime works much better for me. This ties in with when we naturally make our thyroid hormones.

You also have low testosterone and so this issue can complicate matters. Thyroid is know to up the testosterone level, so your testosterone should improve with a better balanced thyroid. There is a product which is getting a lot of rave reviews on the ray peat forum. It is called pansterone and has been developed by some academic guys in the USA and they have set up their own nutritional website. All based around legal hormones which can be sold.

The pansterone product is DHEA and pregnenalone applied transdermaly. One dose is 5mg DHEA and 5mg pregnenalone. It seems people have tried applying it to the scrotum and the effects are super effective on the leydig cells in the testicles (make sperm and testosterone). This could be worth a look. I have just read about this product this weekend so thought i would mention it. Here is the link.

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