Thyroid UK

Reverse T3 clearing or cells' saturation with T3?

Merry Christmas to you all!!! Let our hormones be tamed in the future!

Some of you may remember me.

I am the one who started T3 6 weeks ago, stopped T4 4 weeks ago and has reached 85 mcg T3 (30 upon waking, 25 at noon and another 35 at 4 pm), my main hypo symptom being ectopic/skipped beats. On 85mcg T3 I was 70-80% improved but complete recovery still seemed a faraway thing. I was no hyper at all on this dose.

Four days ago I took another 35 mcg T3 by accident at bedtime (I thought I had forgotten to take the 4pm dose). Next day there were considerably less skipped beats compared to their daily number when they were 70-80% less/improved. However I felt slightly overstimulated, my heart rate hovered about the upper 90s. I took only 37.5 mcg T3 that day upon waking and that was completely enough to carry me throughout the day and night.

Yesterday I also took only 37.5 mcg in the morning, I had ONLY 5 skipped beats, however I still felt slightly overstimulated.

Today is the same thing: only 37.5 mcg T3 in the morning upon waking, 5-6 skipped beats (maybe by bedtime there will be a little more than yesterday) and slightly rapid heart rate. I also experience sweating, however I sweat a lot even when hypo, especially before, during, after period and around ovulation.

My reverse T3 was mid-range 1 week after stopping T4, I had never tested it before or after that.

My questions are:

1. Is it possible that I have become slightly hyper due to no T4 intake, suppressed TSH, no T4 production, and reverse T3 falling very low therefore letting cells' receptors saturate with FT3 and I will need much lower than 85 mcg doses of T3?

2. Is it possible that that 120 mcg dose that I took by mistake has saturated the cells enough? However wouldn't its effect has worn off by now, it's been 4 days since then, besides I have been on only 37.5 mcg T3 daily since then.

Should I lower the dose even more? Can I try back some T4 (25 mcg)?

It seems that crossing the border between hypo and hyper/ a little overstimulation is a very easy thing while on T3 only. Like I can never get out of my hypo state without entering into hyper, even a little bit (I have rapid heart rate and 5-6 skipped beats daily now - these are both hyper and hypo symptoms)...

Thank you,


16 Replies

I return your Christmas Greeting.

I am not medically qualified but my answers to your question 1 would be 'No' 'No' and 'No.

I think you may be being a bit irresponsible the way you have reached 85mcg of T3 in around six weeks. First you began T3 six weeks ago along with T4. You then dropped T4 and increased T3 to 85mcg and had an extra dose of 35mcg in 24 hours. Also I believe that RT3 is only converted from T4.

I think you should begin from the starting point again and increase slightly every week. The way you have been taking your doses may make it difficult to judge how each daily dose works for you.


Thank you, Shaws.

I know I have been irresponsible but I felt no effect on this dose, besides I was sick of feeling hypo, especially sick of the enormous number of skipped beats (about 15000 - 20000 daily) and I have 2 kids to look after... :(


Desperate people take desperate risks at times. I do understand but have you had your heart checked? I have had many due to levothyroxine but it settled completely with T3.

This is a link which may be helpful and your kids need you to be well.

I follow Dr Lowe with regards to T3. He himself and his Thyroid Hormone Resistant patients took large doses but only once per day.

One of the links above is 'how to safely get well'. Also one re T3 when you have time to read. Also Thyroid Hormone Resistance.

This is an excerpt:

f you went from 75 to 100 mcg of T3 in one dosage increase, you may have overshot slightly; your safe and effective dose may be somewhere between those two doses. If your doctor decreases your dose, I suggest that he do so only by a small amount, say 10 mcg, to see if that will slow your heart rate enough. His aim should be to lower your dose enough to slow your heart rate, but not so much that your fibromyalgia symptoms return.


Yes, I have had my heart checked hundreds of times. It is healthy. I know my skipped beats are due to my hypothyroidism. When my hormones are OK at a cellular level apparently, I do not have a single skipped beat. Now in a matter of 6 weeks (after starting T3) I went from 15000 to <10 skipped beats per day. It is my thyroid producing my PVCs.

After giving birth due to the natural thyroid function speeding up I had zero skipped beats for a month and a half.

I have decided to try Dr Lowe's approach (taking a single dose daily). Right now I am giving it a go, lol, by taking only 37.5 mcg in the morning.

I am absolutely bewildered how on earth I went on from feeling a bit hypo on 85 mcg T3 (needing a nap in the afternoon and having 60 skipped beats daily, other hypo symptoms gone) to feeling almost OK, even slightly hyper at 37.5 mcg daily (less than 10 skipped beats a day, slightly elevated heart rate, although I don't feel it most of the time).

I really, really hope to be OK at a lower dose of T3, lower than 40 mcg let's say.

I will continue to lower it a bit, lower it from 37.5. I am afraid to stop T3 and start from scratch, I am afraid that my hypo symptoms will return, and I am afraid that I might not be able to tolerate even small doses of T3.

Isn't it possible that the whole case might have something to do with reverse T3 and T4 going down?


Maybe your RT3 is high and stopping the T3 from getting into the cells? I felt extremely awful when I started T3, and I think it was due to RT3 (but I'm not sure as I couldn't afford to have it tested). I was unmedicated for 2 years and felt much better during that timeframe than the first 3 months I was on T3. I developed so many new symptoms and had a constant ache and low energy - kind of like low-grade flu or cold. Then, suddenly (within 2 days), I went hyper and after that I felt fantastic. I wouldn't go back and felt more like myself than I had in 7 years. I've heard so many people say that they gave up on T3 in the beginning because they couldn't stand feeling so unwell. So, it may be tough in the beginning, but it also may be worth it if you can stick it out. Along the same lines of what was mentioned above, you don't want to have too much T3 in your system in case your RT3 suddenly clears (like mine did), rather than slowly clears. Slow and steady :-)


bunnywhisperer, I did not have high rT3 level, at least not in the blood. A week after stopping T4 and 3 weeks into starting T3, my rT3 was mid-range.

Today my heart rate is normal (upper 70s) and I have a skipped beat here and there. So hypo is returning.



If rT3 was mid range you didn't have an rT3 problem. The likely explanation is that your FT3 was low and has increased since you have been using high doses of T3. Now that FT3 is high you have been able to reduce dose.


This is an explanation of RT3 in date March 24, 1999 on the following link just for info :)


Whatever dose of levothyroxine you were taking, you can switch over to an equivalent of T3. This is how to safely get well:-

No one can say in advance how much thyroid hormones will relieve clinical symptoms so it's so and gradual increases. Read the whole of the above article but, as you are taking T3 read carefully page 10 and 11. An excerpt:

Bear in mind that many patients who have failed to benefit from T4 alone or combined T3 and T4, recover from their symptoms on fairly low doses of T3.

Patients and the doctors treating them with T3 shouldn’t forget this. High enough doses of T3 can be harmful to anyone, and it’s crucial that patients not subject themselves to overstimulation from excessive doses.


Thank you, Shaws, Clutter!

I used to be on only 42.5 T4, and I was OK, 5-6 skipped beats a day but only once a week on average.

I guess I'm having a Hashi flare up right now since Levothyroxine was not able to get me out of hypo state even at a dose of 75-100 mcg.

Now 35-37 mcg T3 (taken at once in the morning) is almost enough, however in the afternoon I get a bit rapid heart rate which goes away by the evening and I run hypo by the evening and next morning (skipped beats in the morning and evening).

Since I don't have a problem with a high rT3 can I try 25 mcg T4 again, to keep my FT3 levels somehow steady 24/7? I am scared a bit, but I want to feel 100% myself. I am scared that T4 and the produced from it rT3 might compete with T3 for each cells' receptors.

What would you suggest?


I don't understand when you say:-

Now 35-37 mcg T3 (taken at once in the morning) is almost enough,

Because if on any thyroid hormones we take they should at least last for one full day with no ups/downs nor symptoms.

The only suggestion I can make (in case you have a sensitivity to fillers/binders in some of the hormones and if you take an anti-histamine 1 hour before taking hormones and if you don't have palpitations it could be the fillers etc.


You got it well, I have ups and downs and I am hypo by the evening and in next the morning before the next dose T3 starts to kick in. Apparently I need a higher dose but even this one renders me slightly hyper/overstimulated at times.

I will try that with anti-histamine.

It is not only the palpitations in the late afternoon (heart rate about 100), today I also got sweaty. By the evening, when going to bed, I will experience about 5-6 skipped beats. Same thing in the morning - that is my hypo symptom...

Maybe I should try taking 35 mcg T3 in the evening instead?


It is recommended when introducing hormones to try to get to a level in which you are not symptomatic by increasing NDT or T3 dose very slightly every week until you feel well. (about 1/4 tablet and taking note of pulse/temp). If either goes too high you reduce back to the previous dose. Some people prefer night time dosing. In that case you'd have to ensure stomach is empty - about 3 hours after eating. Due to being hypo our digestion is slow and food in stomach can interfere with the uptake of hormones.

I am not medically qualified and am hypothyroid which was undiagnosed/untreated for years.


Thank you once again, Shaws!

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A little update:

I tried taking my 37.5 mcg T3 in the evening when going to sleep. As a result I had less skipped beats (my main hypo symptom) in the morning upon waking but more in the afternoon. I also experienced fatigue and fell asleep twice. My heart rate was about 80, which is OK, no overstimulation.

When I take 37.5 mcg T3 in the morning upon waking I have more skipped beats before taking T3 and before it starts to kick in but I have much less skipped beats during the rest of the day, no fatigue; heart rate is in the upper 90s - lower 100s - slight overstimulation.

I guess when taking T3 in the morning it wears off by the evening and I go hypo during the night, however I don't feel it since I am asleep, lol. When taking it at bedtime it carries me through the night but wears off by the early afternoon.

Really don't know what to do and how to dose with no overstumaltion and a maximum diminishing of hypo symptoms.


Remember as well that some symptoms can be both hyper and hypo!

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