How did you learn that your T4 was not being converted to T3 but instead into Reverse T3? I ask because immediately after taking T4 25mcg I started feeling worse than before. So, I'm just wondering if I am converting it to Reverse T3 or whether my worsening state is coincidental.
I know the dose of T4 I'm taking is low, but would I feel worse from it? Would I not feel the same rather than worse from being under-medicated.
Note: I've been on T4 only for 10 days now. But, I've been bedridden for the last 5 days.
Current symptoms: Weakness, fatigue, dizziness/vertigo, lack of appetite, air hunger, brain fog. I feel like I have taken 4 shots of tequila and smoked a joint. I'm really out of it.
Fortunately, I am not anxious, nor am I jittery.
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Inana
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Inana, as it is over 40 years since I started Levo, I can't remember how I felt when I started, let alone the dose I was started on! But, many people say they feel worse to begin with.
You can find out how well you are converting by testing FT4 and FT3 at the same time.
Reverse T3 usually happens when there is to much T4 and it makes rT3 in preference to FT3. The results you'd expect to see to suspect rT3 is a very high or over range FT4 and a low in range FT3. In my case, FT4 was way over range, worked out to165% of range, and FT3 was about 40% through range. Of course, there can always be exceptions.
It's one thing to just feel worse, and it is another to feel worse and it being a common side effect. It's quite comforting to hear that a lot of people feel worse at first.
I suffered all your symptoms (except vomiting) before being diagnosed, and more after medicating Levothyroxine but started on 100mcg.. I too felt drunk and had to hold the walls just to go to the toilet.
It is too early to start considering RT3 testing as 25mcg Levo is a very low dose and you have only been medicating for a few days. It takes up to 6 weeks to initially saturate the body which will only tolerate small increases at any one time and your doctor should retest your thyroid hormone levels after 6 weeks and adjust the dose according to results.
Leave 24 hours between last dose and blood draw and have the blood drawn early in the morning whilst fasting (water only) as this is when TSH is highest.
Depending on how long your hypothyroidism has remained undiagnosed, your symptoms may continue for a while, but you should start to see an improvement once you are wholly medicated.
The goal of Levothyroxine is to restore the patient to euthyroid status and for most that means TSH just above or below 1.0 but even then my symptoms lagged behind good biochemistry by months and months..
People with thyroid issues often have deficiencies in vitamins, nutrients and iron that are all required for good thyroid hormone synthesis. Ask your GP to test Vit B12, Vit D, folate and ferritin and post results complete with ranges (numbers in brackets) for members to comment.
A good read is "your Thyroid & How To Keep It Healthy" by Dr Barry Durrant Peatfield.
It was simply awful ... so debilitating ... but mine eventually passed. I think it depends how long we have remained undiagnosed as to how long it takes us to recover.
If I was starting again on my road to recovery, I would have definitely considered adrenal glands a lot sooner than I did. They take a battering when thyroid hormone is low as compensate and this in turn results in other hormone imbalances.
Supporting struggling adrenals will help your body tolerate medicated thyroid hormone ( Levo).
Hope you feel better soon.
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Connection Between Low Thyroid Hormone & Adrenal Glands.
Ask your Gp to check vitamin D, folate, B12 & ferritin
Common for these to be low, and they may need supplementing to help you utilise the Levo.
When you get results make sure you also get ranges & come back here with new post for advice.
You should have repeat Thyroid blood test 6-8 weeks after each dose change. Always get test done as early as possible in morning and fasting. Don't take your Levo in 24hours prior, delay until immediately after the test.
Having read your previous posts I see you are already supplementing. Are you aware to stop B complex 4-5 days before any blood test. Biotin can falsely affect results
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It's quite comforting to hear that a lot of people feel worse at first. 
Is Low Reverse T3 good?
High Reverse T3
How to understand and treating reverse T3
High Reverse T3
Do you only get reverse T3 problems with T4?
