Thyroid UK
84,241 members99,241 posts

Overmedicated with T3? Symptoms feel like it

I think my doc overmedicated me with t3.

While taking NT 130mg/day 6/29/17:

FT3 2.6 (2.0-4.4) (upper third optimal range 3.8-4.4)

RT3 9.9 (9.2-24.1)

TSH 0.151 (0.450-4.500)

T4 0.74 (0.82-1.77)

On 7/27/17 Doc added 30mg T3 and increased NT to 195mg/day

Initially no negative symptoms, then mass hair fallout, hand tremors, anxiety, heart racing, hot and my labs on this regimen drawn 8/17/17:

FT3 5.7 (2.0-4.4)

RT3 20.3 (9.2-24.1)

TSH <0.005 (0.450-4.500)

T4 1.31 (0.82-1.77)

Clearly missed my t3 upper third range of 3.8-4.4 by going up to 5.7.

Started to titrate down the T3 on 8/21 and now at 10mg/day.

Stilly hyper, racing heart, massive hair fallout.

How long until T3 decreases?

Shouldn't my doc have decreased the NT down from !95mg when adding the T3?

Thank you

34 Replies
oldestnewest

Goodness, he actually doubled your dose. Did you do this all at once?....... because you added one grain to your two grains of NT (Naturethroid?) and then added 30T3 which is equivalent to almost another grain. Personally I would have stopped everything for a time.

There must have been an error in there somewhere.

3 likes
Reply

That's a large amount to add to your dose! Should be an incremental increase. Yes your FT3 is high... I think your dr should have simply increased NDT (incrementally) as comparatively (with the other measures in the same blood test), your T3 didn't look especially low. Not sure how long it will take to improve, but I wouldn't think it would happen during this tritation stage and once you are at the right dosage I think it would take a few weeks at least. Poor you I hope you feel better soon x

Reply

Why would you add T3 to NDT. Ratio of Pig 4:1 and Human 14:1 (T4:T3). I would drop synthetic T3 and just increase NDT slowly until you feel good.

Reply

jamesal0,

What ratio of T4:T3 is that for humans?

Bear in mind, the approximate 4:1 of pigs is the ratio of hormones within their thyroids. It says nothing about the ratio of T4:T3 in their blood.

2 likes
Reply

James.... there is a protocol 'out there' for lowering R T3 numbers and it is for one to drop their NDT dosage to 1 - 1.5 grains and add T 3. Maintain this regime for 8 - 12 weeks and R T3 numbers should be resolved. Some even drop their NDT all together and take T 3 only. One of our members stayed on the T 3 for two years and did very well.

---------------------------------------------------------------------------------------------------------------

"But there are other issues where one might have to be on T3-only by itself, or adding T3 to a greatly lowered dose of NDT like one grain….issues ranging from having high RT3 (reverse T3) due to low iron or a cortisol issue, to having Lyme disease (which promotes RT3), to having a rare deodinase enzyme conversion problem (problems converting T4 to T3). There are a small minority who even on high doses of NDT, have to add a little T3 to be optimal."

------------------------------------------------------------------------------------------------------------------

stopthethyroidmadness.com/d...

2 likes
Reply

Which I may do again now that it is available once more. Someone felt we should wear a medical bracelet stating T3 only so if admitted to a hospital they would be aware. I'm thinking anyone with heart failure should have their FT3 check carefully (I think low T3 may be a cause). One physical therapist states that EVERYONE should take T3. There should be studies done but T3 is too inexpensive I guess. Thanks for the post, Phoenix.

2 likes
Reply

Wow what a storm that little comment created. Lets try this then.

People struggle with high FT3 because they doggedly stick to a fixed dose NDT/T3 and end up overdosing.

We need different amounts of T3/T4 from hour to hour (hot cold days, more less exercise etc). Taking the same dose day in day out would be like a Diabetic taking the same amount of insulin every day. Diabetic's test blood sugar levels after meals etc and adjust dose.

Micro analyzing weeks old/single point in time T3/T4/RT3 blood results (as tends to happen here), is a waist of time.

To feel well. People of T3 products have to find other means of judging how they are dosing (daily/hourly). Temp, heart rate, sense of wellness, etc.

2 likes
Reply

Yes, James. I feel we kinda hijacked the thread unintentionally.

Our thyroid does a phenomenal job of producing thyroid hormones on demand as needed. Manual dosing will never approach that level of precision. So, we do the best we can and, even when on thyroid hormone replacement, get our labs done at least every year in order to stay on top of things. Also spreading out our NDT dosage through out the day can be helpful for some.

We can keep a daily log and note our body temp and heart rate and how we are feeling. Remember, before the discovery of the cursed TSH test and synthetic T 4 (Synthroid), doctors prescribed NDT, increasing the dosage slowly and observing the resolution of hypo symptoms, body temp and heart rate to be their determinate.

By the way, I have been on the same NDT dosage for almost 20 yrs with no signs of Reverse T 3 or pooling yet (knock on wood).

1 like
Reply

All deleted. I bow to greater knowledge.

1 like
Reply

i suspect your feeling awful is the reverse t3, it happened to me with ndt. The only way to get rid of it is to stop any t4. You need to stop the ndt and take just the t3 till it clears.

It could also be the addition of extra t3 has suddenly flagged up weak adrenals, which also causes racing heart and shaky feeling.

The drs like us at best are guessing and it will be process of elimination im afraid. If it were me i would stop meds 2 days to settle down and then start with the t3 only split into 2x15mg doses and see how you feel. If you start to feel under medicated start very small reintroducing ndt. I was never able to tolerate T4 in any form after RT3. A

some adrenal support would be good idea mix half teaspoon salt, half of cream tatare (potassium) in water with fresh squeezed lemon or ornge juice helped my adrenal shakiness.

From then on only make small changes so you can identify what makes you feel bad. xxx

2 likes
Reply

Endomad,

We all make rT3 and Furbabymommy's rT3 at 20.3 is well within range and is absolutely fine.

T4 converts to active T3 and inactive rT3. rT3 is the body's brake on converting too much T3.

I suspect Furbabymommy is feeling awful due to high FT3. She should feel better when FT3 is back in range.

3 likes
Reply

yes but she will not be able to reduce what is at top end of range RT3 continuing with NDT i.e T4 i suspect she is getting more t3 than needs and so additional t4 will just automatically become RT3...it is as i said all complete guess work by us and drs. It was a huge leap from previous meds to new meds. adding t3 will highlight any adrenal issues such as shaking, anxiety etc are all adrenal signs too not just over/under medicated. FT3 result is totally dependent on when last dose before blood taken, if it is within 12 hours of last dose it is not high, if last does was 12+ hours before it is over.

Reply

Endomad,

rT3 20.3 is not top end of rT3. Furbabymommy is certainly getting more T3 than she needs because FT3 is over range and she should reduce dose or stop T3 altogether.

1 like
Reply

Thank you, Clutter. Been decreasing T3 since 8/23. Stopping T3 today.

Reply

I was very over medicated several years ago on T3 it was horrible I thought QI was going out of my mind. I couldn't sit still or sleep properly. In the end I had to go to a private Doctor as my GP was saying it was nothing to do with my medication. Make sure you get the proper treatment

Reply

Thank you ALL and keep the ideas about what happened and what to do coming.

My doc left her practice at the time I got overmedicated and symptoms presented-nice timing. The new doc has not started yet and no one in the practice has ideas of what to do. Thank goodness I have you to count on!

Hair fallout was the first symptom, while on the increased NDT at 195mg and no T3 yet.

The hyperactive symptoms started after taking T3 with head itching, which continues.

Yes, adrenals have been a concern we were trying to address. Now unsure how we identify if adrenals an issue in the midst of overmedication.

What is Trapped T3?

THANK YOU FOR RESCUING ME WITH YOUR WISDOM

Reply

Furbabymommy,

It was madness for your doctor to raise NDT and introduce 30mcg T3. I would stop the T3 completely and retest in 6-8 weeks.

I had hair coming out in clumps when my FT3 was over range. I reduced dose and hair stopped coming out after 7 weeks. A blood test a few weeks later confirmed FT3 was within range.

2 likes
Reply

Thank you, Clutter!!!!!

I need this type of oversight now more than ever.

Yes, it was madness for doc to increase NDT and add T3.

Even more madness she did this in cusp of leaving practice and no other doc in place to manage me yet.

Reply

Hi Clutter-can you please advise re: my question on what to do with NT dose given symptoms which presented upon going from 130mg to 195mg?- see below

Thank you

Reply

Furbabymommy,

It will have been the combination of adding 65mg NDT and 30mcg T3 which has overmedicated you. I've advised stopping T3 and retesting in 6-8 weeks. If FT3 is still over range after you've stopped T3 you will need to reduce NDT dose.

Reply

Thank you, Clutter.

NT was 195mg/day when 30mg T3 was added.

I agree with stopping the T3.

Thinking amount of NT to take:

Was at 130mg NT a day on 5/22/17 and hypo symptoms began to reoccur.

On 7/15/17 NT increased to 195mg/day.

Hair loss onset 7/24/17

T3 added on 7/27.

Go back to 130mg NT a day?

Reply

Furbabymommy,

Why do you want to go back to 130mg NDT if you were feeling hypo on the dose?

Reply

Hi Clutter,

We were increasing NT dosage and hypo symptoms crept back in at 130mg NT.

I figure go back and start at 130mg...?

Should I start at next increment higher? What would that be? 130mg plus 32mg?

Reply

Furbabymommy,

It's entirely up to you whether to go back to 130mcg or not.

If you have 65mg tablets you could halve one tablet and take 162.5mg instead of 195mg.

Reply

without a test this is a good way to look at symptoms, Dr Lams stuff easy to follow. This shows hypo V's Adrenal symptoms and easy to see if you fall into one camp or both in which case your adrenals need addressing and till then NDT & T3 will be hindered. x lots of symptoms mimic each other for instance a big indicator of hypo is hair loss but yours is after a big increase, not it seems from being under medicated, it is best to start slow and keep notes x symptoms for one person can be for a totally different reason than for you, we are all different. Trial and error x

Reply

i forgot to put the link x

drlam.com/blog/adrenal-fati...

Reply

Thank you, Endo.

Much appreciated. Very helpful.

Any chance you can offer a response regarding the NT dosage question below?

Reply

if it was me i would go back to 130 for a week and get settled. Then increase by a quarter grain/tablet stay on that for 4 weeks and see how you feel. T4 is slower working than t3 and has to be given time to build up (ndt is mostly t4) if after 4 weeks you still feel need to increase then again by a quarter, again for 4 weeks...it has to be slowly for body to adjust...t3 has a habit of highlighting adrenal problems and they are not straight forward to reverse. Low & high cortisol mimic each others symptoms and you will need to test before trying to do anything but in mean time the potassium salt and lemon juice will help support them

How is your sleep, do you sleep right through night?

Reply

Yes, good plan: 130mg NT as of today and no T3. Thank you for being specific with dosage of NT.

Sleep: when taking 30mg T3 I slept well but woke up early super alert at 5am or earlier. Since going down to 15mg T3 on 8/23 I still sleep through night, am waking closer to normal wake up time (6:30am) though recently harder to fall asleep at night, staying up later.

My doc gave a cortisol test to take now. Should I wait to take this? if yes, when suggest taking this given the medication changes?

Reply

the too much t3 will leave the body quickly so 5 days after last t3 dose will be fine, as long as you feel settled. No point doing it if you feel like your clinging to the ceiling unless that is how you always feel :O adrenal stuff doesnt change over night but you dont want a test thats done on a spike.

Your sleep is pretty stable so thats good.

Reply

Thank you, Endo. I am not usually this hyper. I am going to wait until this spike is over to take saliva/cortisol test.

1 like
Reply

Hi Endo-thanks for this information and the link. So helpful!

I am a mix of hypo and adrenal symptoms and have been before this crisis.

Yes, hair fallout likely overmedicating w T3.

Reply

its all a balancing act x

Reply

Questions:

1) Doc ordered a saliva cortisol test now, in the midst of T3 overmedication. Shouldn't I wait to take this until T3 is down/6/8 weeks when next labs are taken?

2) Hair started to fall out after increase from 130mg NT to 195mg NT and right before starting T3.

Should I decrease NT to amount between 130mg (which no hair fallout occurred but hypo symptoms had started to return, fatigue) and 190mg (when hair fallout started)?

If yes, what amount of NT please?

Reply

You may also like...