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Thyroid UK
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Sourcing t3

Morning everyone

I posted yesterday about what I'd assumed to be straight forward Hashimoto's but was looking more like secondary (Cushing's) hypothyroidism. Does anyone know, bearing in mind conventional medicine won't treat me or even acknowledge there is an issue, how I could get hold of T3? I need to get off NDT, assuming the T4 is making things worse and I may be experiencing some RT3. My latest test results are as follows:

TSH 0.47 (0.27 - 4.2) I assume being suppressed by NDT

Free Thyroxine 15 (12 - 22)

Total Thyroxine 82 (59 - 154)

Free T3 4.2 (3.1 - 6.8)

Both sets of antibodies are below 10, which appears to rule out Hashimoto's.

I've also just had my latest Cortisol tests back:

Morning 6.2 (5.9 - 14)

Afternoon 4.9 (2.0 - 10)

Evening 1.4 (1 - 4)

Night time 11 (0.4 - 3)

If anyone can tell me things are going to be ok and tell me why I'm struggling so much having never been ill before too, that would be great.

Just for reference, Ferritin 150 (120-400) and Folate 40 (19 - 70). I've had to withdraw from Fumerate supplement because of the pain I was in

Thank you.


13 Replies

You might find the following link re RT3 helpful. Read No.4 on the following link:



Well, your TSH isn't suppressed, it's still in range. But, what was it before you started NDT? Doubtful that you have elevated rT3 with that low FT4, unless you had some sort of virus.

Impossible to say if you could have Secondary Hypo without seeing labs before you started NDT. But it would be due to a pituitary problem - that's what Secondary Hypo means - not Cushing's. And you don't have Cushing's with those results. Cushing's is high cortisol all day, not just at night. You have adrenal fatigue.

What happens is, your adrenals are struggling to make cortisol, they struggle and struggle all day to make their quota, and only succeed in the evening, when it's time to go to bed! Which, of course, makes sleeping difficult, which doesn't help anything.

You could try taking Holy Basil in the evening, to lower that evening cortisol, but what would be better would be to help your adrenals to make more cortisol in the early morning, when it's supposed to be higher. And, I'm not sure that taking Holy Basil is the right thing to do for that.

You could try taking an adrenal glandular - something like Nutri-Adrenal. But not an Adrenal support thingie, full of adaptogens. Just pure Dessicated adrenal. Adrenals also need plenty of B vits - a good B complex with methylcobalamin and methylfolate - and vit C - you can take up to 5000 mg, spread out through the day - especially before bed. I would also suggest you take your NDT all in one go, at night, with some vit C.

In the morning, make sure you have a high protein breakfast, as soon as you rise. And, don't skimp on the salt. Adrenals need salt.

I think it's too soon to decide that T4 is the problem. You need to give those adrenals some TLC before you do anything else. You could have Hashi's without the high antibodies, of course, but your Frees aren't too bad, at the moment, so continue like that until you get your adrenals back into shape - well, that's what I would do, anyway. :)

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Thanks Greygoose, that one post has more to calm my fears (currently that I'm never going to feel better) than ANY specialist in several months have. I'm already on high Vit C, full methyl B Complex and diet is strictly Ray Peat (having just started so feel terrible). If I took NDT at night wouldn't it clash with the Cortisol spike though?

I was considering a low dose pregnenolone first thing in the morning too, assuming this would reduce the rate at which my adrenals were struggling. Have you ever tried preg at all???

Thanks again


No, I haven't tried pregnenolone, I'm afraid. My doctor did give me a prescription for it, but every time I tried presenting it at the pharmacy, they all started crossing themselves, and reaching for the garlic! No idea what it was! So, doctor prescribed DHEA, but I didn't get on with that. It just converted straight to testosterone and gave me acne.

I think you might be better off trying without pregnenolone for the time being. See how you get on with just the adrenal support.

I don't think taking NDT at night would clash with anything. Might even help. But, you won't know until you try. And, it will free you up to support those adrenals in the morning. Alternatively, you could try taking the NDT mid-morning or mid-afternoon - two hours after one meal and one hour before the next. :)

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I'm my very own guinea pig. How did it come to this. Thank you

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I'm afraid it's the same for everyone here. :(

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Your thyroid levels on NDT are euthyroid (normal). TSH is low-normal, not suppressed, FT4 is mid-range and FT3 low in range. It's very unlikely you have high rT3 with FT4 only mid-range. Most people taking NDT feel better with FT3 higher in range so you could increase dose.

Have you had serum cortisol tested? Cushings presents with high serum cortisol. Your saliva cortisol is only showing 1 out of 4 high result which I do not think indicates Cushings.


Hi Clutter, thanks! I definitely can't increase the dose - heart palpitations are already pretty severe, the symptomology really is all over the place. It's what I'd imagine Hyper to feel like (it that makes sense) and I'm only on one grain. Do you think I might actually benefit from straight T4? I've not had my serum Cortisol tested but this time several months ago every reading was high - it's like it's bottomed out apart from a huge spike at night. I'm absolutely baffled, the symptoms (what I have been led to believe was Hypo) have all actually got worse with the use of 1 grain of NDT

Rather complex I know sorry!



I don't know. Only way to tell is to try T4. FT3 isn't high so that's not causing palpitations and FT3 is likely to drop if you switch to T4 only. You could try adding a little T4 to NDT to see whether that works for you. If symptoms are worse since you've been using NDT it may be the brand which doesn't suit. Some people have to try several brands before finding one which suits. Ditto Levothyroxine.

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Ah, it's never straight forward. Thank you!


Hi Liam, I agree with greygoose and think you should follow her suggestions. You know there are many functional doctors who would only treat your adrenals for now. I would concentrate on them. If they aren't completely shot you could try licorice root and siberian ginseng. Nourish them as you have with vitamin c and magnesium. I've used Thorne's Adrenal Cortex (not cortrex) or Adrenergize by Enzymatic and I think you could take DHEA along with either. I'm glad you are using Ray Peat as well. You need to enhance your nutrition but if you are deficient it means you didn't digest it in your food and that means you may not digest it in your supplement (almost guaranteed). Take vitamins AND minerals with food and take food with digestive enzymes or Betaine HCL. I would get both and take them at separate meals. Now that you KNOW what's wrong you can do something about it. Best wishes!

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Thanks Helouise. It just seems so counter intuitive and is so frustrating that I'm having to treat consequences and not causes - I basically said to my NHS doctors months ago if you don't help me now my adrenal function will go and then my liver will deplete itself and here we are, the exact scenario unfolding! I've actually literally just started Thorne Adrenal Cortex- I seem to have real issues with absorption initially and then have a breakthrough point. I still don't know if its my adrenals suppressing thyroid or the other way around though, this lack of antibodies has really thrown me.

Thankyou for all your help and support


Yes, and the real unfortunate part is some of those causes are not going anywhere. There are lots of toxins we face daily. Stresses the body was not prepared to have to deal with. We live in a chemical world but it's all we have.

A lot does come down to nutrition and absorption so if you can support that... I like to juice vegetables. I also use proteolytic enzymes but I don't want to get too far ahead. You know the Pharmaceutical industry would prefer to give you a drug for everyone of your symptoms with no end in sight. You could add Gaba to help you with your sleep, which you know is important.

Yeah, we've all been our own doctors and been through many trial and errors although I think everything I've tried has helped to some degree. The last summit said it didn't need years to resolve, possibly just a few months.

Don't give up.


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