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Thyroid UK
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Dry cracked skin in ears, could dual t4/t3 help?

Hi, I was diagnosed with Hashimoto's 4 years ago. Started on a slow 25mg increasing by 25mg for the first 12 months because I seemed to be sensitive to the levothyroxine, joint pains, etc. Feeling well but have started to feel more tired in the mornings and getting cracked, painful skin in my ears, scalp and a little in the summer months on my heels, this has started in the past year. Have read so many articles on Hashimoto's and underactive thyroid and one in particular seemed to indicate that T3 synthoid might be a way forward? My endocrinologist offered me 18 months ago NDT which I declined because I feel well on the levothyroxine, plus I am vegetarian. Has anyone got any advice they could offer? GP will give me another refferal to my endocrinologist through NHS if I ask.

Keen to hear if anyone has been down this route?

4 Replies


If you post your recent thyroid results and ranges I can tell whether you are optimally dosed on Levothyroxine. Being undermedicated can make dry skin worse. I'm not aware that T3 improves dry skin, certainly hasn't for me anyway and I've been on T3 only and T4+T3.


So you are only taking 50mcg? This is a very small starter dose

Suggest you add your latest thyroid results and ranges, TSH, FT4 and FT3.

Members can advise

As you are vegetarian do you supplement B12, folate or good B complex?

B12 and folate levels need testing

Essential to also test vitamin D and ferritin

If any of these are too low they need supplementing to help thyroid hormones function correctly

Hashimoto's affects the gut and often leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ask GP for coeliac blood test first

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance










OK thanks.


Doctors often think one little pill and all Swell but sadly not as easy as that. It takes time to get on the. Or text dose for you plus vitamins etc need to be optimal so not a quick fix but a longer plod adding things in as you go along


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