I'm new here and have a question/concern that I have not seen posted here. I was NDT and had to stop because of chronic chest pain (at any dose). I then went on straight t4 and felt awful- so now I've been trying to add a tiny bit of T3 to my 50mcg of synthroid and every time I try to increase just a tiny bit ( 2.5 mcg) I start having chest pains. I had a stress test done and doc said my heart looks great (no symptoms on treadmill or with exercise ever). On 3 mcg of t3 (twice a day) I'm ok- on 5mcg the chest pains start. I feel like crap on just t4 and even a smidgeon of t3 helps my low mood and energy. Anybody else have this issue with chest pain on low dose t3? I read about the doses of medication that folks here take and am dumbfounded. Does anybody here benefit from tiny amounts of t3? My integrative doctor also suspects that I am a very slow metabolizer of all meds. I've read 3 books on thyroid disease and just keep trying to get it right! I also take Vit D3, B complex, magnesium, vit C, selenium, and a basic multi.
Last blood test
TSH 4.5 (prior 2.7) 1 year ago - I felt better at these levels but NDT had the bad side effects (chest pain and anxiety/irritability even at low dose)
t4 .7 (prior .9)
T3 2.6 (prior 3.9)
I am very sensitive to medications in general and have never been able to increase my thyroid meds very much without tons of adverse effects.
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jjyankee
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I added T3 to T4 ( 75 mcg) earlier this year starting off with 1/8 th of a 25 mcg T3 pill so little over 3 mcg, and got tight chest / palpitations along with raised Bp/ pulse but over a month gradually increased the dose upto 25 mcg. After about 3 weeks these symptoms literally disappeared overnight to normal Bp/ pulse and no palpitations/ tight chest ... so I personally would suggest be patient. Have you got a Bp/ pulse machine to test yourself at home- might help you introduce T3 confidentially?
yep- I have a BP cuff- my blood pressure is always great (usually 110/60ish) but my heart definitely has increased some (I wear a fitbit). I will try to be more patient - thanks for your response @Judithdalston
Have you had your vitamin levels actually checked - ferritin, B12, Vit D, folate and blood count? What levels were they?
Are you eating enough? I only mention that because personally I have difficulty tolerating higher levels of thyroid meds if I start to eat less as busy or something or my symptoms of deficiencies get worse if i take a higher dose - such as iron on my heart etc? My body doesn't want to work faster or more efficiently when I have either or these two issues so thought just worth a check?
Also I would suggest you actually need T3 or higher meds if neither of those issues apply as you're not on enough medication in general as tsh is way to high and needs to be nearer 1.
I can't say much about your T3 and T4 levels without the ranges (the numbers in brackets after the result)
Yes- TSH is too high- t4 and t3 is in bottom 25th percentile. However, I've been on meds for years and have never been able to raise much without horrible side effects- I honestly feel like jumping out of my skin and get so anxious and agitated and the chest pains- like I have all the symptoms of going to being hyperthyroid even with tiny increases. But the chest pains are a more recent side effect- I think I need to find the right ratio of t3 & t4- The ratio in the NDT was too much T3 for me and I think that is either 3:1 or 4:1
Hopefully you get to the bottom of it soon but please get those vits tested and bring the results back as what is in range is often out of date or not optimal for thyroids or treated adequately. Some of them like iron will cause heart issues
Please post your results with ranges - they may be fine but not OPTIMAL. B12 - Folate - Ferritin - VitD need to be optimal for your thyroid meds to work and for you to feel well ...
I’m sensitive to meds too. The advantage is that you are able to finely adjust meds to your body’s needs, but the disadvantage is more side effects. When I first took thyroxine I got some chest pain and I used to get it on increasing dose. I have read that it can be due to a speeding up of the heart following dose increase after a period of undertreatment which has led to some furring up of arteries due to high cholesterol arising from hypothyroidism. However, I used to tell myself it was just anxiety as it always resolved in a few days. Have you tried reducing synthroid first?
I do have high cholesterol as well- and yes I have tried decreasing synthroid. Some days I seem to be getting better and then other days I don’t want to get out of bed because I’m so tired and incredibly depressed- but I can see that I’m certainly not alone in my frustration. My pharmacist told me that the therapeutic window for these meds is very small and it’s just a hard thing to treat effectively. I’m just so tired of it 😞
Also, I'm not liking the sound of your 'multi' vits + a B-Complex - you may end up having too much folic acid in them when you add up the totals which for many people is not helpful. Large doses of folic acid given to an individual who has a vitamin B12 deficiency and not a folate deficiency can cause neurological damage. I much, much prefer methylated versions of folate and b12 as they don't require conversion to the usable forms. Conversion issues seem to be a thing for many with an under active thyroid.
Do hope people read your links. I self inject B12 weekly - sometimes more - having been on my B12 journey for many years. Terminal ileum removed in 1973 - and I live with the consequences of medical ignorance ...
I just want to add that nutrition and good gut health is crucial for good health. Sadly the conventional doctors are not taught this. I highly recommend books by dr amy Myers and dr Isabella Wentz
Not if I take it before noon. When I was getting used to it I poured out about half of the capsule then worked up. It really makes a big difference in energy and mood. Funny such a small amount.
That makes sense- I take my second dose of t3 around 12:30 (can't take any later either). You are taking a small amount but it's added to the T3 in your NDT. It's strong stuff- some of us just don't need much. I think I'm going to ask doc for the slow release- only problem is that I'll have to pay for it out of pocket : ( but if it works it would be worth it.
I'm in your same boat I'm really sensitive to meds I've tried a few. NDT had way too much T3 for me or at least not enough to T4. I had a lot of chest pain's and anxiety On NDT but then my doctor added 12 milligrams of T4 (Tirosint) and I started feeling better so I added another 12 and up to 25 and I felt OK, except that Tirosint gave me horrible headaches so I switched all together to another T3 T4 combo. It's been four years of not feeling myself. I just keep telling myself life doesn't have to be perfect to be wonderful . I tried to really enjoy the days I don't feel like crap. I add my T3 in 2.5 mg doses and it comes from a compounding pharmacy in it slow release. That has helped me. I've worked my way from 5mg to almost 15.
Thanks so much for sharing this- how much t4 are you currently taking with the t3? I guess I'm just going to have to titrate VERY slowly. I also found the t3/t4 ratio in NDT to be too high for me- finding the correct ratio is my goal.
I take 112 mg of T4 and 15 mg of T3. My gut tells me if I just add a little bit more T3 I'll be great but my doctor won't let me because of my TSH. So next visit I'm going to try to convince her to at least give me more T3 and maybe lower my T4 since I don't think I'm converting. I still battle fatigue
I called my Integrative doc today and asked him to call in a SR t3 at my compounding pharmacy and he agreed- (5mcg to start but could dump some out if I have adverse side effects) So I'm anxious to give this a try. I'll start low and see how it goes-
Yes I'm really sensitive to t3. T4 only doesn't relieve my symptoms though, so I have to add t3. I haven't found a perfect ratio yet, it's a moving target I find. Using 12.5mcg or 6.25mcg increases of t4 and 2.5mcg of t3, I've been tweaking for a year. I can either have good sleep, good energy and chest pain with higher t3 to t4 ratio or insomnia, exhaustion and no chest pain with lower t3 to t4 ratio. I don't think supplementing hormones will ever be like how it was having my own hormones produced. I think I prefer no chest pain and lower energy but I hate insomnia.
I'd like to try slow release t3 but getting standard t3 on prescription is difficult enough.
I was on synthroid for 15 years with compounded T3 which was not bad, but I became very sensitive to things I had taken for many years, such as foods and supplements. Then my dr. recommended WP thyroid and it was great! for a whole year I felt I had my life back. Then came the shortage of product, and I was switched to Nature Thyroid ... and 1 days later I began having shortness of breath and it just got worse and worse. Doctors thought I had pneumonia, and I developed this awful bronchospasms.... when i researched the bronchospasms, I learned that it was a reaction to something I'm allergic to .... and I thought again about NT... finally after 2.5 months of being really sick, with chest pains, sporadic heart palpitations, and feeling like I couldn't breath for 3-5 hours a day ... I stopped taking it, and the very day i stopped, it was like a cloak had been lifted off me. When WP was finally brought back, I was so hopeful, and to my chagrin, I started having chest pains etc. I stopped after 10 days. I had to go back to synthroid but I am starting ERFA ... if I have the same chest pains, I will have my compounding pharmacy put togehter a t4/t3 pill. It's probably the new product that is causing the alergic reaction.
Since writing that post I have found a solution- I now take Synthroid (50 mcg) (has to be brand name) with a small dose of Naturethroid (3/8 grain) and this is the best combination I have found- no Chest pain or hyper feelings. It took many months to work up to this dose of meds, and I still need to increase a bit more, but I feel like I'm on the right track. I came to this protocol after reading the book " The Functional Approach to Treating Hypothyroidism" by dr. Kenneth Blanchard- I'd read many thyroid books, but for me, this one made the most sense as related to my experience with t3 reaction.
I also got a script to switch to WP but couldn't get hold of it so stuck with Naturethroid.
Because of all the sensitivity issues that I developed I had to start over with only 25 mcg Synthroid and 1/8th grain NDT- then added t4 in 12.5 mcg and NDT in 1/8 grains verrrrrryyy slowly. Good luck to you- hope things work out better.
Yes!! I was even lowered to 1.25 of t3 as 2.5 gave chest pains. We may try compounded t3 or a different brand as we are working on iron and adrenals etc as well. I was so looking forward to t3 and hopefully I will find a way to take it. (My t3 is very low).
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