T3 made me worse

[Floob]

I started having intermittent symptoms of fatigue, brain fog, heart palpitations, slow heart rate (55 - 60 when feeling bad), depression, constipation. Had a few blood tests done and thyroid usually came back with similar numbers. The latest were:

TSH 2.78 (0.27 - 4.2)

fT4 16.9 (12- 22)

fT3 4.6 (3.1 - 6.8)

Never had rT3. Had antibodies once and they were TGAb <10, TPOAb 20.9 (0 - 34).

Anyway I thought these were not optimal after a lot of internet research so found a clinic to prescribe me T3. Started on 10mcg per day once a day and it made me feel progressively worse such that I had to come off it after 6 days. I felt a bit better stopping although still symptomatic but now things are getting worse again and the symptoms are now constant rather than coming and going.

I got Iron & saliva cortisol done which seemed fine. Just the waking cortisol a bit low perhaps.

Waking - 8.83 (6 - 21). 12:00 - 5.29 (1.5 - 7.6). 16:00 - 4.47 (0 - 5.49). before bed - <1.5 (0 - 1.99)

Iron - 25.78 (10.6 - 28.3). TIBC - 59.08 (41 - 77). Transferrin saturation - 43.64 (20 - 55). Ferritin 201 (30 - 400).

I don't know whether the fact that I got worse suggests I did have a thyroid problem or not. What would happen to a person with a healthy thyroid if they took T3?

Could it be that the dose wasn't high enough and my natural production dropped straight away? Was I even hypothyroid to begin with? Maybe my body just didn't like Thybon. I have some Thiroyd but not sure whether to try it in case it makes me even worse still. Getting a little desperate as it is affecting my ability to work so tempted to try a Thiroyd tablet just in case it helps.

I'm male btw. Also I don't have some classic symptoms like weight gain and feeling cold (although maybe difficult to tell in this heatwave) but I have noticed hair thinning & drying and itchy skin recently. GP's have no ideas as to what is wrong with me as all bloods have been normal.

I'd love to hear peoples thoughts. Thank you.

[greygoose]

10 mcg was too much to start on. Should have been 5 mcg for the first two weeks. Give your body time to get used to it. Why did they give you T3, anyway? It might have been better to start on levo.

[Floob in reply to greygoose]

Ok, he did suggest lowering the dose when I told him the effects but I was hesitant to go back on it after it made me feel worse. I did think T4 might be better but the doc seemed to think it could be conversion issue or resistance so gave me T3.

If I were to try my NDT what would be a suitable starting point? Half a grain?

[greygoose in reply to Floob]

Stupid doc. Nothing wrong with your conversion, and why would he think it was 'resistance'? Two entirely different problems, neither of which show up in those results.

The starting dose for NDT is 1/4 grain, increasing by 1/4 grain every two weeks. When you get to 1 grain, hold for six weeks and retest.

[Floob in reply to greygoose]

Great, Thank you

[SlowDragon Administrator]

Before starting again I suggest you get vitamin D, folate and B12 tested

Low vitamin levels can cause symptoms in their own right and can also affect Thyroid

Presumably this was a private doctor suggesting you start on T3

Many people manage fine on Levothyroxine. It's cheap as chips and so ideally see if that works.

But first getting vitamins tested

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, and if on T3 don't take in 12 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Have you had testosterone tested?

[marsaday in reply to SlowDragon]

Please only start with 2.5mcg (1/8th tablet if 20mcg size).

T3 is potent and people start out much to high.

If you still get negative effects on a lower dose then you need more investigation. More t3 will not be answer

[Floob in reply to marsaday]

Maybe that's where I went wrong. I increased it to 20mcg after 5 days as I thought the dose might be too low and my heartrate was still pretty low but felt worse still.

[marsaday in reply to Floob]

I think this is to do with your t3 to cortisol balance. They are out of balance. If cortisol is low the t3 will exacerbate this.

Lower t3 doses will allow the cortisol supply to adapt and match the t3 demand. So start small and hold for a few weeks then increase again.

[Floob in reply to marsaday]

Ah ok, thanks. It did feel like the only thing that gave me some relief was coffee.. maybe it increased cortisol temporarily. I have stopped drinking it now to see if it helps at all.

I will definitely start slowly when I start again. I'm not sure whether to start with T3 again or try NDT though. Is it just a case of trial and error in figuring out which type of medication is best for you?

[marsaday in reply to Floob]

Coffee is a great weapon for low thyroid people. So yes it will be giving you a cortisol boost.

Ray peat sees coffee as a nutrient and it is really good for us. Have a google for his articles.

Why are you not trying t4 first. All patients should try it first on its own as it can help most people. Especially as you are male. There is a big minority who do badly on t4 only but you should always try this out first.

You are having issues with t3 so It would be better to see how you react to basic t4 before you try any other protocol.

Your thyroid results were ok but tsh was a little raised. It is ilkley your issue is absorption of the t3. It would be good to see your results with a ft4 of 20. This may mean you only need 25-50mcg t4.

Your ft3 should come up a touch and this maybe all you need to balance up.

It sounds easy but getting balanced is a tough but to crack sometimes. Best to start low and see where the bloods are.

[Floob in reply to marsaday]

Thank you, that makes sense. I will ask the doc if I can try t4

[Floob in reply to SlowDragon]

Thanks! Yes it's a private doc but not sure how experienced he is with hormones. My Vit D is not too bad as I have been supplementing for a while. Last test was 113 (50 - 200). Never had B12 or Folate done so will get them tested.

Yes had testosterone tested. That is another avenue I am looking at. Its high but free testosterone is low in the range. I've usually only had blood tests done in between periods of being symptomatic but now that I feel like this all the time I will get more done to see if any change.

[SlowDragon Administrator in reply to Floob]

What was vitamin D level before you started supplementing?

Low Vitamin D and low B vitamin levels can be linked

drgominak.com/sleep/vitamin...

[Floob in reply to SlowDragon]

It was 41 back in May 2017 and that was after supplementing with 25ug for a while so I must have been pretty deficient to start. I'm now on 75ug daily.

[Singoutloud]

It may also be worth trying a different brand. Manufacturers use different fillers and Bulking Agents in their tablets that maybe don't agree with you. I have to avoid acacia powder but also need to take an antihistamine alongside some of my supplements to avoid the side effects the fillers cause.