Hypo or Hyper or what?: Hi Everyone, question for... - Thyroid UK

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Hypo or Hyper or what?

superakcraig profile image

Hi Everyone, question for everyone, can someone with Hashi's, have thyroid numbers within the "optimal" area and still deal with anxiety (physical and emotional symptoms), cold hands (comes and goes throughout the day), mood swings, low energy, no lunula (finger nail half moon), quickly thinning hair (male pattern baldness), no libido, and loose stools (TMI i know...sorry)?

I really feel like I have a combo of both hypo and hyper symptoms. I take Tirosint and have for several years now but have never felt "right" since my initial diagnoses 7 years ago.

FYI, I am a runner and usually run up to 20 miles a week (when I feel like it and not afraid something bad is going to happen to me).

Thank you for your time!

33 Replies

Have you got a copy of your latest thyroid blood test results that includes the lab ranges? If so post here along with any vitamins that have been tested and people can give you good help. If not, then get a copy from your GP receptionist and post the results here along with the lab ranges and people can start to help you work out what is going on.

Optimal is not a number on a lab sheet. It is the way you feel. You are obviously not optimal if you have all those symptoms. Something is wrong.

jgelliss profile image
jgelliss in reply to greygoose



Well my TPOs started fluctuating big time in April so from that point forward, my meds were adjusted a couple of times. Prior to that in January my numbers read as follows:

TSH 1.4 (.45-4.5)

FT4 1.58 (.82-1.77)

FT3 3 (2-4.4)

TPO 38 (<35)

Regarding my vitamin testing, just last week they read as follows:

Vitamin D 40.6 (30-100)

Folate 14.42 (4.78-24.2)

Vitamin B12 550 (211-946)

Zinc 70 (56-134)

Ferritin 70.8 (30-400)

shaws profile image
shawsAdministrator in reply to superakcraig

You didn't click on the reply button so the above two members wont be alerted to your response. I will add them in now Nanaedake and greygoose

in reply to shaws

Hi Shaws, excuse butting in. How do you tag someone? Even when I put the exact name it doesn't come up in blue as it did above.

shaws profile image
shawsAdministrator in reply to

Just put an @ in front and as you type the first couple of letters look below and there will be several suggestions, i.e. @ Jne etc - no spaces


in reply to shaws

Thanks x

superakcraig profile image
superakcraig in reply to shaws

Thank you shaws

What sort of a doctor doses by the TPOab? Antibodies do fluctuate, your dose of levo has nothing to do with that. Your problem your FT3 is still under mid-range. It's the T3 that causes symptoms. You don't convert very well, and could do with a little T3 added to your levo. Who told you your results were in the 'optimal' range?

Your vit D is a little on the low side. Your zinc is low - that will cause muscle pain. Your ferritin should be at least mid-range, which it isn't, so that's going to cause a lot of fatigue and hair-loss. And your vit B12 would be better nearer the top of the range.

I'm afraid you still have a lot of optimising to do before you're going to feel well.

My Endo wasn't treating based solely on increased TPO, she was treating based on my TSH going below 1 (0.164), and my FT3 being 3.8 (highest it had been) AND my TPO jumping to 160.

Well, that's not exactly what you said before, but never mind. :)

The most important number is the FT3. If that is in-range, then you are not over-medicated, no matter what your TSH is. You have Hashi's, so your numbers are bound to jump around. So, your doctor shouldn't be reducing and increasing your dose, but allowing you to stop taking it for a few days, if you have hyper-type symptoms, and then resuming your dose as it was before.

Sorry for not providing the right information oringally. I was trying to make the post as condensed and not so long and detailed. Here are my previous two years of readings.


0.45-4.50 .82-1.77 2-4.4 <35

2/4/2016 1.49 1.33 3 29

4/14/2016 1.47 1.25 3.1 31

7/21/2016 1.73 1.35 3.3 100

10/28/2016 1.14 1.3 3.1 86

2/2/2017 1.53 1.32 3 49

5/11/2017 1.26 1.54 3.5 31

7/31/2017 1.08 1.58 3.6 35

9/27/2017 1.4 1.63 3.4 34

Well, you definitely have Hashi's. And your FT3 has never been over mid-range, so you've always been under-medicated. So, what are you taking now?

I am currently taking Tirosint 5x75mcg and 2x50mcg a week which has been my "regular" dose for the most time since starting Tirosint.

Here are my readings for this year including the first one I shared.


1/4/2018 1.4 1.58 3 38

2/24/2018 0.776 1.52

4/12/2018 0.164 1.72 3.8 160

5/24/2018 16.52 1.04 2.4 243 2x75mcg/5x50mcg

7/5/2018 8.14 1.26 3.1 209 4x75mcg/3x50mcg

Those swings in TSH and FT3 were caused by changes in my "regular" dose.

But, why was your dose changed? There was never any need for it according to those results.

Well...I have been dealing with fairly intense anxiety now for about 10 months. Based on that symptom and the fact my TSH was lower and my FT3 was higher, she made the adjustment. I realize as I am typing this, it doesn't make alot of sense to me.

The one thing I will say about my Endo, she DOES listen to me and will adjust if I request. Because anxiety is normally a "Hyper" symptom, she and I both tend to believe that I am over medicated.

Is it possible to have anxiety and be HYPO?

Absolutely. Anxiety is more often a hypo symptom. I am at my most anxious when my dose is too low.

That is very good to know...thank you!! You don't find that much when you google anxiety and hypo...it tends to be documented as a hyper symptom or over medicated.

Very few people - especially doctors - realise how many symptoms can cross over, and be both hypo and hyper symptoms. On here, we tend to get more hypo people complaining about anxiety, the hypers. I have been over-medicated myself - according to my FT3, not just my TSH - and I wasn't anxious. But, if I'm under-medicated, my anxiety is terrible.

So I would like to add another symptom, I get noticeable heart palpitations after I eat and until it’s been digested (2 hours or so). Hypo or hyper?

Could be either.


My Sympathy for you . With FT4 at 1.5 Personally I experienced hyper symptoms . Anxiety , sweating , insomnia , aches and pain . Lowering my T4 and having FT4 anywhere from 1- 2 my symptoms went away . On the other hand my FT3 Personally I need around 3.5 for my energy and wellbeing . Everyone is different . Some might need higher . I dose with combination of NDT for my T3 and a added T4 . Ask for a copy of all your labs and write on it the dose you where at the time . Journal with each dose change your symptoms . THE ARE VERY TELLING .

Nutrients are Extremely Vidal for our thyroid meds to work better for us . Vitamin "D" K2 , B-Complex B-12/Folate , Iron if your ferritin test low, magnesium . Zinc you might want to be a bit careful with since it can lower cortisol levels . You would need to take a 24 hour saliva test to check your Cortisol/Adrenal levels . DHEA-S is best test via Serum .

In addition supporting your adrenals is very important too . Most Dr's don't know anything about it . I support my adrenals with Vitamin "C", B-5 , and for **electrolytes** Some Sea Salt drinking WATER is Very Important . Also going on Gluten Free Dairy Free Sugar Free diet is EXTREMELY HELPFUL .

SeasideSusie has Excellent Posts on vital Nutrients .

SlowDragon has Great Posts on G/F D/F Diet .

Best Wishes on your next Steps .

Considering how much time you are outdoors you have low Vit D. Should be higher... Low in range Zinc is a problem too and being inadequate in both will make you prone to infection. I suspect low stomach acid could be partly responsible here so take soluble Vit C before meals, look into improvement in Zinc and Magnesium as they work together with B6 to lower dangerous homocysteine and check Seaside Susie guidance on Vit D too.

superakcraig profile image
superakcraig in reply to HLAB35

Thank you, I am currently taking 200mg currently of Magnesum. I am a little nervous about taking Zinc as I have read it can lower copper and cause even more problems.

I am currently taking a good Vitamin C. Its funny you mentioned the homocysteine levels, I had that checked recently because I discovered i had the MTHFR thing (taking Folate currently for that) and those levels were actually good.

HLAB35 profile image
HLAB35 in reply to superakcraig

The trick to taking zinc is to take it in the evening away from iron as the two will compete. Zinc is only considered toxic at extraordinary levels >100mg over several months or more. Taking zinc with magnesium in the evening works fine for me. You can always find a mineral salt that contains all the trace minerals like copper to take in the mornings with ascorbic acid.

Dr Myhill who writes a lot about these things is very keen on all her patients having 30mgs of zinc per day. She also writes about anxiety..



Gm from when I was diagnosed I hv had more hyper symptoms and thought I was hyper not hypo but my numbers showed diff . I had to fight for synthroid when my free t4 was at the complete bottom of range . My antibodies r sky high I’m due to be retested . I hv those feelings mostly everyday besides the pains anxiety etc still always searching for an answer

After many years of thyroid replacement I’ve concluded that it is indeed possible to have a combo of hypo and hyper symptoms. I don’t have a thyroid at all, so all the t3 I get is from the rx I take, now t3 only. It seems that the cells don’t necessarily process the t3 the same way. You can have an adequate level of t3 in your blood, but there are several levels of biochemical activity that have to go on at the cellular level, assuming the t3 from your blood even gets into a particular cell. Seems different cells can have different sensitivities to the t3. There are some genetic issues. Antibodies may be affecting different cells in different ways. Very complicated, but bottom line is your blood “numbers” don’t tell you much about how each system in your body is responding to thyroid hormones, and I’ve found that symptoms can be all over the hypo/hyper spectrum at the same time or from day to day.

HLAB35 profile image
HLAB35 in reply to Helenca

This is what I've finally concluded. I think it's down to inflammation..

I don't take t3, but realised a while ago that conversion for me is vital so I needed to get my iron levels near to 100 which had been a struggle due to inflammation. Iron does not reduce inflammation though - and that is part of the problem... you need one (iron) to resolve the other (poor conversion), but the real problem is inflammation.. and this can be quite localised and unique to different people (due to environment and genetics) ... so there are multiple conditions, but a common cause.

Inflammation can be linked (although not the same as) pain, cognitive function, anxiety /depression, poor adrenal function... the list is massive. Some things that are not necessarily recommended for thyroid can indirectly help as they reduce inflammation .. by tackling high homocysteine levels... these include Magnesium, Zinc and B6 (p-5-p) and eliminating inflammatory things from the diet such as gluten and dairy. This approach has paid off as my inflammatory markers are suppressed and iron is very good. The t3 must be getting into my cells as my hypothyroid symptoms are not that obvious now.. I still lack some energy reserves ... I can't overdo things as I'll pay for it (!) but that is all.

Very interested to read what reallyfedup123 has said about the effects of long distance running on T3 levels, as I too used to be a distance runner. I have learnt such a lot from this site within a few short weeks of discovering it - including that I also have Hashimoto's (high TPO antibodies). I was diagnosed hypothyroid nearly 11 years ago by chance (with no real symptoms), and have been on 50/75 mcg levo ever since, though no doctor has ever used the term Hashimoto's. Looking back at problems I have had over the years with periods of unexplained depression, which never really responded to antidepressants (and I have learnt from further research that T3 is often needed with SSRIs to boost efficacy even in non-hypothyroid patients) now make absolute sense when I read terms such as 'brain fog' and 'Hashi's flare up' which perfectly match my symptoms at the time. If I had known, I would've asked for a blood test to look at my T3 levels. I now also know the importance of vitamin levels, folate testing etc and the impact this can have. I cannot lose weight by diet and regular exercise and am currently seeing a nutritionist who has given me invaluable advice. She recently attended a conference on Hashimoto's and one of the points covered was that people with Hashimoto's are usually super-sensitive to carbs. I am now also trying to eat gluten free. Regarding T3, I have also learnt of the unbeliveable increase in price of this through the NHS and that it can be sourced much more cheaply in other countries. In fact, after learning this I decided to try as we were about to go to Greece on holiday. I was able to buy a pack of 30 x 25mcg tablets of T3 fot 1 euro. 1 EURO!!! I am considering taking this alongside my levo but am waiting first to see any effect of changes to my diet and supplements prescribed by my nutritionist, plus what the results of tests she has advised - iodine levels and cortisol levels- reveal.

So I started running shortly after being diagnosed only because I thought it would help with my then depression. Are you saying this might be part of my issue??

Even if my runs are only 30 mins (3.5 miles) at a time and at the most 6 miles maybe once every other week or so?

It’s the Tirosint. I am having heart palpitations since December after only 4 moths on the drug. I was on Levothyroxine and decided to try Tirosint as a better alternative to all the fillers and dyes, but ended up being over medicated at 88 mcg. Doctor had to reduce dose to Get rid of the heart palpitations, but six weeks later now I feel hyper still, but having symptoms as well, which I never had on levothyroxin. I have my labs done on Monday so I will see where I am at, but I really don’t want to be on this anymore. Is much much stronger than anything else and you need a less of it than you normally would on a pill form

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