Can’t raise t3

[Maffster08]

Currently taking 37.5 mcg t3 feel ok

Tired no matter how much sleep

Brain fog not too bad

Mood swings now and then.

Tsh still needs to come down, but can’t raise t3 as makes me to ratty and argumentative hypo ish

Any thoughts

[Judithdalston]

I see you have had Hashimoto’s for five years, but only seem to have been on T3. 37.5 mcg is still a smallish dose. Have you not tried Levothyroxine... ..it is an easier medication to try/ use, and would give you a better idea where your thyroid bloods (T3, FT4, FT3 and total thyroxin, plus antibodies) actually are. Once you take T3 only the FT3 result really has any meaning. Before you started T3 did you have your folate, ferritin, vit D and B12 tested...Hashimoto’s suffers often have poor gut absorption resulting in low nutrient levels, while we in fact need optimum ( high) levels of these, and many of us take supplements. Low nutrients could be a cause of some symptoms like tiredness. Have you opted for a gluten free diet to try to get your antibodies in hand, and possibly reducing Hashi ‘flares’ that might be responsible for your swinging symptoms?

[SlowDragon Administrator]

How much do you know about hashimotos?

Hashimoto's very often affects the gut and leads to low stomach acid and often then low vitamin levels. Low vitamin levels can affect Thyroid hormone working

Have you had recent tests of vitamin D, folate, ferritin and B12 ?

Do you supplement any of these?

Are you on strictly gluten free diet already? If not you may need to try it

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

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

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

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

Do you take your T3 in smaller split doses? 2 or 3 times a day?

[Aurealis]

Ratty and argumentative is not usually hypo ish. You may be overtreated. Both mood swings and feeling tired also occur with overtreatment. You may need some T4. Do you have any test results? T3, T4 and tsh.

[marram in reply to Aurealis]

I am not sure that ratty and argumentative is only a hyper trait. I have seen some really nasty spats on here between people who are most definitely UNDER medicated!

But she did say if she takes MORE than 37.5 she gets that way, so you are right in this instance, probably. I think any thyroid imbalance can make people sensitive and ratty.

People who are very overactive can suffer the most dreadful rages, too, sometimes getting totally out of control.

[MissGrace in reply to marram]

I get ratty and argumentative. Not down to my thyroid though. I’ve always been difficult, stubborn and contrary. Lol!

[EVESARAH]

Test your adrenals

[SilverAvocado]

Some people struggle to raise their dose, particularly T3, because of adrenal problems. It can give them a speeded up/overmedicated feeling.

Usually people in this position have been ill for a while, and have thyroid panel blood tests that show they're very undermedicated.

[SilverAvocado in reply to SilverAvocado]

I've just seen that you do say your TSH is high, which probably is a clue you're clearly undermedicated - most people who are feeling comfortable on T3 have an extremely low TSH, and probably get to the point where their TSH isn't saying anything useful at all long before they get their dose high enough.

The advice I'd give if you're undermedicated but can't raise is two parts:

1) Look into adrenal fatigue, the first step with this is to get a 24hr cortisol saliva test and see where you are. Adrenals also benefit from getting vitamins optimal, good diet and stress free life with good quality rest and meditation.

2) The reason it can be hard to raise is the shock it gives your body when your metabolism increases. You may still be able to raise your dose super slow. To get a very small dose increase cut your tablets as small as you can with a razor blade or completely crush them. Try a dose increase smaller than you've ever had before. So if you've tried to increase half a tablet before you could start with a quarter, but you may need to go much smaller, until its just a pinch of the crushed powder.

Now try to add this tiny extra increase to your daily dose, and if you feel okay, stick with that for several weeks. If the symptoms return, drop back to where you were and try an even smaller increase. Once you've found something you can tolerate, stick with that for a few weeks, then try another tiny increase, in the same way.

The good thing about raising your dose is that all these elements help each other. Getting your thyroid well medicated helps your adrenals recover, and getting vitamins right helps both.

Another general option is to try adding some T4. T3 is the most common thyroid replacement that gives this shock to the adrenals, although it does crop up on the forum with Levothyroxine, too.

[Hillwoman in reply to SilverAvocado]

That's very good advice. I found that after being ill for many years I could only tolerate slow titration of T3 in tiny doses, even though I really, really needed it.

[radd in reply to SilverAvocado]

Also iron ...

Peeps with low iron levels can find T3 hard to tolerate.

A full iron count will only give a proper insight to iron levels when you have Hashi.

[Maffster08]

Thanks all

2 years on levo

1 year on amour NDT

Better results on t3 only

I have low cortisol at 8 in morning then out of range by 10 .

Private endorsed says not adrenal ijust have low cortisol.

Low testosterone as well.

Having sunachthane test after new year.

Stayed symptomatic on t4 TSH came down but stayed ill slowly getting worse, then made jump to NDT.

[Hillwoman in reply to Maffster08]

Do you mean you are having the short synacthen test? If so, do be aware that if your results fall anywhere within the reference range, even at the bottom, you are likely to be told your adrenal function is normal. Endocrinologists don't recognise adrenal problems unless they are severe and life-threatening, i.e. Cushing's or Addison's.

You may need to consider doing a private 24-hour adrenal stress profile at some point.

[radd in reply to Maffster08]

.. "Private endo says not adrenals, I just have low cortisol" ? ? ...

Low thyroid hormone results in low cortisol levels when the adrenals are forced to compensate.

An adequate level of testosterone is required to help T3 work better.

Also, do you have blood sugar issues as insulin resistance can suppress testosterone

levels ? ..