i have had mental symptoms for the passed 2 years since my labs came back like the bottom 2 on this chart..
i.e
derealisation,
depression,
anxiety.
still under an endo, who has tested basically everything, and says i dont need T3 as its 'normal'
i did buy some tiromel t3 but it gave me worse anxiety and made me really angry...
all my vitamins are up to scratch, as i supplement and eat really well including liver.
when i take more levo my ft4 goes over and i get bad side effects, but then the ft4 settles and goes a little below the top of the range then i get depression and need more, then take a tiny weeny more to get bad side effects again then settles... and so the rollercoaster ride carrys on.... hell!!!
The worst for me IS THE DEREALISATION, feeling like everythings surreal and im not all here in a bubble and then freaks me out and i feel like im going crazy...
my endo has done more recent labs hes testing the hereophile antibodies with the usual ft4 ft3 and tsh at a different lab.. whatever that means..
Written by
ThyroidObsessed
To view profiles and participate in discussions please or .
Hi i have tried every brand of Levo to no avail the best out of the bunch for me is mercury pharma i get it ordered in for me in my local chemist as it's hard to get hold of round here...
Any chance of getting the actual numbers for those measurements? I can't believe that someone actually decided whether the results were "high" or "normal" without giving you the actual numbers. Are you in the UK or US?
That chart doesn't look useful at all, none of it makes sense!
Almost everyone will have the conventional pattern of TSH, freeT4 and freeT3, with a few variations for individual differences. I don't see how psychosis would make any difference to that.
Psychosis can be a symptom of being very undermedicated, though, as can lots of mental and physical symptoms.
I don't think it's very useful to talk about 'normal' when it comes to thyroid panels, either. The goal of treatment is to get OPTIMAL results for the person involved, and that means whatever is necessary to resolve symptoms. Most people will need freeT3 fairly high in the range, and if taking Levothyroxine only will need freeT4 high, too. 'Normal' is likely to be too low.
I was thinking it was quite a scary chart, too! Luckily I don't think it's correct at all.
I've seen your thyroid panel blood tests you posted above. This is a really clear cut case of a conversion problem. You're taking T4-only, and its enough to push your freeT4 pretty high, but you're body isn't able to convert enough of it into T3. It's T3 your body needs to keep you feeling well, so that's why you're getting do many symptoms.
Your freeT3 is about middle of the range, but once on hormone replacement most of us need it close to the top of the range. It's because your freeT3 isn't high enough that your TSH is high.
I have a friend with a very similar pattern, and have seen it in the forum a few times. It's not super common, so your doctor is probably confused (his definitely was). But it's fairly simple if you interpret the tests in terms of freeT3, which is best practice anyway.
It sounds like you've also had a similar experience to my friend in adding some T3. It's tricky to get the balance, because really you're kind of overmedicated, just on the wrong thing that isn't helping you. My friend introduced 10mcg of T3, and reduced 40 or so of T4 at the same time. He also got a bit angry and anxious but managed to push past it and get stable on that dose.
But now we don't know where to go next. I think both you and him probably need to reduce the T4 by quite a bit, while introducing some T3. All you can do is move by trial and error and perhaps very small dose changes if you get unpleasant symptoms. It's very clear that you need some T3, so all you can do is try whatever it takes to get some into you.
I'd say the default thing to do is introduce 10mcg of T3 and simultaneously drop 40 or 50mcg of T4 and then retest in 6 weeks. If you're body doesn't respond well, you could cut the change in half and do it in smaller steps, add 5mcg of T3 and reduce 20-25mcg of T4 and again retest in 6 weeks.
It's possible that will also be too much, so you can proceed by cutting the tablets up into even smaller pieces and adding in the smallest dose of T3 you can. Always reduce by about 4x the amount of T4 (rounding up because overall you probably want to cut a bit more than the equivalent T4).
I hope this makes sense to you! Please don't worry about the psychosis, I don't think it's true. You've just been very low on T3 for a long time, which does make you feel like your we going mad But it's not your fault, it's entirely a physical thing, your brain and body are trying to operate without enough energy.
I've just gone back and looked at some of your old posts. Even more similarities with my friend, who was also fine on Levothyroxine for years, but at some point suddenly seemed to stop converting well and became ill.
I've also seen that you've had big trouble introducing T3 in the past. This is a pretty common symptom on the forum. I've noticed it always seems to be when people have blood tests that show they really really need it. Its said to be because of adrenal problems. Unfortunately it puts you in a catch-22 situation. Because you really really need that T3 in order to improve your health.
There are three main paths you can take to treat this:
1) Add the T3 super slow. Cut or crush the tabs to powder and add the smallest amount you can as a dose increase, wait a few weeks and then add another tiny crumb, and so on. Drop back if you get symptoms and go even slower.
2) Research and treat the adrenals. The starting point is the 24hr saliva test, there are several herbs that can help, as can resting well, eating well, sleeping well, reducing stress in your life, learn to meditate, etc, etc.
3) Get vitamins optimal
All these things feed into each other, increasing your freeT3 will help out adrenals, good vitamins are needed to use thyroid hormone, etc, etc. So each part gets easier as you make progress in the others.
Yes, I know. But I can't see what good it does to know that, it's not as if you can do anything about it. And, just because you've had EBV doesn't automatically mean you will get Hashi's, and you can still have Hashi's without having EBV. So, it's a mystery. I do hope the OP will let us know once she finds out.
I'm afraid I have no idea. I've never had EBV - to my knowledge, anyway. Still got Hashi's, though! I did google it, but couldn't find much information.
Yes I googled it too but to no avail... I'm at the hospital Wednesday so hopefully they will have my recent bloods back as they got sent to Cambridge and take longer they were done Monday..
I will let u all know what they say about the heteorphile test...
Could you post your exact labs results to give a better picture. You do not have psychosis with psychosis people hallucinate and have very fixed unusual ideas. De realisation can feel very strange and be a bit distressing but it is not psychosis.
Having a high TSH and high t4 is very unusual so would like to see full bloods including the relevent vits. Off the top of my head I wonder if you have conversion problems and your tSH has risen to help you produce loads of T4 to make up for lack of conversion to T3 or you have had a bump to the head/whiplash that has affected your pituariaty.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
But it's not your fault, it's entirely a physical thing, your brain and body are trying to operate without enough energy. 
What does it mean to have normal TSH and Free T3, but have high free Thyroxine (T4)?
T4 what does it mean? 
Hello does anyone know if having an under active thyroid means I can have the flu jab?
Hi I have Hashimotos and have just been tested positive for Andrenal antibodies in my latest blood test. Does this mean I have Addisons?
High B12 - what does it mean?
