Yesterday I came on here in a state because my heart had gone into a fast, irregular beat at 8am just after taking my Levo and T3. I have been diagnosed with atrial fibrillation in the past (not currently under any medication or specialist for this as it has only been happening for a short time every now and then). It's still going today. When I woke this morning it was very faint and I thought it would stop, but having taken my Levo and T3 it seemed to get stronger again.
Symptoms:
Irregular fast heart beat
Anxiety and distress (will not be helped by the heart issue I was not anxious or stressed the day before yesterday)
Feeling very over-heated for quite a few weeks now, especially in the evening. Throwing off the bed covers and exposing my skin to cool down. I am on HRT and so I don't think it's that. The heat has been an issue. We have lit the fire in the evenings over winter and I've had to go to lie on the bed to cool off.
Dripping sweat when doing something like pushing the hoover around a room
Actual temperature is normal (36.4 this morning when I got up and took it, even though I felt very hot. This is a normal morning temp for me)
My husband says I don't feel hot on the outside but I will be clammy and sweaty
My bowels are now loose (started yesterday)
Dose is 125mcg Levo and 12.5 Tiromel T3
My details are in my profile. There has been a lot of chopping and changing as I tried to introduce T3. I was hoping to hold this. But I can't run the risk of heart issues.
What should I do? I'm thinking about dropping the T3 back to 6.25 a day. Does that make sense?
I have felt better concentration and a tiny bit more motivation since adding the T3.
It seems to have taken forever to get to this point since I started Levo back in the summer of 2017 on a stupidly low dose of 25 every other day. The doctor I trusted at the time made me so much more unwell with her very odd ideas about dosing. I don't see her now. Instead I am trying to do it myself with as little input from my GP as possible because they don't know a lot about it.
Did I start adding T3 too soon?
Written by
FancyPants54
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Did you drop the Levo before adding the T3? What were your blood test results prior to starting T3.
Sounds like symptoms of over-medication but it’s hard to tell without blood results. If you are concerned and uncomfortable it might be worth pulling back and getting some blood tests. Perhaps you are particularly sensitive to T3. I’m really sensitive to Levo. I often wonder what T3 would do to me!
If you are concerned about your heart, I wouldn’t hang around - go to your GP or A&E - get it checked out to put your mind at rest.
All my results are listed in my profile to make it easier to see what's been happening.
I did drop my Levo by 25mcg when I added in the first T3 but I felt unwell and blood test showed that my TSH had risen, my T4 had dropped and my T3 had moved up by a tiny amount only. It looked like the small amount of T3 had reduced rather than added to my situation.
I put the T4 back up and immediately felt better. I think I might have messed the T3 introduction up. Perhaps even jumped the gun and should have held out for a rise in Levo to 150. But the gap between T4 and T3 seemed to be growing.
I'm hoping the heart will settle back down on it's own. If I go to the GP I will have to admit the T3 and that will cause a lot of issues.
Do you have a pulseoximeter or blood pressure monitor that records pulse? What is your heart rate? I was advised if mine goes over 120bpm then ring for an ambulance.
My first episode of tachycardia, my HR reached 179. It was on and off for a couple of days, on the 3rd day I ended up in A&E (after surgery told me off for not calling an ambulance the first day). When discharged, after waiting 2.5 hours in an ambulance queue, another 3 hours to see a doctor (altogether 7 hours after leaving home) I was told everything was normal but to call an ambulance if HR goes over 120 again. GP surgery told me the same thing. Normal resting HR is 60-100, mine can be anywhere between 70 and 90.
It could be, but your TPO antibodies are so very close to the upper end of the range this might be down to Hashi's activity.
If you're considering reducing your dose, I'd send for a Medichecks test and do it before reducing to see what's happening. If you reduce and then decide to test you'd have to wait 6 weeks.
Suggest you get a Fitbit or equivalent that constantly records your pulse. Gives good electronic record of pulse right through the day, everyday. Pulse a weekly resume.
I got Fitbit when I started T3, as TSH became suppressed and I knew they might start on about being over medicated.
My pulse goes high on T3 when UNDER medicated. So if been too busy, then pulse rises (I assume to cope with low FT3)
I have also found the wrist pulse monitors extremely inaccurate. I bought a finger monitor in the end. I also have a free app called ‘instant heart rate’ that measures pulse by placing a finger over the camera on my iPhone - that is more accurate than a wrist monitor too and tracks my pulse over time. 🤸🏿♀️🥛
It’s an app called ‘instant heart rate’ by azumio. There’s another one called ‘Heart Rate Lite’ that is also free and does a similar thing. I’m sure you can probably get them for android phones too if you search in the App Store. 🤸🏿♀️🥛
You may have an issue with T3. My understanding is some cannot tolerate it. I had bpm of 150 on many occasions. You can slow your heart rate by taking a breath and push down as if you're going to the loo.
Leave off all your thyroid medication for one or two days. If your heart issues don't occur and you don't feel hypo as a result then it suggests over-medication or a hashi flare. In that case, don't restart meds until you feel very mildly hypo then reduce dose (very slightly!) of either your Levo or T3 and then restart your thyroid medication. Which one you should reduce is really a guess - but your last blood test results for Free T4 and Free T3 might help you make the decision.
Other possible issues that could be causing your heart to misbehave...
1) Low iron and ferritin - don't supplement this without more info on your overall iron status.
2) Wrong levels of cortisol for you.
There are no doubt a hundred other possibilities that I know nothing about.
You feel so bad because your TSH is still over range & you have had many dose changes up and down with both T4 & T3.
Recovery rarely comes quick because it has taken years for our bodies to get into these states, so can take months to start recovery even with meds.
T3 can not be introduced too soon if you need it but the dose can be raised too quickly. Cortisol issues can mean adrenals struggle to keep up with the increase in metabolism, and low iron is a common reason for hindering the bodies tolerance of T3 introduction. Low iron can also cause heart issues when medicating any thyroid hormone replacement.
Your ferritin level looks ok, but as it is an inflammation marker and given that your CRP was elevated, your ferritin could be giving a false impression of adequate. Ask your doctor for a full iron panel for a more comprehensive iron profile.
Heat issues are often felt with the introduction of T3, reducing after about three days but heart issues can be a sign of over or under medication, or meds introduced too quickly.
Any thyroid hormone replacement has a long slow cumulative effect, even T3 which has a short half life and many don’t require that higher level of T4 when medicating T3, and their T4 levels will actually drop.
As long as you are taking an adequate amount (proven by a reducing TSH) this doesn’t matter, as the T3 result will eventually become the all important once your body allows dose optimisation.
Your TSH was reducing and you were on the right path but rushed it. You need to hold on a 6.25mcg T3 dose for much longer, then retest & reduce Levo according to test results before adding more T3. Members will help you with the correct amounts.
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Iron and cortisol issues with thyroid hormone replacement.
Thank you. I found your reply reassuring. You are right. Too many changes too fast and too much T3 too fast. I'm most annoyed because I am a very cautious person where this is concerned and I have been going very slowly and testing after every change before doing something else. Then I seem to have lost the plot a bit with the T3. I was acting on advice from here, but there were two differing views and I opted for the most cautious. However, by reducing my T4 my TSH went back up and T3 stayed low whilst T4 reduced and I felt much worse. And I missed a test out by increasing my T3 too soon. Some schools of thought here are that you can increase by 1/4 tablet every 2 weeks until you take a whole tablet, then hold. That's why I went from 6.25 to 12.5 so quickly.
Anyway, now I'm trying to repair the problems I have created. Today I am not taking any medication at all to let levels fall a bit. Tomorrow I will continue with my 125 levo and drop back to 6.25 T3 and that's where I will have to stay for 6 weeks unless I can't stop this heart issue or I continue to be too hot.
The next test I do will be a full blood draw so will include iron.
The usual protocol is to raise T3 by 6.25mcg every 1 - 2 weeks if there are no ill effects felt. Otherwise T3 should be lowered to a level that is comfortable and benefits are being felt ,until such a time when more can be tolerated.
It is not progressive to keep stopping & starting meds. It is the T3 that has made you hot, anxious , etc, so reducing the T3 dose is wise but considering your TSH is still over range you need your Levo to keep thyroid hormones levels increasing.
There are lots of reasons why a person may find T3 difficult to tolerate and therefore have trouble raising. I have detailed the two main ones above.
I know now that it was bad to alter things but it's too late. I can't go back on that. But I have to alter them again now as I can't keep doing the 12.5 T3 + 125 Levo and I felt worse on less Levo.
I know you pointed out 2 issues that can make this hard. I'm working on iron and have been for well over a year. Cortisol? Everyone talks about it but no one has an answer as to what to actually do about it and the medical profession really rubbish the saliva tests. I've had my morning cortisol tested after a suppression tablet the night before and my results were good.
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Can anyone advise .e on T4 and T3 doses please?
Symptoms of under-medication, but blood tests indicate over-medication
Over medication symptoms and odd pulse
Is it okay mixing tablets of T3
Too much T3! 
