Fluctuating Symptoms with T3/T4 combination - Thyroid UK

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Fluctuating Symptoms with T3/T4 combination

SAUK
SAUK

Hi all.

I have been taking T3/T4 combination since mid December 18'. The first month was amazing. Was on 100mcg Levo, 10mcg lio am and 10mcg lio midday. I had so much energy and felt like myself. Over the last 2-3 months my hypo symptoms have become variable. My endo and GP dropped my levo to 87.5 but cont. with the 20mcg.

The worst is a week before my period, when I feel awful and then takes about 5 days post period to feel good again.

After than I have a few days when I am great, and a few days when I am much more symptomatic.

Has anyone else experienced this?

Does this ever settle and I can have a consistent presentation.

Thanks

15 Replies
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SeasideSusie
SeasideSusieAdministrator

SAUK

You have Hashi's, fluctuations in symptoms/results are par for the course. Did you have thyroid tests before Levo was reduced?

SAUK
SAUK
in reply to SeasideSusie

Thank you.

Yes I had pre and post test.

TSH pre 0.03 post 0.05 (0.35-5)

T3 pre 3.9 post 4.2 (3.5-6.5)

T4 pre 10.8 post 9.6 (9-24)

My endo is happy for me to increase my levo to 100 again on days I feel unwell but this is so variable and in the past have not tolerated alternating doses well

SAUK,

Many feel great and then experience the hypo feelings return as symptoms catch up with the shortfall of thyroid hormone, whether caused directly through an inadequate dose or an optimal amount that is working inadequately.

Yes, there is a definite connection between unbalanced thyroid hormones and periods. Am brain foggy tonight 😳 ... but remember that the HPA-Axis & HPT-Axis should work in parallel, and cortisol & TSH should correlate.

So all hormones are dependant on each other and any deficiency (or elevation) may have repercussions up the line. Ask your GP to test sex hormones and post results complete with ranges (numbers in brackets) for members to comment.

SAUK
SAUK
in reply to radd

Will do. Thanks

HashiFedUp
HashiFedUp
in reply to radd

My Testosterone is low - on the edge of the lower part of the range. 0.1 away from below range. Could this be causing more thyroid problems then?? I’ve queried the low testosterone with Endo and GP (no sex drive whatsoever) and neither have made any helpful comments!

radd
radd
in reply to HashiFedUp

HashiFedUp,

Low thyroid hormone can result in low testosterone, either through compromised adrenal glands or elevated prolactin.

Cortisol is the well known stress adrenal hormone but if adrenals are tired, all adrenals hormones will be compromised.

TRH (thyrotropin-releasing hormone) stimulates prolactin production, which may become too high when excess TRH is increased to encourage low TSH, hoping to instigate more thyroid hormone production.

I read that low testosterone often reverses itself once thyroid hormones are optimised.

Have you had SHBG tested ?

HashiFedUp
HashiFedUp
in reply to radd

Not sure what the test is for - SHBG? Thanks

helvella
helvellaAdministrator
in reply to HashiFedUp

My Abbreviations and Acronyms document has that and more:

dropbox.com/s/og3lmxa1dqadb...

SHBG = Sex Hormone Binding Globulin

HiddenThis reply has been deleted
SAUK
SAUK
in reply to Hidden

Thanks

I’m going through the exact same thing! I felt amazing for the first 3 months on combo T3/4. Then had an awful 6 weeks. Then went to half tablet T3 am and half after lunch - felt better for a week then feeling awful last few days. It’s driving me mad. One minute I’m fine the next back to square one. I don’t understand the fluxuations.

Try taking T3 in the evening. I picked up on this on a post here. It definitely suits me and helps me to sleep a little better, plus have energy (well more than normal) in the morning.

Have you got all your vitamins and minerals optimal too? Since adding T3 I’ve been more vigilant with those too. It’s a minefield of information to take in and learn (still getting there) but I’m definitely improving and I’ve been on the T4/T3 combo since last June. Think it took at least 6 months before I felt happier with my levels.

Do you take magnesium (tablet or lotion etc)? That might help with everything. ☺️

SAUK
SAUK
in reply to Lovecake

Hi. Thanks. I only take vit b tablets and vit D spray. I will look into magnesium. I was thinking about an iron spray but not sure

Lovecake
Lovecake
in reply to SAUK

I would get a test first, but that’s just me. I eat liver occasionally and liver pâté, plus there’s always lotus flower seeds, popped if you’re vegetarian etc.

My iron reserves were depleted about 5yrs ago. GP found that when I kept going back saying I was constantly fatigued. They prescribed iron tablets for 6 mths. That was before I learnt about thyroid issues and the fact they do tests without telling you. My TSH was 5 at that point, I only know now because I have access to my tests online (they go back about 6yrs), could have saved me a lot of wasted life if I’d known about the TSH issue back then. 🙁

I've been trying to track my symtoms since being diagnosed with Hashimotos a year ago. I've been feeling really terrible a few days before ovulation. I read that estrogen has an inhibitory effect on thyroid hormones. So whenever your estrogen is higher, you may feel worse. In my case, I've been getting very bad nausea, similar to morning sickness when I was pregnant and also dramatic PMS symptoms during the entire luteal phase. I can't explain it fully, but there's got to be a connection.

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