Bad day...

Hey everybody,

I have just come home from work completely exhausted, it's a new job which I have started about 4 weeks ago. I feel sick, nauseous, my tummy is swollen, legs are stiff, I'm shivering from cold and fatigued. I am so close to quitting. Nobody there knows about my condition and I am wondering if I should tell my manager, I have a call with her in an hour. I am now taking 150 mcg t4 and 2.5 mcg t3 for the last 9 days approximately. I know sometimes gets worse before it gets better, but I don't know if I can continue with my job, which is my dream job as well. I think I have made a mistake on going to t4 only instead of keeping some of the t3 from NDT. When will this end

[Greekchick]

Hi cupofcha,

Don’t rush into anything about your job yet since it’s your dream job, and I would not tell your boss yet either. Sounds like your meds are still not right and likely you need the T3 - can you get into see your endo for an appt and blood work? Can you take a sick day to catch up?

I know you feel so dispirited and weary of this condition and I am there myself some days too. If it’s your meds, those can be adjusted and you still get to have your dream. Don’t throw in the towel yet. 🤗🤗🤗 you will get there.

[Hidden in reply to Greekchick]

Hi Greekchick, thank you for responding, I feel I have no one to talk to. Its a dream job, it's extremely demanding and technical. I have to present in less than 2 hours to my manager and a group of people and I feel extremely terrible I think I need more t3, this t4 only business doesn't work for me unfortunately. My endo knows all this and doesn't want to see me until mid-June. I called my internal medicine doc, who prescribed me t3 before, he might see me tomorrow or Friday , waiting on a call. I barely slept last two nights too which doesn't help xxx I could potentially say to them that I feel sick and to reschedule presentation, but I know they won't be happy , since I already had a viral infection and missed two days of training

[Christinah61]

Hi sweetie im ill in bed with a migraine hang on in there it will get better xxx sending hugs

[Hidden in reply to Christinah61]

Thanks hun x I am so sorry to hear about the migraine, hope it goes away soon....xxx hugs

[Greekchick]

First, don’t panic. They may not be happy rescheduling but you may feel worse if you can’t do your presentation properly - either way they won’t be happy so you need to decide if you truly can’t present - I know you were already out sick but I can’t say for you which is the worst of two evils - you are in a better position to decide.

Second, let Internal med guy call you to see how fast you can get in to see him - T3 works fast and you will be better relatively quickly.

As I have seen for myself, this medication adjustment is very tough. Just take a deep breath and think what will be best and decide. I hope all goes well and thinking of you. 🤗🤗

[Hidden in reply to Greekchick]

I think I will do it to the best of my abilities, that's all I can do. I have a supply of t3, probably 30 or 40 pills 25 mcg each. So far I have been adding 2.5 to 150, but don't know if I should be reducing t4 while I'm doing that...I might be thinking too much and being too hard on myself too xxx big hugs xxx

[Greekchick in reply to Hidden]

Yes, I agree - you will do fine today - cut yourself some slack - clearly you are good at what you do or you wouldn’t have this job to begin with! See internal med guy before adjusting any dose if you are not sure how much to take - and tonight rest well. 🤗🤗

[Hidden in reply to Greekchick]

That sounds like a good plan! Presentation in 10 minutes! Forgot to ask - are you taking any t3?

[Greekchick in reply to Hidden]

Just starting

[Hidden in reply to Greekchick]

Oh cool, and how it's been? Are reducing t4 while doing it? How's your ft3? So many questions!

[Greekchick in reply to Hidden]

I will let you know soon - I will be starting next Monday - fingers crossed 🤞

[Hidden in reply to Greekchick]

Will keep my fingers crossed for you xxx

[Greekchick in reply to Hidden]

Started T3 3 weeks ago - feel like a different person ! I can’t believe it... not got exactly the right dose, but at least I don’t feel like I want to collapse after 3 pm. Now I’m playing with proportions - I’ll have to see what works. I saw your post tonight to greygoose and sounds like you are getting there too - some tweaking will be needed but at least you seem to be on track. Hope dream job is going well for you!! 🤗

[Hidden in reply to Greekchick]

Really happy to hear it!!! Well done! Did you reduce your Levo when you added t3? I didn't and now I'm suffering, but hopefully not for long. I might have realised too quickly too.but definitely difference in energy levels

[Greekchick in reply to Hidden]

Well in my case I was not in enough meds, so I did not need to lower levo, but am raising T3. Levo gives me palpitations and makes me anxious and T3 does not and gives me energy. So I will now have to see how it goes - I’ll let you know and let me know how you are doing as well. I am atypical as I respond to very low doses of medication, unlike others who seem to need more. So.... the journey continues. All the best and so glad you let me know. 🤗

[Hidden in reply to Greekchick]

Interesting. Levo gave me palps terrible anxiety when it was high in range. I upped t3 too quickly, I also respond to small increases and I overshoot it, I am very sensitive to meds...may I ask how much t3 you are taking and when did it kick in exactly? Super happy it's working for you, it gives me hope!!!

[Greekchick in reply to Hidden]

So I was on 75 levo and 3.75 T3 . ( I was increased from 62.5 levo and 2.5 T3). The 75/3.75 ratio is good but the levo makes me edgy and my heart races. So I went back to 62.5 levo plus 2.5 T3 in am and take 2.5 T3 (I added 1.25 T3) at 3 pm. I will see how it goes - I’m sure i will need more T3 but I am taking it up in increments of 1.25 T3 and only after 1 week n each new dose.

I take all med increases very slow - because I react quickly but I stick it out because I also take time to adjust. So it’s an ongoing process but I am being patient with it - i want to figure it out so I can teach in the fall .

All the best!

[Hidden in reply to Greekchick]

This sounds like me. I should have also increased slowly, I am incredibly sensitive. You will teach in the fall, I know it as your approach is perfect! Big hugs and let's keep in touch.

[Greekchick in reply to Hidden]

Absolutely - I want to know how you are doing ! 🤗

[Hidden in reply to Greekchick]

Will do for sure! Keep me informed please 😃 I might split my dose into two as well, this could be where my problem is 🤗🤗🤔

[Greekchick in reply to Hidden]

I found putting the T3 in am with the levo helped me - my endocrinologist was surprised but he said "whatever works" for me is fine for him! I am amazed at how different we all are when it comes to our dosing. It is truly a trial and error exercise.

[Hidden in reply to Greekchick]

So do you take it twice a day or just once a day with Levo? I added 7.5 to Levo in the morning

[Greekchick in reply to Hidden]

I take 62.5 levo + 2.5 T3 in am and then 1.25 T3 in pm.

[Hidden in reply to Greekchick]

Ah gotcha, thank you! I used to do it with NDT, taking majority in the morning and the 1/3 in the PM

[nanapops55 in reply to Greekchick]

This is the advice that hits me....Don't Panic! Since developing hypothyrodism it seems I tend to panic first. For me that is the number one thing I have decided to control. NO more panicking. Just do the best you can and things will work out as they should. You know yourself. So trust what your instincts are telling you. And try not to panic!!

[Christinah61]

Hope you feel better soon and get this sorted out xxx to much pressure .....no good xx

[Hidden in reply to Christinah61]

Hope so too xxxx I think the biggest pressure is the one I possibly put on myself...xxx

[JumpJiving]

If you have a probation period that you have not completed yet, I wouldn't say anything other than telling everyone that this is your dream job.

Even if you have completed the probation period, I wouldn't say anything unless somebody in management questions whether you are unwell, struggling etc. You might want to keep it fairly vague - "I'm changing thyroid meds at the moment and feeling below par, but will be fighting fit again soon", but reiterate that this is your dream job whatever you do.

[Hidden in reply to JumpJiving]

Keeping it vague - I can do it. I was discriminated in my last job because of Hashimotos. They actually wanted to fire me, and I have heard I have made it easier for them that I left and got a new job...it truly is my dream job

[JumpJiving in reply to Hidden]

The vaguer the better. "A bit under the weather" as Greekchick suggested is perfect.

[Christinah61]

I hope you did your presentation. I agree dont say anything to them about your health cupofcha. You will get it sorted out. Dont be so hard on urself xx take care and be strong xx

[Hidden in reply to Christinah61]

I hope I will get it sorted, some days losing hope! X I did the presentation, just finished, it didn't go super well, have to do it again for practice, but they told me not to be too hard on myself xxxx take care hun

[Greekchick]

If someone asks you , just say “Oh just a bit under the weather today - I’ll be just fine - thanks for asking!” I have worked in a corporate environment and you get labelled the minute they know something is wrong with you.

I agree with JumpJiving : just keep telling them it’s your dream job and so happy to be there . Let us know how it went!!

[Hidden in reply to Greekchick]

It's a good idea, I will do that xxx

[greygoose]

2.5 mcg T3 is a very small dose, and probably isn't doing much to help. In four days, you can increase it to 5, then two weeks later, to 10 mcg. So, don't give up yet.

[Hidden in reply to greygoose]

Hey grey, always good to hear from you it is small, right? I have been on 2.5 + 150 for 9 days. Should I be reducing t4 when adding another 2.5? I react to adding a small amount (slight anxiety, feeling spaced out, but goes away after a few days, unless I raise too fast, then it's more dramatic). My ft3 was at 32% on 150 levo, ft4 was 80%.

[greygoose in reply to Hidden]

Did you reduce the levo when you added in the first 2.5? If so, leave it where it is, for now. See where it is the next time you test.

[Hidden in reply to greygoose]

I didn't reduce, no...I was thinking of reducing to 143.5 when adding another 2.5 to the mix. I want to do bloods in about 2 weeks time, that would amount to 4 weeks in total

[greygoose in reply to Hidden]

Well, if I were you, I wouldn't change anything before then. It would be too soon to test.

One usually reduces levo when first introducing T3. After that, it's usually not necessary to reduce again, because taking T3 lowers the FT4. But, as you didn't, wait until after the test to see exactly what your FT4 is.

[Hidden in reply to greygoose]

The reason why I didn't reduce was that I thought that t4 will convert to t3 as t3 would stimulate conversion (also suppress ft4). And didn't want to miss my sweet spot. But I could have been wrong

[greygoose in reply to Hidden]

There's never been any proof that I'm aware of that taking T3 stimulates conversion, although I know it has been stated on here. But I don't think it has any backing in science, just a hypothesis to explain why taking T3 lowers the FT4.

[Hidden in reply to greygoose]

Got it. My issue is that I feel really bad with low t4, I have to have it at least mid range so was afraid of that too...

[greygoose in reply to Hidden]

Then that's another reason not to lower your levo. It's not obligatory.

[Hidden in reply to greygoose]

thanks grey, I just want to feel normal, it's been too long to be on hold

[greygoose in reply to Hidden]

You're welcome.

[Hidden in reply to greygoose]

Hey Grey, my hypo situation seems to be getting worse - cold, swollen ankles and above knees, nodding off at meetings at work, my bathroom routine is poor :/ I am going to see my MD tomorrow, he is a big fan of t3 and I suspect he would up my t3 straightaway and possible lower Levo. Would you still wait or go with it? T3 did work a bit the first few days and how I don't feel anything anymore :/

[greygoose in reply to Hidden]

Oh, I'd definitely go for the increase, no question.

It's very common that when you start thyroid hormones, or have an increase, you feel good to begin with, and then you don't feel so good. And, that just means you need an increase in dose.

[Hidden in reply to greygoose]

Yeah I'd be going with that, will see what he says tomorrow. He wanted me on t3 only, but I don't do well with low on no t4. Is this normal that you can see yourself swelling day by day more and it gets worse so fast??

[greygoose in reply to Hidden]

There's nothing normal about thyroid disease! lol But, it can happen, yes.

[Hidden in reply to greygoose]

Normal thyroid, what's that?? 😂

[greygoose in reply to Hidden]

I wouldn't know!

[Hidden in reply to greygoose]

Hey Grey, just back from the appointment. I have 6 months of t3 thybon 10 mcg he wants me to go up with t3 slowly, 5 mcg now for a few weeks, then to 7.5, and 10 mcg. He also wants me to reduce t4, he expects that I will need somewhere between 100 to 125 mcg t4. Does this sound good? He also added that I will be the best judge, need to listen to my body and that everyone is different

[greygoose in reply to Hidden]

That sounds wonderful! Where did you find this paragon? I think he's maybe being a little too cautious with dosing, but that's a small price to pay! Go with it, and see what happens. So happy for you.

[Hidden in reply to greygoose]

Did you mean thybon? It's actually 20 mcg, he made a mistake I will see how it goes, thank you! He was also willing to put me on t3 only, but unfortunately I need that t4 too! So now it's a balancing game again !

[greygoose in reply to Hidden]

Sorry? You've confused me, now. What about thybon?

[Hidden in reply to greygoose]

OMG Grey, I have a brain fog. I was thinking to myself, grey must have done a typo, she probably meant thybon, because I didn't know what paragon means, I had to look it up in dictionary 🤣🤣🤣 funny story actually, I was admitted to hospital two years ago because of palpitations and swelling, they thought I had lymphoma, he was the MD on duty and managed the ward, told me not to worry about TSH, only ft4 and ft3, when the a&e doc freaked out about my supressed TSH before admission. He also told me today my antibodies should halve on t3 , only one doctor who cared about my antibodies.

[greygoose in reply to Hidden]

OK, I see!

I'm not sure he's right about the antibodies. They don't respond to thyroid hormone replacement because they're nothing to do with the thyroid.

[Hidden in reply to greygoose]

No, but I think what he meant is that t3 will supressed thyroid so less attack

[greygoose in reply to Hidden]

Well, maybe.

[Hidden in reply to greygoose]

I need to lower t4, which I'm freaking out about what would you advise re dropping? I don't think I want to drop to 100 from 150. I was thinking of going down to 137.5 or 125 and adding 5 for a few days, then 7.5, 10 and hold for 8 weeks. Not sure how to do it took my 5 mcg this morning, a bit anxious , but that's normal.

[greygoose in reply to Hidden]

I certainly wouldn't got from 150 to 100. Reductions should only be maximum 25 mcg every six weeks. But exactly how much you reduce by depends on your present FT4 level.

[Hidden in reply to greygoose]

Okat, thank you Grey! My ft4 on 150/155 was 80-90% of the range

[greygoose in reply to Hidden]

OK, so it would be easiest to reduce by 25 mcg, than messing around with fiddley numbers like 137.5. Try 25 and see how you feel in six weeks.

[Hidden in reply to greygoose]

Brilliant, thank you Grey

[greygoose in reply to Hidden]

You're welcome.

[Hidden in reply to greygoose]

Hey Grey, I have a few questions if you don't mind. I have been increasing t3 to 7.5 currently, but haven't yet reduce Levo as I didn't get any overdose symptoms. However! I am unusually fatigued and dizzy. Good news - legs are not stiff anymore, started regular bathroom routine etc. I am afraid to lower Levo , but thinking it might be necessary when I go up to 10 mcg t3?

[greygoose in reply to Hidden]

What is your FT4 level? Not everybody needs to reduce levo. It depends more on your FT4 than your T3 dose.

[Hidden in reply to greygoose]

It was 17 (9-19) on 150 mcg t4 only

[Hidden in reply to Hidden]

Also the choking feeling in my neck is gone completely.

[greygoose in reply to Hidden]

Well, that's great!

[Hidden in reply to greygoose]

It awesome to have a skinny neck, my face and neck and fingers are the skinniest part of me currently, still a lot of Michelin man here and there LOL

[greygoose in reply to Hidden]

Hopefully, it will all go, with time.

[greygoose in reply to Hidden]

Yes, it's quite high, so might be an idea to reduce by 25 mcg when you go up to 10 mcg T3. Nothing to be afraid of, you can always increase it again if you need to. But, only after a six week test.

[Hidden in reply to greygoose]

Okay, thank you Grey I was afraid to lower levo, because I was crashing on 137.5 levo only and put on like 2-3 kilos in a week but in fairness, I did eat a lot of bagels that week I was away on a business trip

[greygoose in reply to Hidden]

Yes, but you weren't on T3 then, were you? The T3 will be replacing the levo.

[Hidden in reply to greygoose]

Correct, I was not why am I so scared lol

[greygoose in reply to Hidden]

The unknown can be very scary.

[Hidden in reply to greygoose]

Hey Grey me again! I'm experiencing a really dry nose, eyes, hands, feet since adding 5 and 7.5 mcg t3. I had this before. Also a bit anxious and angry since last evening. Yesterday changed from 5 to 7.5.

[greygoose in reply to Hidden]

Under what circumstances did you have that before?

Anxiety and anger can be symptoms of under-medication. And your dose is still really small. Perhaps you are increasing too slowly.

[Hidden in reply to greygoose]

I seem to have it when increasing t3 or NDT (didn't really experience it with Levo only). It almost feels like I'm going hypo before things tend to get better if that makes sense, maybe because tsh drops initially and it takes time for hormones to build up on the back of it. I also feel a bit colder, but I get really warm...strange.

[greygoose in reply to Hidden]

It almost feels like I'm going hypo before things tend to get better if that makes sense, maybe because tsh drops initially and it takes time for hormones to build up on the back of it.

No, that doesn't make any sense. lol The TSH dropping wouldn't make you feel hypo. In fact, the TSH itself doesn't make you feel anything. And, the FT4/3 levels would change before the TSH did, it's very slow moving.

Anyway, I take it that these feelings go away as you get used to the dose change, right?

[Hidden in reply to greygoose]

Yes,they go away I think, sometimes appear again when something is off. Today I am sleepy all day, anxious and a bit shaky (hand tremor), when trying to have a nap my leg starts kicking on its own. Last time I felt similarly it was month ago before going to business trip and my hormones were really high. I think it's time to drop t4 ?

[greygoose in reply to Hidden]

I would not drop them until you increase your T3 if I were you. You need to do the two together to get a smoother transition. But it sounds more like under-medication to me. Remember T4 is a storage hormone, and if it doesn't convert well to T3, it doesn't do much.

[Hidden in reply to greygoose]

I never have tremors and anxiety when I'm low (when low I am very depressed, stiff, but calm) only when too high , or during a flare up. I get also crushing fatigue when overdosed, different tiredness to the one when very hypo. What do you think of dropping Levo by 12.5 and few days later increasing t3 to 10? I'm still on 150 of Levo.

[greygoose in reply to Hidden]

Well, it's all trial and error, so give it a try. It wouldn't be my goto solution, but you never know if you don't try.

[greygoose in reply to Hidden]

Those leg jerks are Restless Leg Syndrome. You are probably low on some nutrients. Try taking some magnesium. But, have you had your vit D, vit B12, folate and ferritin tested? Or, it could just be a symptom of your low T3.

[Hidden in reply to greygoose]

I only get RLS when overdosed, never when hypo, from my notes, they go away instantly once the dose is reduced....

[greygoose in reply to Hidden]

But you are not over-dosed. Your FT3 would be over-range if you were. And, from what you've said, you're a long way off that.

[Hidden in reply to greygoose]

So maybe I increased too fast. It's always a sign of too much for me, will do bloods on Tuesday to see where I am

[greygoose in reply to Hidden]

I really wouldn't say you increased too fast, either. A lot of people start on 10 mcg T3.

Let us know what the blood tests say.

[Hidden in reply to greygoose]

Thank you Grey

[greygoose in reply to Hidden]

You're welcome.

[Hidden in reply to greygoose]

Hey Grey, so I did my bloods last week and it turned out my ft4 was 19.1 /9-19/ and ft3 4.38 /2.89-4.88/. That was already after dropping t4 to 137.5 for 5 days and with 7.5 mcg t3. Since then I have been feeling overdosed with anxiety, high erratic pulse, palpitations and now very frequent visits to bathroom I have dropped to 125 the last 3 days and still feeling overmed after 3 hours of taking 125 + 7.5. hopefully within the next few days this will get better, beta blocker helped with heart the last few days, but also made me super tired x

[greygoose in reply to Hidden]

5 days after a drop in levo dose is much too soon to test. That test doesn't tell you what your real FT4 level is. But, your FT3 is good. I wouldn't change anything until six weeks, if I were you. Give the levo time to catch up.

[Hidden in reply to greygoose]

I also think I need to drop my Levo finally. But I want to hold until Tuesday, I'm getting bloods done at 3 weeks, just to see how I'm progressing, but I know it will be too early to make decisions

[greygoose in reply to Hidden]

You still won't get an accurate result for the FT4 on Tuesday. You need to hold for six weeks. It takes about four weeks for that reduction to get out of your system. After starting so slowly, you're now started rushing things!

[Hidden in reply to greygoose]

That's the problem - I have increased t3 too fast - I should have waited 6-8 weeks on 150+2.5 and then drop Levo and maybe as next step increase t3. I am ultra sensitive to meds, with NDT I had to increase by 1/8 grain every 6 weeks before otherwise I would have had symptoms I have now - palpitations,diarrhoea, jitterness, debilitating anxiety, high pulse, overheating for over 2 weeks now. My ft4 has gone up since I have introduced t3, I could feel it in my body. When I'm undermedicared I have completely different symptoms . At least I now know - can't increase as fast as everyone else. And maybe I do need a miniscule dose of t3. Ft4 higher than 80% gives me the worst symptoms

[greygoose in reply to Hidden]

No, you should have started on whatever dose you wanted to start on, AND at the same time drop levo by 25 mcg. Then, you could have waited for six weeks if you really wanted to, or increased your T3 after two weeks. But, there's really no point in testing on Tuesday. Testing at two weekly intervals is pointless. It won't give you any useful information.

I really do not see how your FT4 can have gone up after starting T3. But, If i were you, I wouldn't alter the levo dose at the moment. Reduce your dose of T3, if you wish - but not by more than 5 mcg. And, then hold for six weeks and see what that gives you before deciding what to do next.

[Hidden in reply to greygoose]

Thanks Grey I should have added that my ft3 was measured unfortunately just over 24 hours after taking it...so on 4.36 which is 73% in range, I would be overmedicated as this is false low...

[greygoose in reply to Hidden]

As a rough calculation of what it would be, add 20%. That makes 5.232. So, not that much over-range. Try dropping your dose by 5 mcg and hold for six weeks. Then retest leaving just 8 to 12 hours after the last dose. Then, you will know where you really stand.

[Hidden in reply to greygoose]

Thanks Grey, will do that. I am also already on 137.5 mcg t4 for the last 2 weeks, should I maintain since my ft4 was over range on 150? Thank you again!

[greygoose in reply to Hidden]

Yes, hold your T4 there, don't change it again until you've had the six weeks test.

[Hidden in reply to greygoose]

Thank you - done and done now just 6 weeks should fly by LOL

[MissGrace]

Well done - you did it! Don’t let this illness drag you down. This is your dream job - you will get better if you get the meds balanced. Everyone has off days - no one is perfect. Be kind to yourself. 🤸🏿‍♀️🥛

[Hidden in reply to MissGrace]

Thank you MissGrace, this is it - kindness. It feels like I'm kind towards everybody else but myself x

[Greekchick]

Glad you got through it! I knew you would - take care of yourself! 🤗🤗🤗

[Hidden in reply to Greekchick]

Thank you - take care xxxxxx

[Hidden]

Thank you Scrumbler I am increasing my t3 and lowering t4 tomorrow, hopefully this will all help x