I saw my GP yesterday for a blood pressure checkup. I was put on perindopril 10 mg two months ago after my blood pressure reading came back at 170/92. Yesterday, it was 112/81 so doctor was happy. However, my resting heart rate is 95, and she said that's too high and most likely due to being hyperthyroid. That assumption is based on my TSH (<0.01) although my free Ts are well in range on NDT. But my GP, of course, only looks at my TSH.
So my question to others on NDT or T3 is: has it affected your resting heart rate? Is it normal that it's slightly higher than on T4 only? Is there cause for alarm (my GP said it should be between 60 and 80 but def not higher than 85)?
My latest labs are from Oct 10, 07:52, on 3 grains of Thyroid-S (1.5 taken 24 h prior and 1.5 grains 12 h prior). Also on Thorne vit B complex, cod liver oil (said to contain >100% of recommended intake of vit D) along with prescription drug Losferron (iron):
FT4 0.7 ng/dL(ref 0.7-1.5)
FT3 2.7 pg/mL (ref 1.6-3.2)
vit D 30.9 ng/mL (ref >30 but doctor would like to see it >50)
vit B12 1050 pg/mL (ref 189-883)
ferritin 41 ng/mL (ref 10-205)
no folate tested (never have had that tested, will have to ask for it in the future)
My ferritin levels are surprisingly low considering I've been on Losferron for the past year.
I don't rely on TSH or any thyroid blood test. I do only two things and I am doing fine. I test my temperature before rising (before getting out of bed). It should be 36.5C. If higher, then
I must reduce my NDT. Then I take my pulse reading and if in the 80-90, I must reduce my NDT. I have gotten to the point that 1 1/2 grains per day is ideal. Give it a try, and be your own doc here...John
If you are over 36.5 C while still in bed, just waking up, then you have to reduce a little of the NDT. It takes about 3 days to see the difference. If your pulse rate is high, you might have to cut back a little on the NDT. They should both be high for you, unless you are really "out of shape", then your NDT dosage might be fine, but your heart has to work overtime. If you can remember what your normal pulse was before you took your blood pressure meds, then you can use that as a guide.
You're welcome, I've been working on this for many years; only have half a thyroid, so tougher for me. Good luck to you..Here's my latest book: ForeverYoung-Healthy.com, all about stem cells.
I've no idea really, but looking at your blood test results, there are are a couple of things you can do. Vitamin D needs to be about 100. I take 1000iu's all year round and it keeps mine hovering around this level. I buy mine from a place which has very few fillers, is from UK, and is cheap.
They also do a 4000iu version which I used to get my levels up to 100.
The other thing is your ferritin level is too low. It needs to be 70-90 for your body to convert T4 to T3.
I have no idea whether these will help with heart rate, but they should help generally and aren't harmful.
My other thoughts on things you can investigate are as follows.
High blood pressure seems to be one of the symptoms of low T3 at the cellular level. There are two main genetic mutations which affect thyroid hormones.
The first is one which reduces the conversion of T4 to T3. There are two SNPs that have been identified that do this. DI01. (Dee eye zero one)
The second is a genetic mutation that governs how well our bodies absorb T3. DO02
SNPedia is a good source to find out more about this. It's wikipedia for SNPs.
Search SNPedia on 'thyroid SNP DI01' and 'thyroid SNP DI02'.
Look at facebook group thyroid patients canada. There are some really good research articles there. One shows that your FT3 ÷ fT4 should be higher than 0.27. Mine is always under this, even though I'm now on NDT it has improved but not got above this level. I have had a genetic test done and it shows I have problems both converting and absorbing thyroid hormones. Maybe you have too?
By the way, thereare several research studies that show it is the fT4 and in fT3 levels that are important, not the TSH result. In fact I go on only the fT3 level.
I have had a real hard time getting my ferritin levels up. The product you linked to seems interesting. One thing is clear: the prescription drug has done nothing for me, and I've been taking it for a year. Sometimes I wonder if my doctor is that good; she just renews my prescriptions, even though my levels are not optimal.
On 3 grains of NDT daily I have hypo symptoms, not hyper, so I probably need more but have to correct some vitamin and mineral deficiencies first.
What you say about low T3 levels at cellular levels makes sense to me, and of course that won't show up in blood.
To anyone reading this post. I didn't realise that your fT3 and fT4 are in different units so 3.86 is NOT the answer.
I've just done the calculation fT3÷ fT4 for the figures you supplied
2.7÷0.7 = 3.86
This is way above 0.27. So maybe you are over-medicated. So the question is why do you still have symptoms of being undermedicated. Have you ever had your cortisol levels tested?
I have never seen that calculation before so can't comment on it. My previous reply was pointing out that you can't do the calculation that BB001 did when units of measurement are different.
However, you are taking NDT so conversion doesn't come into it.
When taking NDT it tends to lower, even suppress TSH which is reflected in your result of <0.01. FT4 is often low in range, which yours is at 0.7 (0.7-1.5) and FT3 is generally best in the upper part of it's range and yours is 2.7 (1.6-3.2) which is 69% through range. So your thyroid results actually look pretty good and not unexpected for someone on NDT. However, when taking any kind of combined T4/T3 hormone replacement, we are all different as to where we need each individual hormone level. Your FT3 level would be OK for me but if my FT4 level was the same as yours I would be very unwell. I need a much higher FT4 level even on combined T4/T3.
But that wasn't what your original question was about.
The other results you posted earlier in the thread show that your Vit D level is low and the Vit D Council/Vit D Society recommends 40-60ng/ml. BB001 is in the UK and the 100 level she quotes is when the unit of measurement is nmol/L which is used here and you aren't in the UK and your unit of measurement is ng/ml, so forget the 100 level mentioned.
Your Ferritin should be half way through range and SlowDragon has mentioned that low Ferritin can affect heart rate.
Chicken has about half the iron content compared with beef, but chicken livers are a good source of iron and have the highest iron content of all liver.
Very valuable input as always, Seaside Susie! i imagine chicken liver capsules are not available as a supplement Would be great if they were...but no such luck, I guess...
i imagine chicken liver capsules are not available as a supplement Would be great if they were...but no such luck, I guess...
That would be good
There are desiccated beef liver capsules and I did try them but wasn't that impressed, I've found that eating liver is the best way for me to raise my ferritin. My favourite way is to cut lamb's liver into strips and do a sort of stir fry type dish with onions, peas and anything else I fancy popping in it then have it with rice.
Only takes a few minutes, bung enough other stuff in (I like loads of onions, add some tomatoes too, and peppers, anything you fancy), add peas and rice, stir all together into one big mess and you might not notice the liver .
Lambs liver is quite mild. You could try chicken livers, I've never tried them so can't comment on their taste.
My T3 is 2.9 and my T4. Is 1.0 and my GP swears I am normal and I am not, I have insomnia and rapid heart beat that wakes me up at night or shoots up from 70 bpm to 160 while being out in the heat or doing any minor activity. I have taken my cortisol test and mine are high at night when I am resting she keeps saying it’s anxiety but I know it’s not if I stop taking Amor thyroid 45 mcg it stops within a few days. GP already knows that, she tried to prescribe me a beta blocker, I refused as now have been wearing a heart monitor for two weeks will turn it in to the cardiologist on the 27th. Cardiologist told me that people on thyroid meds get Atril Fib as the thyroid meds speed up your metabolism. I will see what happens! Good luck ASanders69. I get my vitamins done again in January. It’s hard to feel well when your laying in your bed ready to sleep and you can hear your heart beating like a drum. Doctors don’t listen so we must school ourselves!
I use Amour thyroid compound 25 Mcg T4 and 7 mcg T3 Does that mean I need less T4 and more T3 or More T 3 on top of what I take now? believe it could be a conversion problem as I discussed with greygoose but it’s so difficult to talk to these doctors it disheartening. I have tried to stop meds for a day or two just to see if it will go away and it does, I actually feel better, but can’t do that for long because I become symptomatic I also have Hashimotos disease and prediabetic which I also feel is increase by thyroid meds. It’s a no win situation with doctors who won’t listen! My TSH 2.30 - 0.40-4.5 range but it’s as you say T3 tells if you are symptomatic and I know those two I gave you are on the lower range but these doctors won’t listen, I will have to go back to find a new endocrinologist. After I finished with the cardiologist, heart disease runs in my family so I have to rule that out first. Once I do and he gives me a clean bill of health heart wise lll leave my GP. Thank you 🙏
The TSH is useless when on any medication containing T3 as the latter tends to suppress the TSH below range. Most endos don't know this, of course, so they tend to just prescribe enough T4 to get your TSH anywhere in range, although most people on levo only anecdotally feel better with their TSH in the lower part of range (around 1 or even lower, and definitely below 2). So yours is highish and, along with lowish free Ts, tells me you are under medicated.
One of the worst scandals when it comes to thyroid disease and treatment is that most doctors are unaware that patients on T3/NDT are likely to have labs that deviate from those on T4 only drugs. They freak out when they see a suppressed TSH and tell you to immediately go off T3 or NDT and back on T4. I have been in that situation more times than I can count...
You are the only person who can really answer this question. Thyroid medication requirements are so individual. Do your vital measurements and symptoms indicate you are under medicated? My friends fast pulse rate went when she added a small amount of T3 only. T3 is potent, be particularly careful that you do your research on how to dose with it and just increase by a small amount T3 every couple of weeks if you decide to use it.
To be more accurate, i know I need to add t3, i just balk at ordering it off a body building website. It feels like the equivalent of ordering from the drug dealer on the street corner! In this instance though at least it isn't addictive.
3.86 is a good result for fT3/fT4 ratio. In humans it's ~4:1 and in pigs (where the NDT comes from) it's 3:1 and ASanders falls in the middle of those two - that's good.
Are you vegetarian? Best way to get iron levels up is to eat chicken. This avoids the negative health problems associated with eating too much red meat.
Iron needs vitamin C for it to be absorbed, so eat chicken with a glass of orange juice!
No, I'm not a vegetarian. Always thought red meat was the best way to increase iron levels, though...but actually prefer chicken so thanks for the tip!
Measure vitals & symptoms to see if you're overmedicated
Eat chicken with a glass of orange juice.
Buy a fit bit if you can afford it. Though calibrate its results against measuring your pulse yourself at the same time to check the fit bit is accurate.
Though a fitbit is not essential as it's no substitute for taking your own basal pulse & temperature & symptom measurements.
On your low ferritin, I’ve been seeing a Functional Medicine specialist who recently pointed out that viruses require iron to survive and thrive and that low iron/ferritin despite supplementation can be an indicator of a subacute viral load. In this case supplements actually feed the virus population. 😱
Naturally, the viral load will confound the task of feeling well again.
First there must be blood tests to identify the virus. We’re working on getting orders, since this specialist cannot write them. Then an essential oil that targets the virus will be deployed. There’s a recent article on Elsevier that tabulates the best matchup between viruses and essential oils.
No, it seems most are blissfully unaware. It took the Functional Medicine specialist (not an MD) to notice that my "normal" blood count showed a disproportionate number of lymphocytes compared to neutrophils, suggestive of chronic infection. The GP, since fired, saw nothing in the CBC and said "you cannot take too much supplemental iron."
Elsevier is a Dutch publishing company that sells medical, scientific and technical journal articles (One billion downloads per year). In this rare instance, they've made the content available for free: sciencedirect.com/science/a...
Sorry I didn't give the link right away. I was tucked in bed and it was dark and cold and I didn't want to get up and turn on the computer.
I should warn you that there are undocumented side-effects for some people who are put on T4, whether from Levothyroxine or NDT. One of them is high blood pressure, which your doc decided to fix with perindopril. I recently came across a case similar to this on a health board, where the patient was having multiple symptoms: high BP,
hairloss, high cholesterol, weight gain. This patient went on T3-only and symptoms resolved. I suspect both blood pressure and heartrate are elevated when the body does not respond properly to T4. If I take more than 50mcg levo (not nearly enough for full replacement), I can feel unpleasant anxiety, but even on that amount, I have noticed that my BP is too high and it's something I'm going to have to deal with soon. Maybe it's adrenals. Maybe I still have some nutritional deficiency in spite of my efforts to cover all bases. Unfortunately, MDs don't know the cause(s) of atypical response to T4, and I doubt there are any endos who do, either.
VERY interesting, thank you so much!!! My latest LDL cholesterol was highish, my HDL very low, and my triglycerides have gone from 70 to 150 in the past year (sorry, don't have access to ref ranges right now but they should not be higher than 75 according to doc). I was told high blood sugar and insulin levels would raise cholesterol and triglycerides...so it's all about the chicken and the egg. The weight gain is really annoying, +27 kgs/60 lbs in less than four months with no change in diet or exercise levels...I have displayed ALL the symptoms you mentioned during that time!!! However, I've always been afraid to switch to T3 only, afraid what would happen if I did not have any T4 in case I ended up in a coma for months (unlikely, I know), etc...I have been brainwashed with the "the brain and body need mostly T4 and a little T3 which you can get from conversion", so, even after going on NDT, I still tend to see the T4 hormone as crucial to survival...but what you say makes a lot of sense, and I cannot ignore that all of the symptoms you mention have appeared in the past year. I cannot say I have derived any benefits from NDT specifically in the past year, but have mainly gained a ton of weight while on it...so something is definitely wrong. The doctors only care about my suppressed TSH and want me back on levo asap, but I know it's not as simple as that...
US natural doctor Westin Childs (restartmed.com) has written extensively about the increased need for T3 in patients with conditions such as insulin and leptin resistance (often both present), diabetes 2, and chronic inflammation as he claims these conditions create a pathway for more rT3 production.
Now, if we accept the idea that rT3 does not, as previously believed, block the action of free T3 (and this myth has been convincingly debunked in several posts by greygoose ), I imagine it could still be a problem if you take NDT which is 80% T4. If your body converts that mainly to rT3, and not free T3, it's logical to assume you would end up hypothyroid as an end result since rT3 is inactive. In such a case, raising NDT or adding levo to NDT would not make sense.
Dr. Childs has had success adding T3 to a decreased dose of NDT or a low dose of levothyroxine, and in some cases even using T3 only, to increase FT3 levels in patients with insulin and leptin resistance, diabetes 2, and chronic inflammation who remained symptomatic on NDT and levo.
If your body converts that mainly to rT3, and not free T3, it's logical to assume you would end up hypothyroid as an end result since rT3 is inactive. In such a case, raising NDT or adding levo to NDT would not make sense.
It depends on the level of the FT4. It's only when it gets to a certain level that it converts to more rT3 than T3. But, even if it were converting to more rT3 than T3, you still have the T3 in the NDT to consider. The more you raise the dose, the higher the level of T3 you're getting. So, the FT3 will rise eventually if you take enough NDT, even though the T4 is converting to mainly rT3. Not the ideal situation, admittedly, and that is why many people add T3 to NDT.
Yes, that makes perfect sense! And that is something that doctors such as the Hertoghe doctors, who prescribe NDT, don't seem to realise...I have not heard of a single one of them adding T3 to NDT, or prescribing T3 only, even though many patients seem to recover only when they take mostly T3 or T3 only. I used to believe what the STTM said about NDT being the ideal drug for everyone, but now realise that is far from the case...plus, even if it works for you initially, your hormone needs may change over time. One case comes to mind: Elle Russ, author of "The Paleo-Thyroid diet," who did just fine on NDT for several years before having to switch to T3 only because, for some reason, NDT no longer worked for her the way it used to.
The majority of doctors and STTM have one thing in common: they both believe there's a one-size-fits-all solution. There isn't. Which is why I take all of what they say with a huge pinch of salt (another thing they got wrong!) and do my own research.
Paul Robinson has written some books that I fund useful. 'The thyroid patient's manual' covers the relationship between T4, T3, rT3 and TSH and gives links to the research articles he has used. It's more complicated than 'rT3 blocks T3'. This isn't how rT3 works. It also covers dosing with NDT and T3 or combination therapy.
'Recovering with T3' is the next book to read.
If T3 only dosing on its own isn't working, he's written a third book called 'The CT3M Handbook' which incorporates how to dose in accordance to one's circadian rhythm.
Yep, same here. I would love to increase my NDT just a little bit but past experiments have caused my BP to shoot up - with accompanying higher HR. The doc put me on Lisinopril to pull the BP down and that works. I take 1/4 of the amount he prescribes because I have severe white coat affect (which he doesn't seem to accept - just says I have super high BP - I don't)
Sounds familiar! What I have found in the past, is that if my FT3 is within normal range, then I can add more T3 in the form of liothyronine, and my body reacts much better to T3 than T4. T4 can cause both anxiety and increased BP, in my case. I've been able to determine that my T4 ceiling is about 50mcg; take more than that, and all hell breaks loose.
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In the early 1990s I'd been on Levothyroxine monotherapy - with no T3 since 1973 for about 20 years when I started getting high BP. It was very high in the late 1990s. In 2003 , I had breast cancer of very slow growth and got over it well . In 2010 I had a TIA/ light stroke and got over it in 6-7 months. I still had high BP. In 2015 I had a heart attack - entirely unexpected, I'd never had any heart problems and was learning to dive. After three years I had a triple heart bypass. I have since realized that the breast cancer was caused by a lack of immunity, and the HBP stroke and heart attack leading to the triple bypass were all caused by lack of energy in the heart. I had no heart problems before then.
All of my lack of energy and lack of immunity was caused by levothyroxine monotherapy. In the 1970s and early 1980s I had NDT prescribed on the NHS and had no problems. They started in the late 1980s, when I had only levothyroxine and started to go to the GP to say there was "something wrong" (but I thought levothyroxine was good) and didn't put the facts together till earlier this year when I began self-medicating with NDT. Levothyroxine may still be good for some people under some circumstances.
I have established scientifically through medical articles that people with no thyroid glands do need T3 or NDT, probably from the onset of treatment but certainly after the first year or so. Can't speak for anyone else.
Yes, that makes PERFECT sense, since some of the T3 is made directly by the thyroid gland. I have never understood why doctors insist patients with no thyroid should feel great on levo only, thus making them completely dependent on T4 to T3 conversion which can be impaired for so many reasons...!
Maybe direct your GP to the NHS website that states: "Most adults have a resting heart rate between 60 and 100 bpm" and "See a GP to get checked if you think your heart rate is continuously above 120bpm or below 40bpm, although it may simply be that this is normal for you" : )
First try taking your pulse at home, when you've not eaten recently and have been seated for 15min. "White coat" stress is a real condition for some people, who get stressed being with a health professional.
I've been on combo and also for a while on NDT. I believe our heart/cardio health suffers from having thyroid disease. My pulse was always in high 80s. Hip issues led me to do cardio exercise 5 days a week to improve joint muscle tone.
It's taken 18 months, but my Fitbit gives a resting pulse of 70-74, now influenced by sleep quality and stress. N.B. resting pulse is not anything recorded during sleep; my pulse 1-6am is 59-64.
Definitely recommend fitness tracker with heart monitor function. Good software makes adjustment for height, weight, age and gender.
If you have a Samsung phone, use the Health app and see what your stress level is - mine came down hugely due regular exercise., which initially was focused on flat-out / alpine-style walking.
If you haven't the resources for a Fitbit or the Kardia solution by AliveCor, there's a simple pulse oximeter available from pharmacies or online merchants (Amazon) for about an eighth the cost. In clips on you fingertip and measures pulse and oxygen saturation by looking through your fingernail at the hemoglobin in motion. If you happen to wear nail polish that blocks that view, the device can be flipped over to look through the skin on the pad of the finger and it seems to be just as accurate.
Hi, I have been on NDT for 3 yrs plus. Resting pulse 48 and blood pressure 120/60 with TSH (<0.01) My pulse did rise initially to 60/70 but has dropped back to 48. Sounds like B/P and pulse are not related to your thyroid unless you are taking too much NDT.
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Would be great if they were...but no such luck, I guess...
Heart rate on liquid thyroxine 
T3 only and heart rate
Stopped taking NDT thyroid
Resting heart 170bpm 
High heart rate worries
