T3 dosing and advice on symptoms please

[Netty510]

Hi everyone sorry i think i deleted my last post . I have some recent labs. Tsh <0.1(0.4-4.2) in the past tsh was 00.1 with other ndts.freet4 1.6(0.8-1.7)my free t4 was always 1.4.free t3 5.8(2.0-4.4) for years i didnt test my free t3 because i felt great but when i did it was 3.9.reverset3 32.5(9-24)i know many dont beleive in rt3 i guess some call it thyroid resistance?...vitamin d 28(20-79)im supplementing 2000iu a day to start off d3).ferritin jan 30th was 31(22-291)havent tested recently.folate 13.1 (>=40)b12 918 (>2000) tibc 289(250-450)uibc 157 (131-425)

Iron 132 (27-154) sat%46(15-55)..i was supplementing iron going off ferritin alone and i stopped since my iron wasnt low. I also did blood work for antibodies for hashi and graves which i never did.waiting for results. Labs above with 2.5grains of thyroid-s.

Ok so for my symptoms ill try to be as clear as possible sorry if i ramble...i been feeling anxious emotional, sweaty/clammy between my toes?hot flashes if i cook im sensitive to it from the heat and when i shower after temps go to 99.0 sometimes,i got nausea a few times, my armpits would sweat on and off have under boob sweat.haha.my temps were at waking 98.6 i read over 98.2 is hyper?..(using old school mercury thermometer 5 min.)at 3pm its 98.6 or 98.7(i read if afternoon temp is 98.6 im optimal) im not constipated like hypo but i get cold on and off,i lowered my ndt to 1.5 grains and added t3 i dont feel as anxious and mental like i was , hot flashes not that bad but still present when i take a dose .no shakes i did have shakes when i was on 2.5 and super emotional seen white spots at one point and felt like i lost some breath tht happned once i was super stressed.

..ok so i tryed to take my 60mg tab ranging from 8 to 10am whn i get up,but i felt anxious and emotional by the time noon came around..so i did read some articles by Paul robinson(i ordered the books) about cortisol levels being better 4 hours before waking up.so i did try this i took my 60mg+1.25mcg t3(cynomel)at 630am its hard to fall back to sleep but i did i guess i got some tiny palps here and there but subsided and i woke up better and took my 2nd dose at noon of 30mg+5mcgt3 i feel ok got some warm/hot flushes and very slight headache.i take 5mcgt3 at 5pm then a bed dose at 10ish 2.5mcg.

Since being on this for a week things arent as intense but have symptoms or either hyper or hypo mixed..my temps are still 98.6 before rising out of bed and affer noon is 98.6 to 98.7

Yesterday i lowered my morning dose to 30mg+6mcg t3 and i got to tell you i felt like shit ran over twice..i was a hot mess all day until maybe 6pm and felt some relief and finally ate something the depression was horrid.it was so bad i wanted it to all end i had adrenal pain to not sure if theres a such thing.Today i went back to 60mg+1.25mcgt3 and felt better its 1pm here now and dont feel like i did yestrday.

My cholesterol went down from 157 to 136 hdl went down and ldl..i was confused because thats a sign that hypo is better?not sure it can be other things to.

I never felt like this on other ndts armour,erfa,np thyroid neverr been on t4 only this all started on thyroid-s not sure if its stronger ect.

I was hypo for maybe a few months (erfa stopped working for me then np)

I wear glasses and whn i look at a object it looks like double sometimes fuzzy vision on and off my glasses are new.

At the moment im.only taking vit d waiting on my activated b's complex and drinking a mix called the adrenal cocktail.just started it yesterday.

I do have a saliva cortisol test, but!there no way in hell i can stop thyroid meds to do it? Im also on benzos (ativan) for 15 years 1mg.

Thank you so much for replying your advice is appreciated, p.s

Also no weight gain i felt like i may have lost a few or jist slimmed down .

I forgot to add ,when i was on 2.5 grais5 i felt like i couldnt handle any stress..im.still like that but not as bad since lowering..sorry for long paragraphs i wanted to try and add everything i may be missing some stuff.thanks. its 130pm now and sweaty armpits and temp is now 98.7 also sensitive to noise on and off

Forgot to add adrenal pain was noticeable yesterday when i felt like crap when i lowered my morning dose to 30mg today i dont feel it as of now since i went back on the 60mg.

Tpo ab antibodies 10(0-34) thyroglobulin <1.0(0.0-0.9) thank you.

[greygoose]

reverset3 32.5(9-24)i know many dont beleive in rt3 i guess some call it thyroid resistance?.

No, nobody calls it thyroid hormone resistance. That's another thing entirely. And, it's not that people don't believe in rT3, it obviously exists and has a purpose. What they don't believe is that it is of any importance or does any harm. It used to be believed that rT3 blocked T3 receptors and therefore made you more hypo. But, now we know that rT3 has its own receptors, so doesn't have any effet on T3. rT3 is inert, and only stays in the system for a couple of hours, before it is converted to T2.

There are many, many causes of high rT3 and only one of them has anything to do with thyroid. Your high rT3 could be due to your high FT4, but as it's so high, there could be other causes as well.

Your FT3 is also high, so you're probably a little over-medicated. Do you have other results on the same dose?

my temps were at waking 98.6 i read over 98.2 is hyper?..

You can't be hyper because you've obviously been hypo in the past - otherwise you wouldn't be on 2.5 grains of NDT. However, if you do turn out to have Hashi's, you could be having/have had a Hashi's 'hyper' swing.

My cholesterol went down from 157 to 136 hdl went down and ldl..i was confused because thats a sign that hypo is better?not sure it can be other things to.

It's a sign that your FT3 is higher. But that won't necessarily be better in either sense of the word.

Tpo ab antibodies 10(0-34) thyroglobulin <1.0(0.0-0.9) thank you.

Ok, but one negative antibody test does not completely rule out Hashi's because antibodies fluctuate. Also, 20% of Hashi's people never have raised antibodies. So, it's still a possibility.

[Netty510 in reply to greygoose]

Hi greygoose,my tsh has always been suppressed and its not, on thyroid-s ever since starting it ive had issues from day 1 since tsking all my past ndts even from switching another ndt to another didnt have issues.so with a high free t3 with hypo symptoms and hyper..what could that be?i thought if its adrenals temps r low?im not sure if it could be hashis i was hyperthyroid when i got rai then was hypo ..i felt ok yesterday when i lowered my afternoon dose from 30 to 1/4th ndt and 6mcg t3 and did fine i felt the t3 in a good way but today have achi bones ,eye twitching and feel kinda anxious im so lost .i know cortisol can have a play..im drinking a adrenal cocktail i really dont want to take steroids i did in the past when i first stsrted out when i didnt need it..can adrenal pain vome from just being hypo and stressing adrenals out?im confused ugh wish my last ndt never went

[greygoose in reply to Netty510]

didnt have issues.so with a high free t3 with hypo symptoms and hyper..what could that be?

Are you really sure the symptoms are both hypo and hyper? Because so many of them can be both hypo and hyper, it can be difficult to tell which is which.

im not sure if it could be hashis i was hyperthyroid when i got rai then was hypo

Unless you had some functioning thyroid left after the RAI, it's unlikely to be Hashi's responsible.

i know cortisol can have a play

I'm not sure cortisol could make your FT3 over-range. Unless it's stopping the T3 entering the cells. But, if you feel better when reducing the NDT, then I doubt it has anything to do with cortisol.

can adrenal pain vome from just being hypo and stressing adrenals out?

I'm afraid I know nothing about adrenal pain. Is that even a thing?

How long did you leave between your last dose of NDT and the blood draw,

[Netty510 in reply to greygoose]

I read that decreasing ndt or t3 will make someone feel better if theres not enough cortisol to eat up the t3 instead of building up in the blood and causing hyper symptoms. Since im not optimal and feel hyper i think?like you said i agree that hypo and hyper can show same symptoms my tinnitis has gotten louder now since lowerring my 30mg to 1/4 n afternoon,i felt better not hyper feeling.but now its hypo feeling..and feel bad so i cant raise it or lower it apparently,,i waiting 24 hours before blood work..not sure about being over medicated since my tsh is not suppressed..

[greygoose in reply to Netty510]

T3 cannot build up in the blood and cause hyper symptoms. Did you read that on STTM? T3 doesn't do anything in the blood. It can only cause symptoms once it gets into the cells - either too much of it or too little.

And it only has a half-life of 24 hours, so it cannot build up. Even if it doesn't get into the cells, half of it has gone in 24 hours.

Tinnitus is more likely to be due to nutritional deficiencies.

i felt better not hyper feeling.but now its hypo feeling..and feel bad so i cant raise it or lower it apparently,

I don't understand that. Who told you you can't raise or lower your NDT because you feel bad?

not sure about being over medicated since my tsh is not suppressed..

Just looked back at your results and it says: Tsh <0.1(0.4-4.2) in the past tsh was 00.1 with other ndts

You do know that 0.1 and 00.1 are the same thing, don't you? And, doctors consider that to be suppressed. Or, did you put the decimal point in the wrong place?

[Netty510 in reply to greygoose]

I cant raise it because when i do i feel symptoms of hyper ,and when i lower it i feel symptoms my tsh always been 00.1 and felt good 0.1 is the doctors range but as you know meds with t3 will really suppress the tsh, past free t4 1.4 and free t3 4.2 now everything has gone bonkers

[greygoose in reply to Netty510]

OK, but 00.1 and 0.1 are still the same thing, and are counted as suppressed. You said you couldn't be over-medicated because your TSH wasn't suppressed, but it is.

But, anyway, TSH doesn't make you feel anything, good or bad. And, when taking T3 it is irrelevant unless it's high. So, forget the TSH and concentrat on the FT3. Is that high enough? Or is it too high? It's well over-range. But, I'll ask again, because I don't think I saw an answer, how long was the gap between your last dose of NDT and the blood draw?

[Netty510 in reply to greygoose]

Sorry forgot ,24 hours

[Netty510 in reply to greygoose]

My issues is that i cant seem to raise and feel good and if i lower i dont feel good thank you greygoose

[greygoose in reply to Netty510]

Well, 24 hours is too long. For NDT it should be between 8 and 12 hours. So, your FT3 is actually going to be higher than that. Therefore, either you are over-medicated, or are having/have had a Hashi's 'hyper' swing.

How long to you stay on any one dose before deciding that it's not working?

[Netty510 in reply to greygoose]

I waited in 2.5 grains for 2 months i jist lowered to 1.5 little over a week ago with some t3.but been playing around with dosages and times to take it

[Netty510 in reply to Netty510]

If i lower it i feel bad but maybe need time to adjust?i would think if i was overmedicated once i dropped my dose i would feel better?as of now if i raise i feel bad if i lower i do.for 15 years i felt good only thing was changed was swtiching ndts,,how do i know if i convert well?thank you

[greygoose in reply to Netty510]

You cannot know how well you convert when taking T3, either on its own, or in NDT. You need to be on levo only. When on levo only, you get your FT4 and FT3 tested at the same time, and compare them. Percentage-wise, they should be quite close in-range, with the FT3 slightly lower than the FT4.

[greygoose in reply to Netty510]

I'm not surprised you don't feel well! Reducing by 1 whole grain in one go is bound to upset you. It shouldn't be more than 1/4 grain every two weeks. Then, adding in T3 at the same time also sounds a bit iffy. Sounds to me like too many changes in too short a time. If you are over-medicated and reduce correctly then you should feel better, rather thank worse.

[Netty510 in reply to greygoose]

Yeah,sounds about right i been desperate and changing things,brain fog obviously has me not thinking straight i go from one decision to another..so with each lower or higher wait 2 weeks before changing?

[greygoose in reply to Netty510]

At least two weeks. In your case, longer would probably be better.

[Netty510 in reply to greygoose]

So update if i add t3 i get hot and sweaty and hyper feeling temps go to 99.0 still at very low dose my temps havent dropped below 98.6 at waking i dont feel fatigue yet..maybe i got high cortisol not sure im doing saliva test sun so i can send it off mon.

[greygoose in reply to Netty510]

How much T3 do you add?

[Netty510 in reply to greygoose]

Hi grey goose,i actually stopped t3 i was still feeling those symptoms so been on 60mg ndt only and temps are 98.6 in afternoon and i even skipped a day and felt perfect temps didnt drop i know im not suppose to mess around but i just been lowering slowly instead of going up with symptoms.i been on a lower dose for 3 weeks and temps havent dropped to *hypo*temps when i added t3 it didnt last long it was only.2.5 mcg 3 times a dsy for 4 days then i stopped i dont feel like my adrenals are trashed i have energy and not sluggish its to weird i got some labs even if its a waste of money i need to see whats going on and where i am at

[greygoose in reply to Netty510]

Not everybody has temperature changes. And, testing too soon won't tell you anything about what's going on. So, no point, really.

[humanbean]

my temps were at waking 98.6 i read over 98.2 is hyper?

"Normal" body temperature isn't that precise or that consistent.

There is natural variation between people.

There is variation caused by the menstrual cycle.

And there is variation caused by how long it is since you last ate or drank something and what time of day it is.

en.wikipedia.org/wiki/Therm...

en.wikipedia.org/wiki/Human...

Another factor is that thyroid disease can cause changes in body temperature - and the longer people go without treatment (or adequate treatment) the more persistent an unusually low or high temperature might be when treatment finally starts.

To use myself as an example, in my 20s my body temperature could drop below 96F. I got my first prescription of Levo in my mid 50s. These days my body temperature can be anywhere between 96.2F - 97.4F. Even when I've been (or felt) over-medicated it almost never gets within spitting distance of "normal".

[Netty510 in reply to humanbean]

Hi human bean,thank you.maybe i have a conversion problem?high free t4 and t3 but still hypo?

[greygoose in reply to Netty510]

If you had a conversion problem, you would have high T4 and low T3, so no, I don't think you have a conversion problem.

[Netty510 in reply to greygoose]

Hi greygoose,so last time i posted i felt off,yesterday was weird i took my 60mg+1.25mcgt3 in early morning and i felt like i didnt need to take my noon dose of t3 because i did it before and had double vision and emotional, so i wanted to test and see so i passed up my noon dose and i went all the way to 5pm until i took 5mcg t3 and i didnt even think i needed it then either

But didnt want to push it.didnt have double vision and felt totally normal all day and night,msybe my levels have to come back down before i start feeling hypo?today as of now i feel ok as well, my graves antibodies was low ,so im guessing i needed to lower my ndt and t3 and probably was overmedicated which my t4 went high and started creating rt3.but will see what happens that would be great if its fixed and i can live again..but thats in the perfect world hahah

[greygoose in reply to Netty510]

Well, one day at a time. You can always increase again later, if you feel the need. But, I don't think Grave's antibodies or rT3 had anything to do with anything.

[Netty510 in reply to greygoose]

Yeah its not clear whats going on,obviously its a sign i need to lower it of om feeling better i know eventually hypo will return so ill keep a eye on my temps if they start dropping then should i add 2.5 or 5mcg t3 to where i feel i need it?i do want to try and stay on ndt and t3 combo but eventually work my way up to 1.5 grains ndt and some t3 .

[greygoose in reply to Netty510]

Yes, best to go slowly, so stick to 2.5 mcg increases or decreases as needed.

[Netty510 in reply to humanbean]

Good info thanks,and wow thats cold brrrr

[Netty510]

Hi lora,yeah im not sure if i have graves or hashi..i lowered my 30mg dose i took in afternoon to 1/4th+6mcg t3 and felt better but waking up this morning i feel.more bone achiness and eye twitching.was waking up several times...its feels like a mix with hyper and hypo...what about adrenals?can temps stay normal temps through the day with fatigue?i thought temps drop if low cortisol

[Netty510]

And how does someone raise ferritin without raising iron?i read ferritin raises gradually over time if iron is good