I have been stable for 4 weeks on a dose of 75mcg t4 and 7.5mcg t3 but still exhibiting hypo symptoms and blood test showed a T4 of 16.1 (10-20) and a T3 of 4.8 (3.5-6.5). My endo suggested increasing by a tiny amount of T4 so I went up by 6.25mcg for 3 days. This has happened to coincide with the heatwave and I live in the hottest part of the UK. By 2nd day I felt more anxious energy and resting heart rate increased a bit and I began waking early and the same happened day 3 and I got more anxious. I was a bit confused as to how such a tiny increase could have an effect but I decreased back to old dose to wait a little longer the following day and I still had axiety, body buzzing sensation and higher pulse. The next day I felt the same and pulse was again higher so I skipped afternoon tiny T3 dose to see if it made a difference and instead I had a period after dinner where I felt awful anxious buzzy and a heart rate between 88-100 for over an hour which coincided with being very hot. Today I woke up and returned to my normal dose but at 3.45pm (before second dose and again when it became very hot) I developed a fast pulse, headache and anxiety again and since then (now 6,51 my pulse is oscillating between 88 and 104. I feel horrible and I am also very hot again - 36 here! I am beginning to wonder if its the heat and my adrenals/low thyroid is struggling. I took 2nd t3 dose at 5.30 thinking my body needed it and nothings changed. I have very warm to touch skin and pulse of 92 and just now I went to pee very dizzily and though my urine was clear I lost a LOT of liquid. Could I potentially be having dehydration issues from being undermedicated and having slightly low (in range) cortisol? I am drinking and don't feel at all hungry!
Has anyone heard of/had this and knows what I can do to help it? Thanks!
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liaratsoni
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Hi liaratsoni Interesting. I’ve had a bad today, like you, anxiety and a body buzzing sensation all day. I wondered if the heat today had some effect on this?
Sorry to hear you've been bad too! Is your heartrate also high? Mine still keeps fluctuating between 88-104 with palpitations its awful! Been going since 3.45 (which coincidentally is when the heat began to intensify - its been 36 here!
I have a headache too and I'm wondering if adrenals are struggling further due to loss of electrolytes from the heat! I just had a complan with salt and potassium in so we'll see how it goes but I have never been this bad even when I was overdosed on T3!
Hi. I don’t monitor my heart rate but I did take a drink with Himalayan salt late in the afternoon and felt it calmed my body down a bit... but it’s so hard to tell with this condition.
Hi there, I had a blood test last week showing I was quite under medicated so don’t think that could be the case. I also had a less severe/long lasting but similar thing happen yesterday afternoon after missing my T3 dose. However I also had a similar but again not as long lasting period on a higher dose of t3 so all in all I’m very confused about right now!
Hey! I also feel awful last few days. I am on levothyroxine 100 since November and I will try 75 tomorrow as I have been unable to cool my body to a point where I have to all day keep my feet in a bowl of cold water, sit next to a fan with soaking wet tshirt. Otherwise I feel like I am having a heat stroke. I drink plenty and pass clear urine almost every half an hour. Evenings when is getting cooler are even worse for me as they seem to trigger my hypo flare ups with blood pressure 195/99 and 99 pulse with chest pains, excessively sweating and shivers. I called ambulance last night but they said it’s not life threatening, directed me to a doctor on call who did not know how to help me. After one hour it passed and I fell asleep from exhaustion.
If anyone has any tips how to cope in this weather please help as I feel like jumping from a heat stroke to hypothermia last few days.
Not sure your endo knows that when TSH goes down, so does the conversion of T4 to T3. So you actually convert more T4 to rT3 which isn’t useful. Plus to do this, the D3 enzyme is more activated which actually impedes T3 action. So a double whammy of less T3 effect. I suggest that your endo should have added more T3 and less T4.
The half life of T4 is 7 days. And your T3 dose is very small. So skipping T3 probably made you feel worse as you were taking away a source of T3.
If you have low cortisol (raises heart rate and lowers blood pressure - have you checked your blood pressure?), then you’re not going to have enough glucose in the cells to concert to energy. Have you done a cortisol saliva test recently? Taking T3 during the day can actually lead to low T3 in the night, when it is needed for for stimulating the pituitary gland to make cortisol. When you know the results of your cortisol investigation I suggest you look into the CT3M method to raise cortisol.
I actually have a constantly non existent TSH because my TSH was normal when I was diagnosed at 1.9! Its always <0.03 now. Yes I only skipped a very small afternoon dose of 2.5mg but It looks like it had a huge impact! Normally I have lowish blood pressure but I had blood pressure done yesterday when my pulse was high (and had been continuously for 7 hours) and it was 124/88 which is quite a bit higher than my normal so I think I had a big continuous release of noradrenaline yesterday probably to compensate for the missed T3!
I had a cortisol saliva test done back in June which showed low but in range morning and in range but slightly elevated results: waking: 9.78 (6-21) 2 noon: 5.19 (1.5-7.6) 4pm: 3.63 (0-5.5) before bed <1.5 (0-2). This was when I was on 75mcg t4 and 10mcg t3 and my t4 was 17.3mcg and t3 was 4.8 (3.5-6.5). Interestingly though I am now on the same t4 and have been on a reduced t3 dose for a month and a half my t3 hasn't moved and my t4 has reduced which I would assume means I am converting better as they were t4 16.1 and t3 4.8 a week ago.
If your TSH is low then conversion to T3 will be impaired. Adding T4, or keeping the same T4 and adding T3 to it is not a good idea, because of the conversion issue. Have a read of the article I posted above. It explains a lot.
It does sound like you have low cortisol (effects include high heart rate and low blood pressure).
Thank you I will check those out! I woke up with a high pulse again today and it calmed to the lowest its been since yesterday morning 20mins after my t3 dose and it stayed there in my normal range for 2 hours but from 11 onwards (2 hr mark of taking t3) its been very high again and I have an awful buzzing sensation in my chest. Hoping this will calm down with my doses returned since yesterday to how they were before I tried to increase because I was doing fine and now this is the worst my pulse has ever been!
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Advice and “moral support” needed with T3/T4 combo
A few more questions.........(Adrenals ???) 
Can someone please clarify re rt3?
