Anxiety

[Mdegnan42086]

Hi has anyone suffered with anxiety and nervousness while on t3

[DippyDame]

How much are you taking....and for how long?

[Mdegnan42086 in reply to DippyDame]

I've been taking 10mg in the morning and 10mg at dinner along with 50mg of levo for about 3 months I got bloods and my TSH and T4 were really low and my t3 was sitting at 41 which is just under half way. So Dr up my t3 to 15mg in morning and 15 at dinner and upt my levo to 75mg 2 weeks ago. Since then my anxiety and nervy chest feeling has amplified and my bowel movements have got upset. I upt my t3 because I was told it should be sitting half way at least. I feel awful

[SlowDragon Administrator in reply to Mdegnan42086]

We always recommend ONLY increasing Levo or T3

Not both at same time

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

If/when also on T3, make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you did your tests?

When were vitamin D, folate, ferritin and B12 levels last tested

What vitamin supplements are you currently taking?

Suggest you reduce T3 in evening back to 10mcg

Some people are fine with low Ft4 but many people find it better to have Ft4 roughly 50%-70% through range

So your increase in levothyroxine to 75mcg should help

Do you always get same brand of levothyroxine?

Which brand

[Mdegnan42086 in reply to SlowDragon]

Yes always the same brand of levo. Just noticed that the 25mg tablets are wockhardt and my 50mg tabs are accord .And no my vitimins were not checked.

[SlowDragon Administrator in reply to Mdegnan42086]

Was test done as advised? How long before test was last dose T3?

Absolutely essential to regularly retest vitamins

What vitamin supplements are you currently taking

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

[Mdegnan42086 in reply to SlowDragon]

Hi I appreciate Ur trying to help but when I get all this information it overwhelmes me and makes me nervous. I know about getting my vits checked and how and when to get my bloods checked. I just need help with symptoms while on t3 and T4.

[SlowDragon Administrator in reply to Mdegnan42086]

Can you remember how long before last blood test you took last dose of T3

If it was longer than 12 hours the Ft3 result was false low result

Endo has increased levothyroxine by 25mcg and at same time increased T3 by 10mcg. It’s likely too much.

As your Ft4 was extremely low, stay on levothyroxine dose increase but consider lowering T3.

Best to only reduce T3 by 5mcg at a time. So dropping evening dose back to 10mcg

In week or so, possibly reduce morning dose T3 to 10mcg

[shaws Administrator in reply to Mdegnan42086]

You have my sympathy and am sorry you are suffering so much in trying to restore your health.

Some doctors don't seem to be very knowledgeable about how some patients' feel on particular thyroid hormone replacements or how they should be taken.

First of all thyroid hormones have to be taken on an empty stomach (usually when we awake- but some prefer a bedtime dose - stomach has to be empty) with one full glass of water and wait for 1 hour after dose before eating. Taking food near T3 would affect the uptake.

I don't split doses of thyroid hormones, especially T3. Dr John Lowe's patients only took one daily dose regardless of the dose on an empty stomach with one full glass of water.

It would interfere with my life if I had to take thyroid tablets several times a day. We'd be tied to 'how we feel' and watch the timing and to have an empty stomach each time .

I've always taken one daily dose of whatever I've taken, be it NDT, or T3/T4 or T3 only. This method means your stomach will be empty as food interferes with the uptake. (T4 being an inactive hormone and T3 the active one).

Some prefer a bedtime dose so you would have to have last eaten about 2 to 3 hours previously.

I followed the advice of a Researcher/scientist/doctor who also was an Adviser to Thyroiduk before he died due to a serious fall which caused bleeding in his brain.

If we take T3 alone, our T4 will be low as we're taking none.

Your dose of T3 is 30mcg equal to approx more than 100 mcg of T4.

Any increases have to be gradual and I've found I need a lesser dose now than I've taken in the past.

drlowe.com/thyroidscience/l...

tpauk.com/main/article/the-...

[Mickeydooley in reply to shaws]

Sorry for jumping in but I’m getting fed up taking 3 doses of meds throughout the day and trying to time eating and drinking around it. I’m interested to hear you take yours all in one go. I’ve wondered about this for a while now. I was worried if I took it altogether I might react badly. (I’m still experiencing shakes after over a year on t4/t3 treatment). Do many people do this successfully?

[jimh111]

Too much thyroid hormone causes anxiety. I would simply reduce your morning dose to 10 mcg and see if you feel better. It's difficult to measure fT3 when taking T3 because of its short half life. If you leave too long between the last dose and taking the blood the fT3 figure can look low.

[SlowDragon Administrator]

Post from 6 months ago

healthunlocked.com/thyroidu...

Vitamin levels need retesting

[Mdegnan42086 in reply to SlowDragon]

Yes exactly so I'm on top of that now. My question today was to get info on anxiety and combo treatment.

[DippyDame]

thyroiduk.org/signs-symptom...

Combo treatment.

First optimise nutrients

Then establish any conversion issues.

Titrating combo can be trial and error I'm afraid

Keep a diary detailing all changes in doses and symptoms

Check resting heart rate and morning temp daily to avoid high readings.

We have to listen to our bodies

I understand your frustration it took me a very long time to reach my therapeutic dose (I'm T3 only though)

Anxiety indicates overmedication.

Have you had antibodies tested to check for Hashimoto's?

Currently...."up my t3 to 15mg in morning and 15 at dinner and upt my levo to 75mg 2 weeks ago"

I'd wait another 2 weeks first of all to see how this dose settles....then decide to change if problem remains Not easy but we cannot rush changes it confuses the system!

Do you know how well you convert...

At this point I'm not sure you need so much T3, your FT4 needs to rise first.

On what basis did your medics suggest T3

I'd be inclined to increase levo to 100mcg (to raise FT4) and take a single dose of T3 (15mcg) either early morning or bedtime

Test after 6 weeks and see how well FT4 rises

FT3 will initially drop on 15mcg but if conversion is good that will compensate

Ideally both FT4 and FT3 shoulc be close to 7t% through their respective ranges

Unfortunately there is no single answer because we are all different with different needs....but slow and steady will get you there!

It is overwhelming but you need to look at one step at a time....been there, it can be a steep learning curve.

We're all here to help, just ask!