Diarrhoea, high ft3 low ft4.: Hey everyone. I... - Thyroid UK

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Diarrhoea, high ft3 low ft4.

Hey everyone. I have been having a bit of a tough time recently.

Been doing good on Armour, then my labs got lopsided (ft4 dropped from 80 to 24%, ft3 dropped from 110 to 80%). Feeling hypo, fatigue, dry skin, apathy, very cold, brain fog, couldn't remember names (I'm 36).

Ft3 = 80% range*

Ft4 = 24% range

*24hrs gap between doses (can only take the dose once a day)

Some weeks ago I lowered Armour by 1/8 and added 6.25 levo as my ft3 was already high, (couldn't raise Armour, add T4 to it without feeling overdosed).

Fast forward 4 weeks later, I'm still cold in the afternoon, my skin is dry, I am very thirsty, but also have insomnia and now also diarrhoea to the point that I feel nauseous and my vision gets blurry.

Tried adding again 6.25 t4 and lowering Armour by 1/8 again, which after a day or two resulted in vertigo, diarrhoea, swelling, severe hypoglycemia starting 2 hours after taking the pill and lasting 5 hours. Went for emergency bloods after a few days of this regime, ft3 again high at 80% (24 hours after taking dose, so I guess it is false-low), ft4 now 50% increased from 24-30%.

ft3 = 80% range*

ft4 = 50% range

*24hrs gap between doses (can only take the dose once a day)

Any advice would be really helpful and appreciated! Please see my previous couple of posts for more info (vits optimised, cortisol in green on regenerus, female hormones fine, not suggesting menopause at all).

Thanks,

TC

15 Replies

I hope someone will be able to help. It is 4am, unable to sleep, have myoclonic jerks, restless, it's been too many weeks like this :(

That sounds terrible but I've been there and still there. In 2020 I tried for 7 months to make NP Thyroid work. It was good stuff but I found myself over medicated on 2 grains but anything less I started to develop severe symptoms like facial swelling, extreme painful carpal tunnel and every morning I woke up feeling terrible. I found myself asking how did anyone get normal on this stuff before synthetics were introduced. My problem on NDT is that I need a certain amount of T4 to feel stable but I didn't need as much T3. I slept better on NDT when I first switched from Levo to NDT because my T4 levels hadn't plummeted yet. Have you thought about just starting with 1 or 1.5 grains and adding more Levo to it? It sounds like you need a lot more Levo so it would make sense to start with a much lower amount of NDT and build onto that. Sorry I don't have better advice. I've since switched back to Levo only and increasing it.

in reply to jrbarnes

Thank you! It is terrible to be awake for most of the 24 hrs every day, this is really breaking me. Like you, I felt better on higher ft4 regarding sleeping, we sound really similar. I wish I could just increase Armour...My doctor wanted me to try to decrease Armour and keep adding t3, but honestly not sure that would work either or who knows, maybe he is right!I think I need more levo, but not sure I want to drop that low since my ft4 is already incredibly low for me. I was thinking of going to 2 1/4 + 12.5 levo from 2 1/2 + 6.25 levo right now.

On top of this, synthetic levo makes me feel heavy and bloated. It's been almost 3.5 years like this from too much Nature Throid, to not enough, to levo only, to combo t3 t4 and now Armour and some t4.

jrbarnes profile image
jrbarnes in reply to

The only time I recall feeling somewhat normal and sleeping normally was on Levo only but my T4 levels have to be at the top or slightly over range. It wasn't until they declined that I started having problems. I've tried the NDT and LevoT3 combo but I can't add T3 to low T4 or even mid level T4. It just gives me anxiety, insomnia, and weak painful muscles. I'm experimenting with Levo only but increasing it this time. The first three days were rough but I was finally able to sleep and last night I qoke up around 3am took the meds and was able to fall back asleep and had dreams. Like you I have not been sleeping for almost 4 years and I've been off work several months. You cannot function when you can't sleep. Everyone started to comment on how tired I looked. I think some people have poor conversion and need more T3, some have resistance and need T3 only, and others just need enough Levo to get the job done.

in reply to jrbarnes

Thank you for you comment. Very comforting, had such a rough night and it's good to talk to someone who understands it. I fell asleep at 8 am, slept 3 hours. I have a blood test next week on Monday and will see what is happening there, it may give me more answers. It is terrible, isn't it? I'm glad you are sleeping now! Even when I get one good nights sleep I dance all day happy! Impossible to work and starting my new job in a few weeks, need some income after 12 months without a job, to afford this expensive Armour ;) my conversion is poor when I take levo only, but when I go on NDT I add a tiny amount of T4 and it converts like crazy. No logic. Like you I tried more t3 less t4 on synthetics, I was anxious, apathetic, lost weight, but was shaking all the time and also not sleeping. I think my only way forward is to wait for blood test next week and then most likely to add levo, reduce NDT a bit (maybe would add that bit of levo at night so I don't experience terrible symptoms the first few hours in the morning!).

jrbarnes profile image
jrbarnes in reply to

The fact that I'm sleeping better and feeling stronger by quitting the T3 and increasing my Levo tells me this is what I needed. I would rather get my T4 levels to a point where I feel strong and stable when I wake in the morning and then add a little bit of T3 to it. Maybe you can approach it that way because perhaps having just a little T3 in the mix helps. I read this approach in an online google book "Functional Approach to Hypothyroidism, Dr. Kenneth Blanchard." He says that he'd have patients come to him on Levo only with a TSH still lingering around 1.5 and he'd add just a little T3 to the mix or 1/4 grain. For me to get my TSH somewhere around 1.5 that means I need my T4 nice and real high and that doesn't make me over medicated. Some people need higher T4 and you'll feel terrible no matter how much T3 you add. I realized that I don't necessarily have a conversion problem because you can't have a conversion problem if your body has a set point to how much T4 it needs to convert into T3 and you're not getting enough T4. If I push my T4 from 82% in range up to 113% my T3 goes from 38% to 70%. If someone were to look at my T4 levels at 82% and see that low T3 of course they would say my conversion is poor. I know I'm rambling and this may not be your situation but considering you're having such a hard time with NDT and it follows the symptoms I was having it's something you might want to consider. Obviously ditching T3 and raising Levo for the first three days was extremely rough but here I am four days later with decreasing anxiety and better sleep. I still have the stiffness because it takes several weeks for the T4 storage and conversion . At that point when I level out I might need to reduce a little or add a small bit of T3.

in reply to jrbarnes

If you were good with such high levo and high ft3, you could be successful with this protocol. I have moved from Nature Throid to Levo back in 2019, February. I suffered a lot, was very hypothyroid. Only got some relief wheh I started to add t3. But synthetics didn't suit me, I had stiffness, water retention, gaining weight, exhausted, brian fog, etc. I definitely need more NDT than levo in my case. Now just need to balance it nicely. My tsh is always 0, even if I take nothing, with ft3 ft4 low.

jrbarnes profile image
jrbarnes in reply to

I don't like this synthetic T3. It feels nothing like the T3 in NDT. I had anxiety over taking NDT since Nature Throid was completely removed during the recall. I was on NP Thyroid and that stuff was great because it had limited fillers and I'd feel good within 30 min after taking it but again how do you make it work if one dose is too high and the other too low. Makes logic sense to add on some Levo but then I felt over medicated. NDT + Levo is a tricky one because it doesn't always go the way you think it should.

in reply to jrbarnes

Absolutely, for me it was like rocket fuel. Same with Armour, I feel it working within 30 minutes, but as you say, how do make it work if you feel still cold, dry, hypo with high ft3. I feel quite overmedicated today, when I took my dose my pulse went up to 92, frequent toilet visits..., tremors. It almost never goes to plan!

jrbarnes profile image
jrbarnes in reply to

I'd like to know how doctors handled this when NDT was the only option. Did they have people take a smaller dose for a few days and alternate to get the T4 levels right? I guess people had to learn to deal with being over medicated. My blood pressure was messed up. I was dizzy, sweating and couldn't do anything in my yard. I dropped down 1/4 grain and a week later had to go to urgent care because my wrist was swelling and painful. I couldn't touch it to anything and my fingers were sausages. my face was swelling.

in reply to jrbarnes

I honestly have no idea, but my guess is it didn't suit everybody, plus ratios were variable, especially if this was a cooked thyroid people were eating (sorry , it's a bit graphic!). I'd day not everyone was properly medicated on it. You know I worked up to 4 grains of Nature Throid before I had to reduce, but it did suit me for a few months, same 3 grains, took it for 6-7 months. What you have described is how I feel. The lack of balance is terrible. I do have to admit that I did try to take most of my Armour 2.375 grains in the morning, and then remaining 1/8 an hour or two later and didn't have tremors back then in December, but taking it together, gave me tremors within 5 hours of my dose. But also, I was very tired when splitting , probably because ft4 already low at 24%, splitting made it worse!

jrbarnes profile image
jrbarnes in reply to

I only wish they had different ratios available in NDT. I've never tried a thyroid glandular but decided to order one. I'm curious if it will give me some of the benefits without the active hormones. When I was on two grains I had to split it three times a day because it was too much T3. That's what I did with NDT just dosed up until I was over medicated then I reduced down to 90 and felt amazing for a week but then terrible after that week. I tried to recreate that with synthetics but didn't feel the same. I think I benefited from more T4 and after a week it was gone. Right now I'm dealing with that low T4 storage and it gets worse at night. I hope after 4 weeks it gets better. Hopefully you get yours worked out because no sleep is maddening.

in reply to jrbarnes

Yeah wide awake again. I had tremors most of today, anxiety, restlessness, frequent toilet trips, stiff neck, nervousness all within 5 hours of taking meds. I think I need to reduce something to feel better. I can handle not sleeping until 2 am, but 5 or 7 am is excessive. I'm wired all day, running on adrenaline. It has to be my ft3. Tried increasing NDT, adding less t4, more t4, I end up feeling more overdosed. I think I should decrease as I am losing the will to live at this point! What is exactly happening with the t4 storage?

jrbarnes profile image
jrbarnes in reply to

That's why I had to switch back to Levo. I couldn't handle the ups and downs of NDT and couldn't figure the stuff out. It's so challenging to get this right.

in reply to jrbarnes

I understand. I will stick with it, because on the rest I don't feel good at all, so I see it as my only viable option, but will need to be brave to tweak it finally. I might wait until my blood test on Monday to see where I am now. My experience so far is that levo is stronger than t4 in NDT, when I add it to NDT, it can be too much, so I need to lower Armour proportionally. I think it is also me being stubborn sitting on a high FT3 trying to make it work, I think this is why I get symptoms within 5 hours of taking the dose. I have also noticed that the last two days I felt worse after taking NDT, because I took it really late in the day and yesterday I did split it. I took it this morning and it is better in a way. Will monitor it. In the past in 2015 or 2016, felt amazing on Armour, so maybe I need to be more patient. I am recovering after 3 years of bad medication, overdose and hypo states. I found that NDT works slower for me than the other meds I tried. Even the smidgen of Levo I added before Xmas is only fully working now, a month later. Only back on Armour since September 2020. In the end, my endo said he will try adding t3 to lowered Armour as a lest resort, that would be interesting! Also, my cholesterol only lowers on NDT...Let's see what happens. So many thoughts! I hope we will both feel well soon! Editz: writing this post made me realise something. I feel hyper, loads of racing thoughts, completely restless!

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