Can high T 3 cause all over body tremor?

[smilingjane]

Hello thyroid comrades

At the New year I had 36 hours of all over horrendous body tremors. It was resting tremors so I couldnt lie down. I could sit but only for a few minutes. So, I was constantly having to walk around.

At the time I thought it was an extension of my restless legs/limbs, which is normaly controlled with medication.

My GP suggested anxiety?

Bloods taken at the appointment were:

TSH - 0.05 - (0.3 - 4.05)

T4 -20.03 - (10.00 - 22.00)

T3 - 8.9 - (3.1 - 6.8)

I currently take 100ml T4 and 20 ml T3 daily.

It hadnt occured to me untill I saw these rather high T3 result that it could be the cause of my tremor. The GP didn't mention it.

In fact now I think about it my thyroid and all night RSl started during pregnancy 30 years ago.

My RSL went down after the birth to 2 hours a night until 3 years ago, when it became 24/7. A nasty affliction.

Does anyone elso out there have these 2 diseases. I know that everything is connected but I am wondering whether there is distinctly close connection between Rsl and Thyroid disease?

I have reduced my T3 to 5mls daily and will discuss with my endo in April.

Ps. Follate and Ferritin are fine.

I would welcome anyones thoughts and experience.

Many thanks

Jane 😊

[SlowDragon Administrator]

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Day before test did you split T3 into 3 smaller doses through the day and take last 1/3rd of daily dose 8-12 hours before test

RSL is frequently linked to low magnesium and/or low ferritin

What vitamin supplements are you currently taking

Please add most recent results and ranges for vitamin D, folate, ferritin and B12

We need OPTIMAL Vitamin levels on thyroid replacement hormones

[smilingjane in reply to SlowDragon]

Hello SD

I hadnt had any meds for 2 days prior to the blood take, (too ill to think about them).

My B12 is high, I SI B13. weekly. I take D3 sub lingual and the rest of the usual vit needs are fine. I take Magnesiun too.

Do you think the high T3 could have caused the full body, 36 hour tremor? Is this something you have come across before?

It was a shot out of the blue for me. Never had anything like that before. I was scared I had MS or Parkinsons. I was given a full nureological test and that said no.

🤔

[SeasideSusie Remembering in reply to smilingjane]

smilingjane

T3 - 8.9 - (3.1 - 6.8)

I hadnt had any meds for 2 days prior to the blood take, (too ill to think about them).

With FT3 that high and no T3 for 2 days beforehand, I dread to think what your FT3 would be taking your T3 as normal. I think there is a good chance it's a very high T3 level that could be involved with your tremors.

In May 2021 you had the following results

TSH O.08 iul/L ref (0.27-4.2)

T4 12.7 pmol/L ref (12-22)

T3 7.02pmnl/L ref (31-6.8)

and you suggested that you wanted to try T3 only. Responses to that post suggested that you increase your Levo and lower your dose of T3. If I had read your post and responded that's why I would have suggested as well.

[smilingjane in reply to SeasideSusie]

Thank you Seaside Susie

Yes that makes absolute sense.

What would you recommennd dose wise until I have my endo appointment?

Another thing to mention here which rather complicates matters, is that I stopped taking my eostrogen gel and progestrogen 2 months ago.

I have read that when taking HRT some people need higher thyrood meds.

So perhaps my T3 wouldnt have been quite so high 2 months ago? Just a thought ....

🤔

[SeasideSusie Remembering in reply to smilingjane]

smilingjane

I'm afraid I can't advise or recommend what you should do about your dose I can only give thoughts on what I might do in the same circumstances.

I currently take 100ml T4 and 20 ml T3 daily.

I have reduced my T3 to 5mls daily and will discuss with my endo in April.

So what exactly are you taking, you have given two different doses of T3 there.

Do you take liquid Levo and T3? Liquid comes in ml and tablets come in mcg.

Have you got actual current levels from a new test done very recently? If not it might be a good idea to test TSH, FT4 and FT3 following the advice we always give about timing of doses beforehand. Once we see current levels and know exactly what you are taking and when last doses were when tested we can make more appropriate comments.

[smilingjane in reply to SeasideSusie]

The blood test results are from 3 weeks ago as the tremor was happenning.

Sorry my mistake re currant dose. I have been taking 100mls T4 and 10 mls T3 daily.

From today, I thought I would try either 5 mls a day (hard to split a pill) and continue with 100 mls T4 or take 10 mls T3 every other dsy, keeping T4 as it is.

Thank you for your thoughts

😊

[SeasideSusie Remembering in reply to smilingjane]

So you're taking tablets, then they are micrograms (mcg) not millilitres (ml) which is used for liquid. If it was liquid it might have been easier to get a much smaller dose.

No point in taking T3 on alternate days, as it only has a half life of 24 hours then we need to take the same, unchanging amount every day.

If it was me I'd reduce T3 to 5mcg daily.

Your FT4 was also high in range considering that you hadn't taken any of that either for 2 days. I think overall you were quite overmedicated.

It's not normal to reduce both Levo and T3 at the same time, we need to know what each reduction does. So personally I'd reduce T3 to 5mcg, it may be OK to test 2 or 3 weeks later as changes with FT3 level are often quicker than FT4 level when we change dose of Levo. See what your FT4 and FT3 are then and decide on the next step.

[smilingjane in reply to SeasideSusie]

Thanks so much, that makes absolute sense.

I will reduce my T3 to 5 mcgs and test again in 3 weeks.

I may ask my endo if liquid Liothyronine can be prescribed in my next appointment and we will see what to do next.

Thanks you for your expert opinion

😊

[SeasideSusie Remembering in reply to smilingjane]

Liquid T3 is more expensive than tablets, you're unlikely to be able to be swapped over unless there is a particular need.

[smilingjane in reply to SeasideSusie]

Theey are so difficult to cut. I usually end up with a little pile of powder and a 2/3rd tablet. I will buy an art cutter.😊

[SeasideSusie Remembering in reply to smilingjane]

I don't think that will be considered a good enough reason. Liquid thyroid hormone is generally only prescribed if the patient has adverse reaction to fillers in tablets.

I think there are some brands of T3 tablets that state that if less than 20mcg is required then the tablet is crushed, dissolved in water and the amount required drawn up into a syringe then the leftover solution disposed of. So I can't see your reason being an acceptable one to prescribe liquid T3. (I am assuming it's made in liquid form but I haven't checked, I do know that levothyroxine comes in liquid form.)

[Digger031145]

I would think it’s the over range ft3 that is the problem.But did you make sure you left 12 hours from last dose of T3 to blood test?

Early morning blood test with no meds and no eating or drinking anything other than water before the test

[smilingjane in reply to Digger031145]

Thanks 130396

I was so poorly that I hadnt thought about meds prior to my appointment. My GP took my bloods. It was early in the morning on an empty stomach. I hadnt had any thyroid meds for 2 days prior to that.

😊

[tattybogle]

So these bloods were on 100mcg levo +20mcg T3 , (but with no levo or T3 taken for 2 days prior to test ) ?TSH - 0.05 - (0.3 - 4.05)

T4 -20.03 - (10.00 - 22.00)

T3 - 8.9 - (3.1 - 6.8) ...... I dread to think what T3 , (and T4) levels were on the days when you were taking your levo +t3.

So knowing this , I would think its almost certain that your fT3 levels were responsible for 'all over 36 hr body tremors'... and i'm astonished that the Doctors didn't mention your high T3 level in connection with your symptoms .

Did they know you had been taking T3 ?

Did they know you hadn't taken any for T3 and Levo for 2 days ?

So you've now reduced to 100mcg Levo +5mcg T3 ?

Good idea for the time being , but you REALLY need to get a proper test done (12 hrs from last dose T3 / 24 hrs from last dose Levo ) so you know what your usual T3/T4 levels are on the dose you are taking ..... waiting till april, and just guessing in the mean time, really doesn't sound like a good idea to me .

[smilingjane in reply to tattybogle]

Definately.

I will arrange blod tests after Ive seen my Restless Legs specialist on Monday. And I will bring my endo apointment forward.

Thanks for your advice and insight

😊

[smilingjane in reply to tattybogle]

Btw, t3 was 10ml daily not 20.

[tattybogle in reply to smilingjane]

Ok so your dose before those tests was also 100 Levo +10 T3 ?

Have you still been taking 100/10 until today ... and do you feel OK ?

Honestly , with those results after 2 days off any T3 , and with what happened re the tremors , i'd be worried about taking any T3 at all at the moment , you seem to have more than enough <<edit, sorry corrected my mistake , see below >> ..... so yes, certainly reduce it to 5mcg.

T3 doesn't have a really long half life in the blood like T4 does ..... so you can't take alternate days doses of T3 like you can with Levo ..... you would need to cut tablet to get 5mcg a day , even if it's difficult .

To get a true blood test for TSH we need 6 weeks on unchanged dose ,but in your case i thing it's more important to reduce T3 dose today , and you also do need to get a test as soon as possible .

[tattybogle in reply to tattybogle]

edit . sorry, my mistake .....

your fT3 was 7 when previously on 100mcg Levo + 20mcg T3 healthunlocked.com/thyroidu....

and you previously had fT3 5.8 ish on either 5 or 10 mcg T3, ( were unsure of previous dose at time of posting those results)

[smilingjane in reply to tattybogle]

No, the question about whether I had taken my medication wasn't asked, or what I took. I am sure the doctor would have checked my meds on screen.

This demonstrates yet again how little GPs know about thyroid disfunction and how to manage it

[humanbean]

Can you translate what RSL and RSI mean, please.

[smilingjane in reply to humanbean]

Sorry!Restless Leg Syndrome for both

😊