Need help - overmedicated on T3

[Msmustang1981]

After a week of feeling extremely bad, I finally got my lab results back today showing I am overmedicated on T3 only. My doctor has offered no guidance on what to do next. Can someone please tell me how long I should let this clear and when I should resume? I was taking 30mcg daily. My labs two months ago on that dose showed me 50% thru the range and now it is showing me at the top of the range.

Free T3: 4.2 (2.3 - 4.2)

TSH: .34 (.4 - 4.5)

Free T4: not registering

My symptoms are abdominal pain, diarrhea, shortness of breath, palpitations, shakiness, depression, extreme fatigue, no energy.

Obviously I will not take today’s medication. My doctor previously mentioned wanting me to try T4 again since I am now medicated for adrenal insufficiency and might tolerate it better. How should I go about adding that in if I totally abandon T3 today? Do I wait for the excess to clear or is it safe to start T4 now since it takes awhile to build up and start converting to T3? I am miserable! Thank you!

[SlowDragon Administrator]

Very unlikely over medicated on only 30mcg T3 per day

How do you take your T3

As single dose or split as 3 x 10mcg at roughly equal 8 hour intervals

Was test done early morning, ideally before 9am and last 10mcg dose T3 approx 8-12 hours before test

Just T3 doesn’t suit everyone

You may need addition of levothyroxine

Suggest you consider reducing T3 by 5mcg and adding 25mcg levothyroxine

Retest in 6-8 weeks

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

What vitamin supplements are you currently taking

[Msmustang1981 in reply to SlowDragon]

Spacing it out throughout the day left me feeling poorly, so I started taking it all it one go in the morning. The day before, I split the dose taking the last 10mcg exactly 10 hours before testing. Test was done at 8:30am.

I supplement Vitamin D with magnesium and k2. I was previously deficient but it has brought my levels up to 45 (range: optimal >30)

I also supplement B12. My level is 1547. Range 200-1100

Folate is 10.2. Range 2-20

Ferritin 80. Range 16-154

I also take hydrocortisone for secondary adrenal insufficiency. Before this, I couldn’t tolerate thyroid hormone. My free T3 was always 50% thru the range on this dose, but now100% thru the range and I feel like garbage. My doctor would like to see me add in T4 but of course has given me no guidance on how to lower T3 or what amount of T4 to start with.

I’m in the United States in cases the ranges look strange to you. Thanks for any guidance!

[SlowDragon Administrator in reply to Msmustang1981]

So you need to change dose cautiously is on steroids

Everyone is different on what suits each person

If you feel Ft3 is too high….reduce T3 by 5mcg

Add in 25mcg levothyroxine

Do you have autoimmune thyroid disease? Hashimoto’s

[Msmustang1981 in reply to SlowDragon]

I never have antibodies that show Hashimoto’s, but I do have nodules and other autoimmune stuff, so my doctor has always said it most likely is Hashis without the positive test. I just had a thyroid ultrasound this week too and for the first time ever the thyroid has shrunk a lot. Doctor is baffled.

If I reduce the T3 by a little, should I space it out when I add in the T4 or take it all together? How long does it take for the T3 level to drop? I didn’t take anything yet today. It seems now with the hydrocortisone, the thyroid med is working too well! Plus all of the vitamins and nutrients seem to have optimized.

[SlowDragon Administrator in reply to Msmustang1981]

Trial and experiment what suits each person

T3 levels drop rapidly

[greygoose in reply to Msmustang1981]

I just had a thyroid ultrasound this week too and for the first time ever the thyroid has shrunk a lot. Doctor is baffled.

Doesn't take much ot baffe a doctor, does it.

If your thyroid is shrinking, you more than likely have Ord's. Ord's is Hashi's without the goitre:

With Hashi's thyroid swells (goitre).

With Ord's thyroid shrinks.

[Msmustang1981 in reply to greygoose]

Nope, doesn’t take much. My doctors call me a zebra repeatedly. I feel like telling them they just don’t know a whole lot. Ords sounds like it could be it. Would it just start after 10 years of having hypothyroidism?

[helvella Administrator Thyroid UK in reply to Msmustang1981]

Ironic that doctors see things in such a black and white way - then go on about "not zebras but horses".

[SlowDragon Administrator]

Loads of people with autoimmune thyroid disease have Ord’s thyroiditis …..where thyroid shrinks and shrivels up

[Msmustang1981 in reply to SlowDragon]

That could very well be it. My doctor said it was because I’m T3 only but I don’t see how. Thanks so much for all of your info!

[shaws Administrator in reply to Msmustang1981]

Quite a number of GPs would blame T3, as they don't think it's much good and it is dearer than levothyroxine.

[Msmustang1981 in reply to shaws]

Mine will really hate the T3 now that I made myself feel bad being at the top of the range. 😞 between that and the increased liver enzymes, she wanted me to stop T3 all together the other week and immediately switch over to 125mcg Levo. No thank you.

[shaws Administrator in reply to Msmustang1981]

I think that because GPs seem to be told that levothyroxine (T4) is the best replacement for those patients who have hypothyroidism. It is also not expensive.

All levo did for me was to have many overnight recordings for the Cardiologist, who was trying to figure out why I had severe overnight palpitations. Sometimes pulse rate was 144+. Not pleasant at all.

When T3 was added to T4, palpitations reduced but when I took T3 alone that resolved all palpitations and I have taken T3 alone for sometime now.

[Msmustang1981 in reply to shaws]

Simply amazing what works. I felt so much better ditching the T4 as well.

[shaws Administrator]

I felt my body was at war as I had developed symptoms that I hadn't had before. Considering that few GPs are knowledgeable about how to restore their hypo patients' bodies we, the patients, struggle.

T4 is an inactive hormone and is supposed to convert to T3 but many of us don't seem to do so. Why not just prescribe the 'active' thyroid hormone (T3).

Many hypo patients recovered their health on NDTs (natural dessicated thyroid hormones) prescribed since 1892 and people didn't die from then on. It was withdrawn without any notice in the UK and many people were panicked.

Then levothyroxine (T4 only) was invented and should convert to T3 but I think many people aren't able to. I am one as I felt awful.

Considering I had to diagnose myself one day after GP had phoned to say my blood test was fine and I had no problems (he didn't know what a TSH of 100 indicated).

[Msmustang1981 in reply to shaws]

That is so sad. I can’t imagine how poorly you felt. I’ve spent so long feeling sick and it makes me cry thinking of all that time wasted. I felt great on T3 only until now I didn’t. I’ll try lowering it a bit and going from there.

[shaws Administrator in reply to Msmustang1981]

Sometimes, (I think) is that when we've been taking a thyroid hormone for a while that has relieved our symptoms we are puzzled when some symptoms return (or are new).

Maybe the pharma company who produced the particular thyroid hormone replacement may have had a small change in the tablet that could have a negative affect.

thyroiduk.org/?s=excipients