Hypothyroid with adrenaline surges

[kv1027]

Hi All,

I have a history of total thyroidectomy (2006) and was on T4 till 2016 and made the transition to T3-only in 2017.

While getting on T3-only, I have not been able to take my optimal dosage (75-100 mcg) due to adrenaline surges / anxiety feelings.

It took us a while to figure out these are adrenaline surges and since then I have tried the following 

1.) 5HTP worked initially as I started with 50, with a gradual increase to 300mg. However, as soon as I hit this dosage, the adrenaline surges came back. Reducing the 5HTP (or stopping and starting with the minimal dosage) didn’t help …I couldn’t tolerate more than 25mcg of T3

2.) A month and half ago, I started on beta blockers:

2a. First up was bisoprolol which didn’t work, tried that for 3-4 days that made symptoms worse. 

2b.Shifted to Propranolol. The build up from Zero to 60mg over a week was good and I started seeing reduced adrenaline rushes…however, as soon as I got to 100mg a day (20*3, 1*40), these rushes came back

3.) A week ago, I was prescribed Zoloft (Sertraline) with half a tablet a day. I have been weaning off Propranolol but last few days have felt very up and down, with waking up with adrenaline surges

The pattern across all of above - these approaches working for some extent, and then ceasing to be effective (or even turning negative) makes me think there’s something obvious being missed.

Anyone has had a similar experience and/or able to shed any light ?

Any inputs on any other medicines that helped curb adrenaline long term and take a normal thyroid dose ? 

Thanks so much for your help

[J675]

Have you had your cortisol levels checked?

I was on combo with only a small amount of t3, but I've had to stop taking it a few weeks ago because of the extreme anxiety that I was getting. I'd been doing well on a stable (ish) dose for a few months but due to some pretty full on lifestyle changes, my already low cortisol level has now dropped really low. I was getting shakey, tense, chest pains, migraines and all those other wonder things that go with intolerance, which have now eased a bit with stopping the t3.

[Lalatoot]

Kv you dont say why you switched from levo only to t3 only. It could be that this is your body telling you that this is wrong for you.

Some folks are well on levo only, some on t3 only and some of us need a combo of levo and t3 to be well.

It may be that your body needs both levo and t3.

[kv1027 in reply to Lalatoot]

I was on Levo only for many years post my TT, with severe drug resistant depression. It improved slightly with as I tried switching to NDT but went away completely only when I switched to "T-3-only".

I tried Levo + T3 couple years ago. I was relatively stable on my T3 dosage at that time, and my endocrinologist suggested adding a small dose of T4 as we were trying to get to an optimal dosage. Unfortunately, the combination didn't work with massive surges after a week. I had to go back to T3-only after this

[Jazzw]

How are you taking your T3? I’m wondering whether splitting it into multiple doses spread evenly throughout the day would help you at all.

Also, what are your ferritin levels like? I’ve noticed that many seem to struggle with T3 when ferritin is low.

Would also be worth making sure levels of all sorts of things are optimal too—B12, folate, Vit D etc (as these tend to plummet when one is undermedicated).

[kv1027 in reply to Jazzw]

Yes Jazzw, I am splitting into multiple doses according to Paul Robinson's books. Ferritin and Iron are okay (I supplement regularly)

The surprising bit it all that I have tried (5HTP, Beta Blocker), has worked initially and then sort of stopped working, which makes me wonder, if am breaching some threshold. If that is so, hoping someone might have solved this issue earlier...

fingers crossed

[susieibbo1]

just a thought, have you read any of Paul Robinson’s books. His 3 books ThyroidPatients Manual, Recovering with T3 and The CT3M Handbook. Have you had a cortisol saliva test. Do you have low cortisol? Hope you work it out. Susie

[kv1027 in reply to susieibbo1]

Yes susieibbo1, Paul Robinson's books were instrumental in guiding me to the T3-only way - very grateful for all the knowledge I got from there. As for the cortisol, yes the values were all okay, that's how we got to know about mine being an adrenaline issue

[susieibbo1 in reply to kv1027]

I am trying to understand it all!! Quite complicated. I have hashimotis and low cortisol. I take T4/T4 combo . Here’s hoping!!! Susie

[Eliotf]

I am not sure why you would only be on t3 unless your body is not converting the t4. I take T3 & t4. I take 137mcg of t4 and 5mcg of t3. the mount you are taking of t3 seems very excessive. I have not had a thyroidectomy, but my T4 and my TSH levels were normal, but I still felt the same as if I was not taking enough t4. So my Doctor put me on t3 and dropped my t4 dose by a lot. after a few months, I was great till the afternoon when my energy levels slumped really bad. So he told me to take the t3 (5mcg) around noon-2pm and see how that works. It works great. As with t4 I have to take the t3 with no meal prior for 2 hours and one hour afterwards. So I found my balance to take it about 12:45pm. T3's half life is about 4-6 hours. T4's half life is about 10-15 days. When I first starting taking the t3 it was a great speed boost like drinking a bunch of caffeine without the jitters. Now I don't notice that part of it. I can take my t4 & t3 in the am and still go back to sleep if I am still tired. SSRIs and some other mood stabilizers directly affect the T4 update. This is why I went to Wellbutrin. Any change of dosage of the SSRI (when I was taking it) caused me to increase my T4. Remembering that I am not a doctor, no do I play a doctor (outside of my house), first go to an endocrinologist who specializes in thyroid. cut way back on the 3t because that does feel like speed. Get your t4 at normal levels. My understanding is that the TSH levels may always be off because of no thyroid. Balance all of that with how you feel. T4 takes a few weeks to feel something. T3 you feel the change probably the same day, but give it a week to get used to