I had a thyroidectomy years ago and have been on T4 (levo) only for majority of the time, I sourced NDT to try get some T3 but found I had high reverse T3.
I am now taking 100mcg T4 (levo) and started T3 (liothyronine) but find I am very sensitive to the T3. I started with 5mcg in the morning with the T4 and have just introduced 2.5mcg in the afternoon.
I can feel as soon as the T3 is absorbed, tingling/warm sensation in my chest, racing thoughts and unable to relax. I also find I’m agitated and have a very low level of patience and no tolerance to noice/conflicting sounds. I go through a range of emotions too. This lasts for about 1.2 hours and then symptoms disappear.
I’m due to test again on Monday, but wanted to find out if it’s normal to have the symptoms in the beginning and if it will settle after time and building resilience?
I do have high cortisol until 11am when it drops. Testing blood cortisol on Monday too to compare (initial test was saliva) . I’ve attached my results for thyroid and cortisol taken two weeks ago before adding T3.
Any advice would be appreciated.
thank you x
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Thyroid_mum
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High rT3 is the result of excessive T4.....dose too high or poor conversion.
It sounds as if you are not adequately converting T4 to T3 with resultant low FT3...
I cannot see any thyroid test results here.....only cortisol.
Without a full thyroid test it is almost impossible to say what is going on.
Full test ...
TSH, FT4, FT3, vit D, vit B12, folate, ferritin and thyroid antibodies TPO and Tg
If your FT3 is low then adding T3 may naturally cause the reaction you feel , and call "hypersensitivity to T3"...but without full labs we can only guess.
Hi DippyDame, thanks for your reply. attached is the thyroid results, seems you can only add one image at a time on a post. I do have a conversion issue.
hello SlowDragon, thank you for you reply and I feel reassured as it is definitely whoosh feeling.
Test was done early morning, T4 was taken 24 hours before but I was on NDT 3 times a day (for some t3 and now I know it’s mainly t4) there was 12 hours between last dose of NDT and test.
I’ve slowly reduced the NDT I was on in order to add the T3.
I did thyroid and vitamins test in September, this was when I started reducing the NDT and T4 (which was at 200mcg) to start T3 as reverse T3 was high and hypo symptoms
I was on 200mcg levo, 3 65mcg NDT. I am now on 100mcg levo, 5mcg T3 in the am, midday an NDT and in the later afternoon 2.5mcg T4
I take vitamin ADK, women’s multivitamin, Omega 3, Oxytech (magnesium), resolor (to go to the toilet) Pharma GABA and ashwaghanda.
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
Calm vitality magnesium powder is cheap and easy to use. Great for constipation. Best start on low dose and increase until get desired effect. Too much can cause diarrhoea
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.
once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
September test results that i posted on your reply I was on 200mcg levothyroxine and have gotten the same script monthly on the NHS. I sourced my own NDT which was raw bovine and i was on 4 tablets a day (65mcg each tablet).
The latest test results posted on my initial post I had reduced the levo down to 100mcg and the NDT down to 2 tablets a day.
The T3 i have been prescribed is Liothyronine 20mcg (Thybon henning which is lactose free) and I use a pill cutter to cut into quarters to get the 5mcg / 2.5mcg
I started the T3 eight days ago and have dropped the NDT down to 1 (will eventually drop entirely) but was advised to do it slowly.
I dont know how much T3 I am aiming for, my goal is to be optimal with T3 & T4 with low Reverse Rt3 (or in range RT3) but was worried about the Whoosh when introducing the T3😅.
I take the first dose at 6am with the T4. At the moment the second T3 dose in the afternoon (4pm) at 5mcg is too much so I have halved that to 2.5mcg and will try increase it to 5mcg in the afternoon in two weeks and see how I react.
Thanks for the advise on the 6-8 weeks to retest.
Hopefully my levels are going in the right direction.
hi SlowDragon hope you’re well. I took bloods on Monday to see what my levels were at for T4 and T3. These results are looking better, still not optimal for T3. I was on 100mcg levo, one NDT 65mcg and 7.5 mcg of T3 at the time of testing, 24 hours between the levo and 12 hours between T3.
I have since dropped the dessicated and upped the T3 to 10.
Dr said to increase the T4 to a 150mcg (as I’ve dropped the NDT) and increase the T3 to 15mcg (3 x 5mcg 3 times a day) we will retest in Jan after 6 weeks on this new dose. A full thyroid panel including vitamins and RT3
I hope it’s okay to ask your thoughts with these results and the next step?
I too had similar symptoms when I started T3 but my ' whoosh ' became a headache and it felt like my head was being constrained in too small a size of a bowler hat and my patience nonexistent.
I stopped as I frightened myself and after a month of T4 monotherapy started self -medicating with NDT and it was a much smoother transition.
I am much improved and can only describe the difference as being like now wearing slippers instead of shoes two sizes too small.
No thyroid hormone replacement works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal and through trial and error I now seem at my best with a ferritin at around 100, folate at around 20, active B12 75++ ( serum B12 500++ ) and vitamin D at around 100.
Other contributing factors to consider are inflammation, any physiological stress ( emotional or physical) depression, dieting and ageing as these too can down regulate T4 to T3 conversion.
My reverse T3 was over range ( I'm Graves post RAI thyroid ablation 2005 ) but once I switched to a much more balanced regime of full spectrum thyroid hormone replacement this excess T4 simply disappeared.
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Will a decrease of 1mcg t3 be enough to replace with 12.5mcg t4? 
Anyone supplementing NDT with T3?
T3 or Not T3, that is my question?
Will adding T4 push my T3 too high?
Do high levels of T3 have to potential to shut down T3 receptors?
