From Hypo to Hyper... Too much T3 concern

[joey82]

Hi,

I'm concerned I've gone from a hypo state to hyper. My endo put me back onto T3/T4 combination replacement 2 weeks ago and I am now concerned I've gone to a hyper state. I was undoubtedly in a hypo state a few weeks ago but today and this afternoon especially I have started displaying the symptoms of a hyper state.

I am getting heart palpitations and I cant see properly. I'm also jittery and agitated with bad brain fog and lack of metal clarity. This is the first time I have felt like this since dealing with hashimoto's and have previous blood tests with elevated T3 and feeling very well.

Does anyone have a similar experience or advice they can offer?

I have just had two virus/cold's/sickness bugs one after the other and an operation last Friday where is was under general for a few hrs so I may be getting confused an worried.

Often when I have adjusted my dosage in the past there may be a few weeks of feeling rough before things have settle down so that may be playing a part.

I think I will order a medi-checks test tonight...

Any advice would be much appreciated.

[Jaydee1507 Administrator]

I'm sorry to hear this Joe. What dose of Levo were you on and what have you switched to?

How did you do the switch? Recommended here to lower Levo dose for a week or two then add in 5mcgs T3 for 2 weeks before adding a further 5mcgs T3. Making the transition too quickly can give adverse effects.

[joey82 in reply to Jaydee1507]

Thank you. Was 175mcg daily, then to 175 daily with 10mcg daily.

[joey82 in reply to Jaydee1507]

switched the next day.

[joey82]

PS: Now on 10mcg T3 and 175mcg daily. Up from 175 daily two weeks ago. TSH was very low, T3 90 of range, T4 140% of range I think from memory.

[Jaydee1507 Administrator in reply to joey82]

I'm surprised the Endo didn't suggest that you dropped any Levo, especially with an over range FT4. You might want to ask them about that. You might want to think about dropping up to 50mcgs Levo.

[Jazzw in reply to Jaydee1507]

I was thinking the same, though a 25mcg drop in levothyroxine would probably do it. 50mcg drop is too much in one go (at least, it would be for me).

[Jaydee1507 Administrator in reply to Jazzw]

Yes you're right, 25mcgs a better amount to drop.

[Jaydee1507 Administrator in reply to joey82]

Just to refresh you these were the last results you posted, presumably on 175mcgs levo.

Free T4 (fT4) 26 pmol/L (12 - 22) 140.0%

Free T3 (fT3) 6.46 pmol/L (3.1 - 6.8) 90.8%

Most people on a combo of T4+ T3 would need their results at around 60-70% of range to be optimally replaced.

[joey82]

Thank you guys. It was an aggressive change but was pulling comparison with a result of the brief good spell I had last spring/summer.

If I drop 25 or 50 mcg from my t4 then I will be back on the dosage I was on late last summer / autumn and I was still very unwell. So I have my doubts that would work if I'm being honest.

I think I'm going to change to 10mcg every other day. I feel like I'm going through hell again. At least my tinnitus has been better the last week...

I'm going to try and join the local support group recommended to me in the the thyroid UK info pack I ordered last week.

[Jaydee1507 Administrator in reply to joey82]

I think you've only recently started to correct vitamin levels as per blood results. It can make all the difference getting the key vitamin levels to optimal.

Did you switch out the folic acid for methylfolate? Many people cannot use folic acid as it requires a conversion for the body to use properly.

T3, being an active hormone is one that needs to be taken regularly at the same time of day, every day.

[joey82 in reply to Jaydee1507]

I have started focusing more on my vitamin levels in the last 2/3 weeks and will continue to do so. No I didn't make that switch but I'll look into it. Ah OK, thank you.

[joey82 in reply to Jaydee1507]

I eat folic acid in the form of parsnips and leaks as well.

[Jaydee1507 Administrator in reply to joey82]

Unfortunately we can't rely on foods for vitamins due to poor absorption.

[SlowDragon Administrator in reply to joey82]

T3 - You can not take different dose on different days

T3 must be EXACTLY same dose every day

Either reduce levothyroxine by 25mcg per day or reduce T3 by 5mcg per day

[joey82 in reply to SlowDragon]

If I go down T4 by 25mcg daily I'll be back where I was last November and I didn't feel good at all.

My current T3 is in capsules not pills so I can't cut them. Can I split the capsules and tip the powder into 10 millilitres of water and drink 5 mil?

[Reefseeker in reply to joey82]

If it's the Roma capsules, they can be split (I was allergic to the gelatine so had to split mine). The problem is it spills and makes a mess and IMHO you don't end up with the full dose.

[Fefe09]

I know how you feel . I was diagnosed around age 17 of being hypo. Then at age 27 I went on a really strict diet and hardly ate enough for a mouse. I lost 75 pounds in 9 months and my hypo flipped to hyper. My eyes were bugging my heart was racing etc etc. The doctor stopped my meds immediately and put me on something for hyperthyroidism. He told me this medication was a temporary fix but I would need surgery to remove my thyroid or to swallow the radiation pill. Anyway after stopping my diet it switched back to hypo and I have been that way till this day several years later. Anytime you have stress like sickness or work or family and you have thyroid problems it can make things worse. Also you have to be careful what supplements you take and what you eat when you have thyroid issues. It’s a constant battle. I just pray for energy everyday. I think diet and having support from friends or family helps. It’s no fun but we just have to play The cards we are dealt. Most doctors have no clue about how to treat the thyroid so if you find one that is good then your a winner already. I pray you get it under control.

[joey82 in reply to Fefe09]

It's been an awful journey so far. How are you feeling now? What hormone replacement are you on?

[Fefe09]

I feel like a zombie . I can hardly get off the couch. No energy and body aches. I’ve been on levothyroxine and synthyroid for 30 years and hasn’t helped me but every doctor I go to will tell me well your levels are good . Im thinking about trying the armour . I’ve heard good and bad but I want to live a little before i die. I pray you find something that works for you. I keep hoping for a miracle drug or cure. It has affected over 20 people in my family from Graves’ disease to Hashimoto’s . Again get well .

[joey82 in reply to Fefe09]

You too and good luck. I hope you get to the bottom of your thyroid issues. Perhaps if you can, get an appointment with an endonicrologist.

[joey82]

I think my initial concerns the other day over being in a hyperthyroid state was me getting into a state of panic due to a culmination of being ill, recent operation, work stress and changing my meds and upping to 10mch t3 daily.

I still feel quite poorly though. The nausea has returned alongside all my other usual symptoms of being hypo. I'm hoping its the transition phase due to my change in dosage, this is something I have experienced in the past a few times after changing my meds.

Hopefully things will settle down over the next 2 weeks, they usually do.

I got to the gym this morning for the 1st time in 3 weeks which was nice, but I felt pretty wasted and couldn't muster the drive or energy to have a semi decent work out.

I wish I'd opted for a small increase in T4, perhaps 12.5mcg instead of 10mcg of T3. But hindsite is a wonderful thing. Maybe in a couple of weeks things will settle down and maybe there will he an improvement....

[Fefe09]

yes when you put your body through surgery or stress or diet or changing meds it can make your thyroid spiral out of control. You had mentioned nausea? I have had severe nausea since 2012 . I thought it was from my fatty liver. Which I did read somewhere that you can get fatty liver and Diabetes and all sorts of other issues with thyroid problems. Hopefully you will get yours under control soon. The endo docs where I live are clueless so I just have to pray to God for help and hope for a miracle. I feel like a burden to my family cause I’m like a sloth. I have chronic pain and it’s no fun and I’m no fun. I just keep saying it’s got to get better…….

[joey82 in reply to Fefe09]

Thank you. I hope you get there too as well. I'm taking lots of advice from people on this forum and hopefully I can get there sooner rather than later.